Diseases of the stomachs

Question 1

A cow presents with abdominal pain, an arched back, reduced appetite, grunting sounds, reduced milk yield and pyrexia. What is your likely diagnosis?

Answer 1

Traumatic reticuloperitonitis

Hardware disease

Question 2

What are 2 sequelae of traumatic reticuloperitonitis?

Answer 2

Septic pericarditis

Liver abscesses

Question 3

If traumatic reticuloperitonitis progresses to septic pericarditis, what additional clinical signs may you see on clinical exam?

Answer 3

Muffled heart sounds (pericardial effusion)
Jugular distension (R-sided heart failure)

Question 4

What is the treatment for traumatic reticuloperitonitis?

Answer 4

Rumenotomy
Antibiotics 5-7 days
Slaughter?

Question 5

How can traumatic reticuloperitonitis be prevented?

Answer 5

Magnet

Question 6

A herd of cows presents with abdominal pain, acute onset of diarrhoea, reduced appetite and productivity. Some of the cows are lame and have epistaxis. What is your diagnosis?

Answer 6

SARA
HERD PROBLEM
(rumeinitis causes liver abscesses which can lead to caudal vena cava thrombus –> epistaxis)

Question 7

How is SARA diagnosed?

Answer 7

Rumenocentesis
pH <5.5
Clinical exam

Question 8

How does SARA affect the bulk milk?

Answer 8

Decreased milk yield

Low fat

Question 9

What are some risk factors for SARA?

Answer 9

Sorting food
XS concentrates
Feeding in parlour - overindulgence

Question 10

How can SARA be treated?

Answer 10

Hay - provide TMR with fibre (promote chewing, saliva)
Temporary sodium bicarbonate supplementation
(oral antacids - magnesium hydroxide)

Question 11

A cow presents depressed, ataxic, cud dropping, with rumen stasis and sunken eyes. The herd recently has had a decrease in average milk yield. What is your likely diagnosis for this cow?

Answer 11

Acute ruminal acidosis

Dehydration!!

Question 12

What is the biggest risk factor for acute ruminal acidosis?

Answer 12

Large amounts of carbohydrates

Feeding in parlour

Question 13

How is acute ruminal acidosis treated?

Answer 13

Sodium bicarbonate
IV fluids
Oral magnesium/aluminium hydroxide (antacid)
Rumenotomy +/- ruminal lavage

Question 14

A cow presents for abdominal pain with bruxism, reduced appetite and melaena. What is your most likely diagnosis?

Answer 14

Abomasal ulcers

Question 15

A cow with a recent diagnosis of an ulcer now has pyrexia, pale mucus membranes, tachycardia and an abdominal ping. What is your most likely diagnosis?

Answer 15

Peritonitis due to ulcer perforation
Type 4 abomasal ulcer
(Pale mms and tachycardia due to haemorrhage –> shock)

Question 16

Name 4 risk factors for abomasal ulcers

Answer 16

Stress - early lactation, transport
Viral disease
High concentrate diet
Ketosis
Inappetence
Handfed calves at weaning
Multiple NSAIDs?

Question 17

What are the 4 types of abomasal ulcers?

Answer 17

Type 1 - non-perforating
Type 2 - major blood vessel perforation with blood loss and melaena
Type 3 - perforating ulcer with local peritonitis
Type 4 - perforating ulcer with diffuse peritonitis

Question 18

Are abomasal ulcers fundic or pyloric in cattle and calves?

Answer 18

Fundic - cattle

Pyloric - calves

Question 19

How are abomasal ulcers treated?

Answer 19

Oral magnesium/aluminium hydroxide (antacid)

Severe cases may require blood transfusion or surgical excision

Question 20

Risk factors for abomasal diseases include anything that causes reduced DMI. Give examples

Answer 20

Early lactation
Housed animals
SARA
Ketosis
Hypocalcaemia
Concurrent disease
Cow comfort - lameness

Question 21

What preventative treatment can be given for abomasal diseases? Should this be given to all cattle?

Answer 21

Monensin bolus

Only if high risk - twins, high/low BCS, lame etc

Question 22

A cow presents with a selective appetite, a slowly reducing milk yield and ketosis 3 weeks post calving. Ausultation of the abdomen reveals a L sided ping. What is your most likely diagnosis?

Answer 22

LDA

Signs: selective appetite, ketosis, 0-4 weeks post-calving

Question 23

Give examples of how an LDA can be managed conservatively (no surgery)

Answer 23

Rolling - ping to see if moves then repeat

Toggling - suture where abomasum naturally lies

Question 24

When is rolling to treat LDAs contarindicated?

Answer 24

Presence of dark faeces/melaena - abomasal ulcer

Can cause rupture!

Question 25

What is the surgical treatment for LDAs?

Answer 25

Abomasopexy (suture to body wall)

Omentopexy (suture to nearby organ)

Question 26

Following surgery to repair on LDA, what medication should a cow get? What type of diet should they get?

Answer 26

Antibiotics - pen/strep, oxytetraycline
Treat underlying problems e.g. ketosis (propylene glycol), fluids
High fibre diet

Question 27

A cow presents dehydrated, tachycardic, with pale mucus membranes and a doughy rumen. The cow has no history of ulcers. You hear a ping on the R abdomen. What is your most likely diagnosis?

Answer 27

RDA
With torsion/volvulus
OR caecal torsion/volvulus

Question 28

What are the treatment options for an RDA (with no torsion)?

Answer 28

Calcium borogluconate
Metoclopramide
Buscopan
Fluids
Surgery

Question 29

What are the treatment options for an RDA with torsion?

Answer 29

Surgery

Slaughter

Question 30

How can LDAs/RDAs be prevented?

Answer 30

Better dry cow management!

Question 31

What is the biggest risk factor for caecal dilatation and volvulus?

Answer 31

Excess carbs

Cause caecal atony - accumulation of ingesta and gas

Question 32

What is the medical treatment for mild caecal dilatation?

Answer 32

Good quality hay
Hydration
Monitoring

Question 33

What is the surgical treatment for caecal dilataion/torsion/volvulus?

Answer 33

Caecostomy

Deflate and correct torsion

Question 34

Give an example of an intraluminal and an extraluminal oesophageal foreign body

Answer 34

Intraluminal - potatoes, turnups, placenta

Extraluminal - pressure from surrounding organs e.g abscess, mass, lymphadenopathy

Question 35

What is the treatment for oesophageal foreign bodies?

Answer 35

Many self resolve - take away food and water, give buscopan and flunixin
If fails - manual removal with Probang
If fails - trochar in rumen to relieve bloat, feed via rumen and wait for obstruction to pass (risk of damage/necrosis to oesophagus)