FAMS Pelzer flashcards
Displaced Abomasum
Left or right DA, gas accumulates within the abomasum and the abomasum “floats” to the left or right becoming trapped between the abdominal wall and adjacent viscera.
Epidemiology:
a) Often associated with postparturient diseases: ketosis, hypocalcemia, mastitis, metritis as these conditions result in decreased abomasal contractility.
b) Most commonly observed within the first 2 weeks postpartum
c) Associated with cattle on high grain diets, especially if no transition diet is provided.
d) High producing dairy cows 2nd or greater lactations. Note: small ruminants can have DA’s as well as beef cows and dry cows.
e) Deep chested cows
f) Cows with elevated NEFAs or BHBA during the prepartum and postpartum period have increased chance of displacement.
a. NEFA = non-esterified fatty acids
b. BHBA = beta hydroxy butyric acid
c. Both of these increase during the breakdown of fat usually due to inadequate DM intake or energy demands of the fetus or milk production.
Pathophysiology:
Atony of the abomasum
- increased VFA’s
- hypocalcemia
- effects of endotoxins
- increased ketone bodies
b) Gas accumulates in abomasum
c) Abomasum floats to the right or left and gets trapped
Simple Displacement Left or Right
Clinical Signs:
a) Anorexia, lack of cud chewing
b) Ketonuria and acetone on the breath
c) Rumen – motility decreased, rumen pulled away from lateral abdominal wall – paralumbar fossa is deep.
d) Last 2 ribs may be “sprung”
e) Auscultation – gurgling or tinkling sound rather than rumen scratches
f) Auscultation and Percussion
- tinny sounding ping between the tuber coxae and the elbow – usually from the lower third of the abdomen at the level of the 8th intercostal space back to the paralumbar fossa, slightly beyond last rib.
- ping usually doesn’t go into the paralumbar fossa.
g) feces are scant but diarrhea maybe present
h) Liptak Test – 6 inch needle into an area below the ping and test pH of the fluid,
- abomasal pH 2 – 4
- rumen pH 5.5 – 8
i) Some cows show mild signs of discomfort and elevated heart rate, 80”s
j) Paradoxic aciduria: Cows are alkalotic yet urine pH rather than being basic may be acidic.
Cow is alkalotic so she tries to conserve hydrogen ions. Because of dehydration and reduced cardiac output, blood pressure is reduced. The cow responds by renal retention of sodium and chloride. The normal exchange product in the kidney would be potassium, but hypokalemia is usually severe, thus hydrogen ions are paradoxically secreted so that blood pressure can be maintained by means of maximum sodium retention.
Clinical pathology
a) alkalotic
b) hypochloremic – chloride is not absorbed from SI as HCL is sequestered in abomasums.
c) hypokalemic – potassium intake is decreased, cow is alkalotic
d) hypocalcemic – not deficient enough to cause overt clinical signs of hypocalemia but calcium levels are lower than normal.
Right Torsed (Displaced) Abomasum
a) Clinical signs
same as above but
- signs of shock – decreased capillary refill, cool extremities
- heart rate 100 plus
- acutely ill, dehydrated
- abdominal distension, borborygmi are absent
Floating DA
a) Cow has some of the clinical signs of a DA but no ping.
b) Cow seems ok then off, back and forth, decreased milk production.
c) Auscultate and percuss low on abdomen rib area may hear the “ping”.
d) May or may not develop into a “full blown” DA.
e) Often the scenario when a cow is trucked in for a DA surgery and upon arrival can’t auscultate and percuss a ping.
Treatment of DA’s
Return abomasum to normal position
Non-surgical
Left displacement– lay cow in right lateral recumbency, and roll her to her left side. Abomasum will float up and over. Remain in this position for 5 – 10 minutes to allow emptying of abomasal gas and contents.
- Give oral fluids - rehydrate
- Replace chloride, potassium, calcium deficits
o 120 g of KCL 2 times a day for 2-3 days
o NaCl
o Calcium borogluconate, oral calcium chloride
- Fix ketosis
o IV Dextrose
o Propylene gycol/proprionate
If leave this way, the DA is more than likely to reoccur
Surgical
) Roll and Tack, Toggle Method
Left displacements only
Lay cow in right lateral recumbency, pull cow up on her back slowly while pushing on the area of the abomasum. Listen for the ping when the abomasum is just to the right of the distal sternal process. Punch trocar thru the abdomen, hands breath behind and lateral-right of the sternum and into the abomasum. Gas will be released, smells like burnt almonds or rancid butter. Drop toggle down into trocar, remove torcar and repeat 3 inches caudal to first trocarization. Tie the 2 toggle leads together. Turn the cow completely over to the left. Stand her up, listen for ping.
Right flank omentopexy
Can be used to fix all abomasal displacements
1. Enter the right paralumbar fossa
2. Reach across the rumen in case of the LDA and stick a needle attached to a drip set into the abomasum to allow removal of gas.
3. When abomasum is deflated, push abomasum down and it will usually go into the right spot.
4. Grab omentum and pull up into incision site until the pylorus is located.
5. At the level of the pylorus, looking for the sow’s ear, a fold in the omentum, and suture the omentum into the first layer of body wall closure.
6. In case of RDA or RTA, correct torsion, deflate and push abomasum down. Look for pylorus and proceed as above.
Advantages of right flank omentopexy
Disadvantages of left flank
Advantage: can correct for all 3 DA’s
Disadvantage: If adhesions on the left, can’t break down from the right side.
Will need to perform a left sided approach, break adhesions down and then replace.
c) Right paramedian abomasopexy
- Roll cow up on back and enter abdomen about a hands breath on the right lateral to the midline and caudal to the sternum.
- Abomasum should be in the incision line. Suture the abomasal wall to body wall while closing the peritoneum and muscle bellies. Do not enter into the abomasum.
Advantages and disadvantages of right paramedia abomasopexy
Advantage: good exposure
Disadvantage: need to lay the cow down, possible dehiscence.
d) Left Flank Abomasopexy
- Enter the left paralumbar fossa and locate abomasum.
- Get 2 straight needles with 6 feet of suture material and place 2 horizontal mattress sutures in the greater curvature of the abomasum.
- Deflate the abomasum and replace.
- Have assistant direct placement of the 2 stitches to the right and caudal of the distal sternum.
- Punch needles thru ventral abdominal wall and tie ends of sutures together.
Advantages and Disadvantages of Left flank abomasopexy
Advantage: can see the abomasum and be sure of placement of sutures.
if the abomasum is adhered to the abdominal wall you can break adhesions down.
Disadvantage: need long arms to place sutures
may tear abomasum while placing sutures
What adjunct therapy can we do with a displaced absomasum?
Fluids:
Oral - most cows are dehydrated, standard is 10 gals of water with salt.
In PMM out in the field, we give Calcium proprionate as well because many of these cows are slightly hypocalcemic. Because of possible rumen changes, probiotics are also given.
Fluid helps restore fluid deficit and adds weight to keep the abomasum in place and stimulates the rumen. Gets the system going again.
IV Fluids – needed in cases of RTA and possibly RDA or if animal is severely dehydrated.
Do not use alkalinizing agents as these cows are alkalotic, unless RTA in which case the cow is more likely to be acidotic. Physiologic saline is best.
b) NSAIDS – may make cow feel better getting her back on feed quicker, relieve pain of surgery.
c) Calcium therapy important to get muscular contractions going again.
d) If ketotic, some glucose precursors orally and 50% dextroseIV
Prognosis of LDA and RDAs
Prognosis:
a) LDA and RDA: good if not long standing and predisposing diseases are resolved.
b) RTA: poor prognosis because of vascular compromise, similar to gastric torsion in the dog.
c) Abomasal atony and diarrhea may occur post correction
d) Animals with diarrhea prior to correction have moderate to poor prognosis.
How do we prevent LDA or RDAs
) Decrease the incidence of postpartum diseases.
b) Prevent hypocalcemic conditions.
c) Increase the effective fiber in diets, reduce grain.
d) Transition ration to get cattle used to eating a high grain ration.
e) Introduce cattle to concentrates slowly.
Epidemiology of gastric ulcers in swine
a) Associated with stress
b) Dietary factors
- Finely ground grain
- Vit E and Se deficiency
- Copper toxicity
- Irregular feedings
Clinical signs of gastric ulcers in swine?
a) Apparently healthy animal found dead.
b) Animals may be - pale, anemic, weak with increased respiratory rate.
- grinding teeth, anorexia, bloody tarry feces.
- off and on anorexia and weight loss and intermittent tarry feces.
Diagnosis of gastric ulcers in swine?
a) Clinical signs
b) Necropsy – ulcers in the pars esophagea with blood clots within the stomach.
Treatment of gastric ulcers in swine?
- aluminum hydroxides and magnesium silicate
- reduce stress
- Tagamet® Cimetadine
- oats/alfalfa hay
- Omeprazole Prilosec®
How do we prevent gastric ulcers in swine?
- adequate Vit E and Se
- reduce stress
- consistent feeding intervals and increase courseness of feed
