Nutrition and GI: Conditions of the GI tract Flashcards
What are the 2 types of bloat?
- Free gas bloat- less common- obstruction
- Frothy bloat- more common, stable foam produced on top of rumen liquid blocks gas release
What are the clinical signs of bloat?
- Rumen on LHS- distended
- Often painful, reluctant to move and eat
- Respiratory distress
- Death can occur quickly
What can cause free gas bloat?
Obstruction of oesophagus
* FB- spuds/placenta
* Chronic pneumonia- mediastinal abscess/tuburcle
Other conditions which interfere with rumenoreticular motility
What causes frothy bloat?
- Occurs most common in animals on alfalfa, lucerne or clover
- Rapidly digested in the rumen and form fine particles that trap gas bubbles
How is free gas bloat treated?
- Pass stomach tube
- Trochar
- Chronic bloat- red devil, rumen fistula
Treat underlying condition
What are specfic signs of oesophageal obstruction?
- Inability to swallow
- Regurgitation of feed and H2O
- Drooling
- Bloat
- Stop eating
- Restless
How is obstructional bloat treated?
- Conservative
- Many self resolve
1. Starve and observe
2. Sedate
3. Buscopan
4. Flunixin
Manual removal
* Gag and pass hand into back of pharynx
* Assitant push FB up
Cardia: push into rumen
If unsuccessful-
1. trocharise to relieve bloat
2. Feed via rumen
3. Wait till obstruction passes
4. Warn owner of possible oesophageal damage/necrosis
How is frothy bloat treated?
- Pass stomach tube
- Trochar
- Surfactant then excercise- oils, commercial preparatoin
How is frothy bloat prevented?
- Aboid high risk pastures
- Buffer feed
- Strip graze
- Antifoaming agents- spray grass
- Remove animals with recurrent bloat
What is the common history of traumatic reticulitis?
- Sudden milk drop
- Hunched appearance
- Stiff gait
- Inappetent
- Often fed a TMR
- Where does the reticulum lie?
- What are its contractions?
- Opposite 6-8th rib LHS
- 3 rumen/reticular contractions
What happens in the primary and secondary rumen contraction?
Primary
* Mixing
* Contraction of reticulum then rumen
Secondary
* Rumen contraction
* Starts in caudal rumen
* Eructation
Order of primary rumen contractions:
1. Reticular
2. Reticular
3. Dorsal rumen
4. Ventral rumen
What happens to each
- Coarse material to dorsal sac
- Fine material to cranio-dorsal, fine material to omasum
- Fine material to craniodorsal, coarse circled, some ventral sac exchange
- Fine material to cranial blind, exchange with dorsal, some fine to cranio-dorsal
How is traumatic reticulitis diagnosed?
Eric williams test
* Listen over trachea
* Feel rumen contractions in L flank
Withers pinch- abdominal pain
Pole test- abdominal test
Faeces- stiffer with long fibre (individual not SARA)
WBC- non specific
Describe the eric williams test
Primary cycle
* Place right hand in left sub lumbar fossa
* Stethoscope over trachea
* Feel contraction
* No eructation
Secondary cycle
* Feel contractoin
* Observe eruction
What are the clinical signs of traumatic reticuilitis?
- Sudden onset
- Increased temp- 39.5
- Reduced rumen contractions
- Eric williams test- +ve, then -ve later on
- Hunched
- Inappetant
- What can cause traumatic reticulitis?
- What are the consequences?
- Tyres, bailing sheep netting, nails, fencing
- Consequences
* If no penetration- no effect
Penetration- local reticulo-peritonitis
* Ventral/lateral better
* Medial- damage to vagus, abscess to medial wall, no pain receptors
* Pericardium- pericarditis
What are the further signs of traumatic pericarditis?
- Pulse and temp raised
- Very ill
- Heart sounds
Initially- pericardial rub
Later- quiet
Later- washing machine
Heart failure develops
* Distended jugular V
* Visible jugular pulse
* Sub-mandibular oedema
Describe and exploratory rumenotomy?
- Left sub lumbar fossa
- Incise
- Palpate abdomen
- Exteriorise cranial portion of rumen
- 2 bone pins- anchors
- Sterile towels as seal around rumen
- Incise rumen
- Hand forward
- Locate rumen
- Search for FB- often ventral
- Close- cushing or lembert
After care
* ABs
* NSAIDs
What causes vagus indigestion?
Complication of trauamtic reticuloperitonitis
* Vagus nerve injury
* Reticular adhesions
Vagus nerve dysfunction
* enlarged rumen bloat or
* abomasal impaction
Can be actinobacillosis of rumen, fibropapillomas, late pregnancy
What is the pathogenesis of vagus indigestion?
- Disturbance in rumen flow
- Disturbance in pylorus flow
Rumen distension - Alteration in reticulo rumen motility- hypermotile or hypomotile
What are the clinical findings of vagus indigestion?
- Chronic inappetance- loss of BCS
- 10 to 4 appearance- bloat
- Dehydration
- Enlarged rumen
- Scant faeces
- Undigested material
- Inadequate response to tx
- Distended abomasum in lower right quadrant
- Hypermotile
What are DDXs for vagus indigestion?
- Chronic traumatic reticulitis
- Abomasal impaction/dietary origin
- Omasal impaction
- Abomasal ulceration
What are DDXs for vagus indigestion?
- Chronic traumatic reticulitis
- Abomasal impaction/dietary origin
- Omasal impaction
- Abomasal ulceration
What are risk factors for GI conditions
- Usually early lactation
- Traditionally in housed but also seen in grass
- ‘Imbalance of fibre and concentrate’
- Assocaited with ketosis and FMS
- Hypocalcaemia
- Concurrent inflammatory disease
- Cow comfort
What are the clinical signs of LDA?
- Reduced milk yield
- Not reaching expected yield
- Ketosis
- Selective appetite- prefers fibre
- 0-4 weeks post calving
- Ping
What are differential diagnoses for LDA?
- Vagal indigestion
- Peritonitis
- Gas in rumen
What abomasal sound are present on LDA?
- Spontaneous- tinkling and gurgling
- Ping- gas fluid interference- map out area
- Absence of sounds over abomasum
- Fat cows- no ping
- What fixes the abomasum in place?
- How can it move?
- Fixed by- omasum, duodenum, omentum
- Middle portion can travel, as rumen contracts abomasum buoyed by gas works its way to left
How can LDA be treated by rolling?
- Cast
- Right lateral recumbency
- Roll to dorsal
- Roll over to left lateral
- Ping to see if moved- can repeat
- Good quality roughage
What are the advantages and disadvantages of LDA rolling?
ADV
* Cheap
* Non-invasive
* Concurrent disease
DIS
* Least successful
* Ulcer rupture
What is toggling?
Placing sutures where the abomasum naturally lies
* Clip before casting
* Avoid major abdominal vessels
* Ample labour
* Knee in abdomen
* Push trochar into abomasum
* Caudal toggle placed
* Cranial suture placed
* Loose tie
What are the advantages and disadvantages of toggling?
Adv
* Cheap
* Minimally invasive
* Relatively straight forward
* Quick
Dis
* Going blind
* Do not see ulcers/adhesions
* Fistula formation
* Risk of getting kicked
What are the different surgical methods of displaced abomasum?
- L and R sided approach
- L side
- R side
- R paramedian approach
Describe a L/R bilateral flank
- Para-vertebral
- Incision 5cm caudal to last rib- both sides
- Both slide hand down wall of abdomen and shake hands
- Decompress abdomen
- Push abomasum to midline
- Pull up to right incision
- Omentopexy
Describe a right side omentopexy?
- R flank incision
- Put hand over rumen in backwards direction
- Feel top of abomasum- release gas
- Withdraw arm
- Arm into abdomen- follow R body wall down under L side
- Grasp abomasum/omentum
- Sweep down, pull to incision
- Idenfity sows ear (pylorus)
- Omentopexy
Describe a L sided omentopexy?
- Left sided incision
- Grasp greater curvature of abomasum or omentum
- Weave suture through omentum or abomasum
- Decompress- needle and tub
- Attach needle to thread
- Bring to R ventral midline
- Penetrate body wall with needle
- Repeat with caudal suture
- Tie sutures tight
Describe a ventral abdominal paramedian
- Sedation/full GA
- Dorsal
- Line block
- Incise where abomasum lies normally
- Locate abomasum
- Cat gut- 4-6 matress sutures to abdominal wall
- Suture
What progression can occur with right sided displaced abomasum?
- Dilation and distension
- Displacement
- Torsion
Causes pooling of H+ and Cl- in abomasum
* Metabolic alkalosis
* Dehydration
* Mucosal damage
* Cytokine release
* Metabolic acidosis
* Severe dehydration
What progression can occur with right sided displaced abomasum?
- Dilation and distension
- Displacement
- Torsion
Causes pooling of H+ and Cl- in abomasum
Metabolic alkalosis
Dehydrationq
What are differential diagnoses for right sided displaced abomasum?
- Abomasal impaction
- Caecal torsion
- Traumatic reticulitis
- Intestinal obstruction
How is right sided DA treated?
Dilation/displacement
Medical-
* Ca 40%
* Metoclopramide
* Buscopan
* Fluids
Surgical- drain and replace
Torsion- slaughter, surgery
What post op care is required for displaced abomasums?
- Fluid therapy
- NSAIDs
- Antibiotics
- Oral KCL
- Ca 40%
- Propylene glycol
What is the usual history of intestinal conditions?
- Sudden milk drop
- Anorexia
- Ruminal stasis
- Abdominal pain- kicking flank, getting up and down
- Minimal passage of faeces
- Palpation of loops of intestine per rectum
- Mild right sided bloat
What are the differentials for intestinal conditions?
- Intestinal obstruction
- Foreign body
- Intestinal volvulus/torsion
- Intussusception
- Intestinal incarceration or strangulation
- Intestinal neoplasia
- Jejunal haemorrhage syndrome
- Peritonitis
- Acidosis
- What does this image show?
- How is it diagnosed?
- Mesenteric volvulus
- Dx
* Clinical signs- abdominal discomfort
* Palpation per rectum- dilated loops
* US
* PM
When is surgery indicated for intestinal conditions- eg mesenteric volvulus?
- Rapidity of deterioration
- Severity of colic and its response to analgesia
- Severity of abdominal distention
- Absence of faecal output
- Heart rate
- Rectal palpation findings
- Blood lactate
- Blood calcium
- What is the aetiology of jejunal haemorrhagic syndrome?
- What are the clincial signs
- How is it reated?
- Unknown- clostridium perfringens type A?, mycotoxins?
- Anorexia and lethargy
- Medically or surgically- not very successful
What is the history for caecal dilation and volvulus?
- Dairy cow
- 1st few months of lactation
- Inappetent
- Decreased milk yield
- Ping in dorso-caudal right sublumbar fossa
- Rectally: Distended, recognisable viscus into the pelvis
What is the aetiology of caecal dilation and volvulus?
- Excess carbs which are fermented in caecum
- Increased VFA, reduced pH
- Caecal atony
- Accumulation of ingesta and gas
- Atony, dilation, torsion
What are the clinical sigs of caecal dilation?
What additional signs are with volvulus?
Dilation
* Anorexia
* Mild abdominal discomfort
* Reduced milk yield
* Reduced faeces
* Ping- right sublumbar fossa
Volvulus
* Dehydration
* Tachycardia
* Abdominal pain
Rectal
* Distension- long cylindrical, moveable organ, blind end points to pelvic vacity
* Volvulus- points cranial and lateral or medial
How can caecal dilationbe treated medically and surgically?
Medically
* Good quality hay
* TLC
* Monitoring hydration and HR
Surgically
* Determine if torsion
* Purse string suture
* Incise- milk caecal contents out
* Correct torsion and suture
* Post op- ABs, long fibre, TLC
Summarise abomasal ulcers and sequalae
- Mature cattle
- Acute abomasal haemorrhage
- Melena
- Perfoation- acute local peritionitis, leading to acute diffuse peritonitis
What are the primary and secondary causes of abomasal ulcers?
Primary: unkown
* Lactation- stress
* Stressfull events
* Handfed calves- weaned
Secondary
* LDA
* RDA
* Vagal indigestion
What are the 4 types of abomasal ulcers?
Type 1
* Non perforating
* Minimal amounts of intra luminal haemorrhage
Type 2
* Major blood vessel perforates
* Severe blood loss
* Melena
Type 3
* Perforating ulcer
* Acute, local peritonitis
Type 4
* Perforating ulcer
* Diffuse peritonitis
What are clinical findings of abomasal ulcers?
- Abdominal pain
- Melena
- Pale MM
- Sudden onset anorexia
- Tachycardia
Perforation- hypovolaemia, unable to stand
How are abomasal ulcers treated?
Generally conservatively
Antacids:
* Magnesium oxide
* Aluminium hydroxide
Blood transfusions/fluids
Surgical excision- mid line
