Milk drop in a freshly calved cow

Question 1

Milk drop

Answer 1

= unexpected reduction in milk yield

Question 2

Freshly calved

Answer 2

• generally means calved in the last few weeks (up to ~6w)
• milk drop is a particularly common clinical presentation at this stage in the production cycle due to increased energy demand -> NEB

Question 3

Ddx - fairly common

Answer 3

• metritis
• LDA
• primary ketosis
• TRP
• mastitis

Question 4

Ddx - less common

Answer 4

• peritonitis
• RDA
• caecal dilatation (+/- torsion)
• abomasal torsion
• pneumonia (inc. IBR)

Question 5

Ddx - fairly rare

Answer 5

• salmonellosis
• liver abscess
• endocarditis
• leptospirosis

Question 6

Ddx that cause pyrexia

Answer 6

usually:
- metritis
- mastitis
- salmonellosis
- pneumonia (inc. IBR)
- leptospirosis

sometimes:
- TRP
- peritonitis (cows are good at walling off local infection so don’t always see pyrexia)
- liver abscess
- endocarditis

• gut and metabolic conditions generally don’t cause pyrexia, but can get pain related pyrexia e.g. with torsion

Question 7

Ddx that cause decreased/absent rumen turnover

Answer 7

usually:
- LDA
- TRP
- peritonitis
- RDA
- caecal dilatation (+/- torsion)
- abomasal torsion

sometimes:
- metritis
- primary ketosis
- mastitis
- liver abscess
- endocarditis

NB - rumen turnover may be decreased due to anorexia - so any of the ddx possible

Really marked reduced turnover leads you towards GI dz

Question 8

Ddx that cause a ping on percussion auscultation

Answer 8

• LDA
• RDA
• caecal dilatation (+/- torsion)
• abomasal torsion

= dilated viscous with a clear fluid gas interface

Question 9

Peritonitis aetiology & epidemiology

Answer 9

Aetiology:
- Acidosis, perforated abomasal ulcer, chronic LDA/RDA, TRP, uterine or vaginal tear

Epidemiology:
- usually sporadic

Question 10

Peritonitis presentation

Answer 10

• tend to be mild/ chronic cf other species
• +/- abdominal pain
• +/- pyrexia

Question 11

Peritonitis diagnosis

Answer 11

• Can be challenging/by exclusion for chronic diffuse peritonitis
• Tests for TRP may be positive
• +/- pain on rectal examination (only if site of peritonitis within reach [caudodorsal])
• Clin path: neutropaenia, left shift, incr fibrinogen (not all that consistent)
• Ex lap?

Question 12

Peritonitis tx

Answer 12

Conservative:
- Antibiotics (>5-7d)
- NSAIDs
- Fluid therapy

Surgical:
- Ex lap – establish cause if possible, debride/lavage

Not a lot known about prevention as sporadic - tend to crop up as individual cases

Question 13

Caecal dilatation (+/- torsion) aetiology

Answer 13

• poorly understood but possibly associated with decreased GI motility

Question 14

Caecal dilatation (+/- torsion) presentation/diagnosis

Answer 14

• Typical “sick cow”
• May be colic signs if torsion
• ‘Ping’ caudodorsal R side
• Less common than DA’s
• Flank watching, occasional kicking
• Caecal pings more caudal than RDA

Question 15

Caecal dilatation (+/- torsion) conservative tx

Answer 15

• NSAIDs
• calcium?
  – no evidence calcium changes outcome but unlikely to do any harm

Question 16

Caecal dilatation (+/- torsion) surgical tx

Answer 16

• (if unresponsive, signs severe or torsion suspected)
• R flank laparotomy, externalise and empty (purse string suture), +/- reposition

Question 17

Abomasal torsion

Answer 17

• Usually a complication of an RDA (RDA -> torsion), can also be a complication of caecal dilatation
• Reduction in feed intake -> more free abdominal space which can lead to torsion
• Often colic and more severe systemic signs, R side ‘ping’
• Surgical correction – R side laparotomy, empty, reposition and pexy
  – Can be really difficult - can bend and twist around multiple different axis and get multiple pockets of fluid - need to empty before fixing but can be tricky due to pockets
• Prognosis guarded
  – Often euthanised instead of going to surgery

Question 18

Specific CS with metritis

Answer 18

• purulent vaginal discharge / abnormal discharge

Question 19

Salmonellosis

Answer 19

• d+ presenting sign

Question 20

Liver abscess

Answer 20

• can be hard to diagnose and often found as an incidental finding

Question 21

Leptospirosis

Answer 21

• zoonotic
• don’t tend to diagnose in an individual cow