Abomasal Displacements Flashcards
What is the pathogenesis of abomasal displacement?
Abomasal atony –> abomasum fills with gas –> lifts to left or right
Most commonly the left
What are some risk factors for abomasal displacements?
Dairy cow in early lactation Housed SARA Ketosis and FMS Hypocalcaemia Concurrent inflammatory process - metritis / endometritis Poor cow comfort and lameness Anything that reduces DMI
What is the most common abomasal disorder?
Left displaced abomasum
What are the clinical signs of a left displaced abomasum?
Reduced milk yield
Ketosis
Prefers one fibre to concentrates
0-4 weeks post calving
How can you diagnose a displaced abomasum?
Resonant Ping sound of the abomasum which is in an abnormal place
Spontaneous tinkling and gurgling
Absence of rumen sounds over the abomasum
What are some treatment options for a left displaced abomasum?
- Cast and roll cow - least successful method
- Feed good quality roughage
- Toggle
- Abomasopexy
What are the toggle positions?
Caudal toggle - 6 inches caudal to the xyphoid,
2 inches to the left
Cranial toggle - 4 inches cranial to the caudal
Name the surgical methods of treating a left displaced abomasum?
- Left and right sided approach - requires 2 vets
- Utrecht - more anatomically correct
- Right sided
- Right paramedian approach
- Ventral abdominal paramedian
What should you do if the cow simultaneously has an LDA and endometritis?
Delay surgery until the septic focus has been treated
Not an emergency
What post-operative care should you give after abomasal surgery?
Pen/strep
NSAIDs
Treat ketosis - propylene glycol, glucose, steroids
High fibre diet
Why is a right sided abomasal displacement more worrying?
Torsion can occur
Animal becomes severely dehydrated, hypochloraemic and has metabolic acidosis due to dilatation
What are the 3 phases of an RDA?
- Atony and Dilatation
- Displacement
- Torsion - more space on the right so more likely to torse
What are the metabolic sequelae of an RDA?
H+ and Cl- pools in the abomasum
- hypochloraemia, metabolic alkalosis, very dehydrated
Endotoxaemia due to ischaemic mucosal damage
What are the clinical signs during the dilatation and displacement phase of an RDA?
Reduced faeces Dehydration Tachycardia Pale mm and dry Doughy rumen Ping in the middle to upper 1/3 of the right abdomen Tense viscous rectally
Much sicker and severely dehydrated if there is a torsion present
What is the recommended treatment for an RDA?
Surgery to drain and replace the abomasum
Poor prognosis if very sick - consider euthanasia
How should you provide post-operative care to a cow with an RDA?
Fluids - 50-100L hartmanns NSAIDs Pen/strep Oral KCl Calcium 40% Propylene glycol
Describe how to perform a left sided omentopexy (utrect method)
Cow in crush
Sedate
Clip left side of the abdomen
Paravertebral nerve block
Surgically prepare the abdomen
Scrub up yourself
Left sided incision 5cm caudal to the last rib
Incise through ext, int and transverse abdominal oblique
Grasp the greater curvature of the abomasum or omentum
Stay suture through the abomasum or omentum - leave 2 long ends
Decompress the abomasum
Attach a needle to the cranial thread
Move the needle and thread down the body wall to the ventral midline site
- 4 inches caudal to the xyphoid, slightly right
Suture into the body wall
Repeat with the caudal suture 4 inches caudal
Replace the abomasum
Pull the sutures tight and ensure that no guts get trapped
Equipment: Buhner needle, nylon suture
Describe how to perform a left or right bilateral flank omentopexy.
Bilateral Paravertebral blocks
Two incisions left and right, vertical, 5cm, caudal to ribs
Move hands down body wall and shake hands
Decompress the abomasum
Push to midline
Bring up to right hand incision and perform an omentopexy to anchor the abomasum
