Cow with a ping Flashcards
what is needed for a ping to be heard within an animal?
when should you check for a ping?
- Gas-fluid interface
- contained space - usually hollow viscera
Every time we examine the abdomen of a cow
- Essential and routine part of adult bovine examination
- Calves and youngstock - possibly (if look like adult cow, check)
Both right and left sides
what can cuase a left sided ping?
Hollow viscera
- Rumen
- Abomasum (if displaced) (normally sits on the midline
Other possibilities
- Rumen void
- Pneumoperitoneum
- Peritonitis
where is the ping on a cow if you have a left displaced abomasum?
blue - long term displament, fluid has weighed down the abomasum
yellow - between rumen and body wall
what is the most likely cause of a left sided ping?
why does this happen?
left displaced abomasum
Abomasum displaces from ventral midline to left abdomen (between rumen and body wall)
- reduced abomasal motility - reduced plasma Ca2+, NEB, genes
- gaseous distension - ?rumen origin?, venteral fermentation
- displacement
what is rumen tympany?
why does it happen?
how is it diagnosed?
Ping usually heard in thin cows on the left side
Thin/absent fibrous mat - causes a Gas fluid interface (not heard in healthy cow as mat present)
If bloat is present diagnosis is obvious on clinical exam + ping in the left paralumbar fossa
what is pneumoperitoneum?
where is the ping heard?
how is it diagnosed and treated?
Gas in the peritoneal space
Ping will be dorsally located
Ping often on both sides
History of recent surgery
No treatment needed
what is peritonitis?
where is the ping heard?
how is it diagnosed?
what is the prognosis?
- Often walled off as a large abscess – can have a gas fluid interface
- ping Maybe located anywhere
- May be history of surgery but not always
- Caudal peritonitis palpable on rectal exam - loss of rectal sweep
- Cranial peritonitis not palpable – ultrasound can aid diagnosis
- Prognosis is ultimately poor although cows can wall off peritonitis well so don’t always look very sick
- if small walled off area can try antibiotics and NSAIDS - but in long term will not make much difference
what is rumen void?
what is it associated with?
where is the ping herd?
How is it diagnosed?
Associated with severe inflammatory conditions
Ping in left paralumber fossa
Rectal findings:
- Collapsed dorsal sac of rumen
- Left kidney moved ventrally to mid abdomen
Treat the underlying condition and will resolve - collapses itself doesn’t cause issue, underlying condition is causing issue
what can cause a right sided ping?
Hollow viscera
* Abomasum (if displaced)
* Caecum
* Spiral colon
* Duodenum
* Rectum
* Uterus
* Small intestines
Other possibilities
* Pneumoperitoneum
* Peritonitis
what causes a right displaced abomasum?
what type of animals is a right displaced abomasum more common in?
where is the ping heard?
- Less common than LDA
- Less strong association with transition period
- Seen in bulls and calves
- Ping heard behind last rib and in last 2 rib spaces in upper ½ - ⅓ of abdomen
- May extend more cranially if volvulus present
- Ping heard over ~20cm area
what is a right abomasal volvulus (RAV)?
What occurs with a RAV?
How is RAV treated?
what are the differnt types of RAV?
Displaced abomasum rotates around the mesentery
More commonly seen than simple RDA
(Thought that RDA precedes RAV)
Life threatening condition
- Electrolyte disturbances
- Shock
- Re-perfusion injuries
Immediate surgery required - Prognosis ~70%
Types:
1) Abomasal volvulus (AV)
- ~60% of cases
- Rotation at the omasal-abomasal junction
2) Omasal-abomasal volvulus (OAV)
- ~40% of cases
- Rotation at the reticulo-omasal junction
3) Reticulo-omasal-abomasal volvulus(ROAV)
- Extremely rare
- Rotation at the junction of the rumen and reticulum
- PM dx
how can you differntiate wetween a RDA and RAV?
Difficult to be sure
* For this reason proceed as for RAV – i.e. immediate surgery
* Definitive diagnosis only possible with ex lap (or PM)
More severe systemic signs usually indicate RAV
* Tachycardia (> 100 bpm = poorer prognosis)
* Dehydration
* Marked milk drop
* Inappetance – may be complete anorexia
More cranial ping (may be as cranial as 8th rib) suggestive of RAV
Due to medial displacement of liver
what lactate reading suggests a poorerpognosis for a sick cow?
Lactate < 2 mmol/L = better prognosis
Lactate ≥ 6 mmol/L = poorer prognosis
where is a ping heard with caecal dilation/torsion?
how is this diagnosed?
what is the treatment?
- Ping heard over a large area (20-30cm, sometimes bigger)
- In right paralumbar fossa and extending cranially into last 2-3 rib spaces
- Overlap with RDA/RAV ping but is heard more caudally
- Rectal exam can aid diagnosis - will feel caecum
- Surgical condition
where are pings heard with spiral colon and small intestine?
what is the treatment?
Smallish area (10-20cm) heard in right paralumbar fossa
Often multiple smaller focal areas of ping heard
SI pings may be heard quite ventrally
No treatment needed - just gas moving through
where are duodenum pings heard?
what is the treatment?
Small area (~10 cm) ping heard dorsally over last 2 rib spaces
Same location as abomasal ping
BUT – smaller area
If in doubt recheck in 30-60mins – has often moved
No treatment needed
where are rectal pings heard?
how is this prevented and what is the treatment?
Ping heard over linear area under transverse processes in caudal abdomen
Often heard after rectal exam
Avoid by performing rectal exam after abdominal exam
No treatment needed
where are uterus pings heard?
what is the cause?
what is the treatment?
Rare
Ping usually heard caudally but can be variable
May be audible on both sides
Metritis
Treatment is medical and aimed at underlying cause (i.e. metritis – see repro week)
how do you perform rumenocentesis?
what will you obtain?
- Left side
- 2-10cm caudal to last rib
- Level with point of stifle
- Long needle
- pH 5.8-6.2
- Higher if not eaten
- Lower if acidosis
- Lots of protozoa (warm slide)
- Multiple sizes
- Highly motile
how can Ultrasonography be used for LDA, RDA/RAV diagnosis?
what will be seen with RDA/RAV?
- LDA = last 3 ICS on LHS
- RDA/RAV = Last 3 - 4 ICS on RHS + caudal to last rib
- Ventral to dorsal direction
- RDA/RAV only
- Liver displacementmedially
- Cannot differentiate DA from AV
