Bovine GI Disease (Betty Jo)

Question 1

what extra equipment do you need to do the left sided LDA approach?

Answer 1

long half curved PM needle, bottle stopper

Question 2

when doing the left sided LDA approach, where are you aiming for to exit the body wall?

Answer 2

5cm right of midline, 5cm caudal to sternum

premark this site because you dont want to hit the milk vein

Question 3

pros and cons of left sided approach?

Answer 3

pros: fast (no deflation), no tugging on omentum, abomasum visible and palpable, easier in last trimester of pregnancy

cons: can’t explore abdomen, if you are wrong you can’t do a prophylactic tack, need an assistant

Question 4

metaboloic derrangements of obstructive disorders progress from

Answer 4

metabolic alkalosis, hypochloremia and hypokalemia, to acidosis and lactemia

Question 5

most lesions of the small intestine cause what things?

Answer 5

obstruction, sequestion of fluid and gas resulting in + succession and changes in abdominal contour

Question 6

what does abdominal pain look like in cattle?

Answer 6

stretching out the hind legs, treading of hind legs, kicking at belly, when severe pain= recumbency

Question 7

the most common site of intestinal obstruction is the _______. with a small intestinal volvulus what do you feel on rectal palpation? how about on physical exam? how do you fix this?

Answer 7

distal jejunum and ileum

feel small intestine wedged in the pelvic inlet

PE: tachycardia, dehydration, succession on R paralumbar fossa

treatment: surgical, gently un twist it, may need to resect large portions, need an assistant

Question 8

how do you assess bowel viability?

Answer 8

color, motility, submucosal edema, hemorrhage

in general: bowel color and contractility should improve within 5 mins of un twisting

usually these cases end in euthanasia because so much bowel is not viable

Question 9

how do cows with mesenteric root torsion present and what is the appropriate treatment?

Answer 9

very severe signs, extreme abdominal pain, shock, etc

humane euthaniasia best

Question 10

where do intussusceptions usually happen? who are they common in?

Answer 10

small intestine usually, then colocolic, then ileocolic. more common in calves (distal to ileum)

Question 11

you have a cow that has low grade abdominal pain, mucus and blood in the feces, has a positive succession on the R side, and has low bilateral distention like a juicy pear. dx?

Answer 11

intussesception

Question 12

how do you do surgical treatment of an intussusception? prognosis?

Answer 12

most of the time you can’t correct it, so you have to resect and anastamose

we often dont see these cows in time to allow for a good prognosis but overall survival is 35% post op

Question 13

what is hemorrhagic bowel syndrome? cause?

Answer 13

acute enterotoxemic disorder, we arent sure of the cause but we suspect clostridium perfringens type A and aspergillus fumigates

Question 14

HBS is common in what kind of cows?

Answer 14

high producing cows at peak lactation who are consuming a high energy TMR, high grain in the diet. where there’s one case there’s probably more!

Question 15

you go see a cow named Sunny who is depressed and has almost no rumen motility. she has had a huge decrease in milk production, has a R sided ping and + succession, looks like a juicy pear, is dehydrated and tachycardic, has pale mucus membranes, and has melena and/or clotted blood in the feces. Dx? how will you diagnose? treatment?

Answer 15

HBS

rectal palp: distended loops of intestine, scant to no feces
profound abdominal distension, on US thickened intestinal walls

IV fluids, lidocaine ( analgesia and prokinetic effects to push clots thru), blood transfusion

Question 16

what is the end result of HBS?

Answer 16

clots and obstruction of the jejunum

Question 17

what condition has a similar presentation to HBS and how can you tell them apart?

Answer 17

abomasal ulcers

with ulcers theres no obstruction or distention

Question 18

why is early treatment of HBS so important?

Answer 18

once clots form and adhere to the lumen, you have to do surgery to fix it and you likely have to resect and anastamose tissue which is a poor prognosis

Question 19

briefly describe how you do a blood transfusion in the field

Answer 19

choose a non pregnant cow, sedate and place an IV, and make sure there’s an anticoagulant ( sodium citrate, dextrose, sterile water). Collect 4-6 L of blood.

Question 20

treatment of HBS for a low value cow?

Answer 20

goal is to prevent clots from adhering

IV fluids, add mineral oil, calcium gluconate, oral KCl

Question 21

prognosis for HBS cases medical management vs surgical

Answer 21

medical: grave if clots become adhered, fair if clots do not adhere, fair to good if farmers are trained to recognize early signs

surgical: poor if surgery less than 48 hours onset, grave if surgery more than 48 hours onset

Question 22

explain how cecal dilation/torsion happens

Answer 22

hypocalcemia, confinement, diets rich in starch, all resulting in atony and distention, predisposing to torsion

Question 23

PE findings for cecal torsion

Answer 23

ping on R side–>higher and more caudal than a RDA
she will look like a juicy apple
dehydration and tachycardia
off feed, reduced milk

Question 24

treatment options for cecal dilation/ torsion?

Answer 24

medical: IV fluids, calcium, oral fluid therapy with laxatives, instant coffee lol, increase roughage in feed, NSAIDs

surgical: typhlotomy for when medical management doesn’t work, typhlectomy for recurrent cases when bowel is non viable (not a field surgery), cecal resection and anastamosis

Question 25

briefly describe how to do a typhlotomy

Answer 25

essentially cutting into the cecum and letting it drain

use double inverting to close

watch it for 10 minutes to see if it fills back up

Question 26

indications for a left sided explore/rumenotomy

Answer 26

hardware disease, vagal indigestion, rumen acidosis

Question 27

briefly describe how you do a rumenotomy

Answer 27

cut into left PLF, do an explore first, tack the rumen to skin, then do a continuous inverting pattern usually cushing, ensure no gaps between rumen and skin, then you can cut into the rumen and remove ingesta (get it all out if theres acidosis), explore the esophageal and omasal openings, make sure the reticulum is moving

to close the rumen: double layer inverting pattern before you remove your tack and rinse well before removing tack

Question 28

indications for a rumenostomy (leaving it open)

Answer 28

chronic bloat in young calves, chronic bloat in feedlot cattle, unresolved vagal cows