Case #1 - What Pings Where?

Question 1

Pt: 3yo, 2nd lactation Holstein cow, 30d in milk
Presenting Complaint: R sided ping noticed in the AM after milking
Hx: calved 30d ago, ketosis and mastitis post-freshening, decreased feed intake over last week, not on any meds, part of a 500 cow dairy in CA

what’s on your problem list???

Answer 1

tachycardic
dull/obtunded
sunken eyes
prolonged skin tent
tacky MM’s
diarrhea
abdominal distension on R side
ping on R side
fluid on succussion
decreased rumination
small rumen on rectal

Question 2

use this to narrow down the problem list

Answer 2

Question 3

what pings on the left side?

Answer 3

green - rumen
blue - displaced abomasum
red - uterus

Question 4

what pings on the right side?

Answer 4

red - uterus
pink - SI
yellow - cecum
blue - spiral colon
green - displaced abomasum

Question 5

how would you adjust the problem list based off these additional diagnostics?

Answer 5

Question 6

which GI organ produces a large amount of Cl?

Answer 6

abomasum (from HCl)

Question 7

what’s the diagnosis?

Answer 7

R displaced abomasum +/- volvulus

Question 8

what are common bloodwork findings in cows with displaced abomasum?

Answer 8

metabolic alkalosis (pH > 7.45)
hypochloremia (Cl < 104)
hypokalemia (K < 3.4)
hypocalcemia ( Ca < 0.95)

Question 9

predisposing factors for displaced abomasum?

Answer 9