Melena

Question 1

Ddx of melena in adult cattle

Answer 1

• abomasal ulcers
• haemonchus contortus
• SI bleed/pathology
• neoplasia
• peritonitis
• lead poisoning

Question 2

Abomasal ulcers

Answer 2

• more commonly seen in intensively managed herds, fed high energy, acidic diets (concentrates)
• maize silage as a major part of the diet seems to be a risk factor
• high yielding dairy cows are seemingly predisposed; esp in the 1st 4-6w of lactation an in the dry period
• long term NSAIDs are also a risk factor

Question 3

Abomasal ulcer diagnosis

Answer 3

• transabdominal US
• lab tests
  – haematology: abomasal ulcer with diffuse peritonitis there’s a neutrophilic with a marked left shift and haemoconcentration
  – bleeding ulcers the PCV can help to determine the extent haemorrhage although PCV decreases only 4h after an acute haemorrhage
• abdominocentesis
  – can be useful in perforated cases
  – it confirms peritonitis if total protein or D-dimer concentration and nucleated cell count is increased
  – nucleated cell count may also be normal because of dilution or utilisation

if peritonitis has occurred, leukocytosis, nuetrophilia and hyperfibronigen may be present

also can diagnose at PME

Question 4

Abomasal ulcer - Type I

Answer 4

• an erosion or ulcer without haemorrhage

Question 5

Abomasal ulcer - Type II

Answer 5

• haemorrhagic

Question 6

Abomasal ulcer - Type III

Answer 6

• perforated, with acute localised peritonitis

Question 7

Abomasal ulcer - Type IV

Answer 7

• perforated with acute diffuse peritonitis

Question 8

Abomasal ulcer - Type V

Answer 8

• perforated with peritonitis within the omental bursa

Question 9

Risks of perforated ulcers

Answer 9

• bacterial translocation
• peritonitis

Question 10

Abomasal ulcer tx

Answer 10

• tx any concurrent dz
• blood transfusion if bleeding
• broad spec AB
• decreased acid secretion in the abomasum
• improve dietary intake
• Mg hydroxide, histamine type 2 receptor antagonists, proton-pump inhibitors

Question 11

Perforated abomasal ulcer tx

Answer 11

• rapid and continued IV fluids
• IV broad spec AB
• surgical closure of perforation and lavage of peritoneal cavity

Question 12

Which medicines are contraindicated for abomasal ulcers?

Answer 12

• NSAIDs

Question 13

Risk factors for abomasal ulcers in pre-weaned calves

Answer 13

• aggressive milk drinkers resulting in milk overflow to the reticula-rumen allowing bacterial colonisation e.g. C. perfringens type D
• stress
• inappetence
• solid feeds causing trauma of the abomasum