The Sick Cow Flashcards
- Mr Umpleby reports cow 792…
- Calved “normally” about 14 days ago
- Has declined dramatically in milk yield
- She gave 45 litres two days ago, 32 yesterday and only 8 this morning
- Looks “a bit empty”
- Came into the milking parlour last
- She normally comes in near the front of her group
What are your differentials? How common are they?
- LDA - occasional
- RDA - uncommon
- Mastitis - common
- Metritis - common
- Primary ketosis - common
- TRP - farm dependent, occasional
- Lameness - common, but unlikely to produce this degree of milk drop
How could we differentiate between:
LDA - occasional
RDA - uncommon
Mastitis - common
Metritis - common
Primary ketosis - common
TRP - farm dependent, occasional
Lameness - common, but unlikely to produce this degree of milk drop
- LDA: auscultation of a “ping “
- RDA - ping
- Mastitis: more commonly found on clinical exam, check pain/heat
- Metritis: vaginal exam showing foetid, brown discharge
- Ketosis: exclusion, find ketones in blood/milk/urine
- TRP: withers/bar test, cranial abdominal pain
- Infectious causes usually more chronic e.g. IBR, BVD, TB not noted clinically usually
Most disease events in the life of a dairy cow are associated with calving – the time around calving is a major determinant of a cow’s health and productivity right through the subsequent lactation. Cows are frequently presented in practice with vague, non-specific signs of malaise in the first few weeks after parturition
BACKGROUND:
Mr Umpleby runs a 300 cow dairy herd in Cumbria, and has been a client of your practice for some time
His cows are housed all year round, and fed a total mixed ration
The average 305 day milk yield in the herd is 9,800 litres
Mr Umpleby calls your practice for a visit to cow 792
The receptionist has noted down the history reported by the client on the phone
You are having a think about the case on the way to the farm.
HISTORY:
Calved “normally” about 14 days ago
Has declined dramatically in milk yield
(she gave 45 litres two days ago, 32 yesterday and only 8 this morning)
Looks “a bit empty”
Came into the milking parlour last (she normally comes in near the front of her group)
What do you think are the likely DDx for this presentation?
LDA – common
RDA – occasionally
Mastitis - common
Metritis – common
Lameness – common
Ketosis – common
Pneumonia - occasionally
Lungworm – occasionally
Endoparasites – occasionally
Toxin ingestion – rare
SARA/clinical acidosis – common/occasionally
Infectious disease – e.g. BVD, salmonella, winter dysentery – occasionally
Ruminal bloat – occasionally
Traumatic reticuloperitonitis (TRP) – occasionally/rare
Abomasal torsion/volvulus – rare
Caecal torsion – rare
Hypocalcaemia? - common
How would you distinguish between your top choices – using more history and clinical exam?
LDA/RDA – abdominal auscultation + percussion
Mastitis – udder palpation and milk assessment (e.g. CMT)
Ketosis – blood BHB/NEFA
Endoparasites – faecal analysis + FEC
SARA – uncommon but rumenocentesis
Lameness – MSK exam including lifting and assessing the foot if lameness is present in the animal
Metritis – vaginal exam à assessment of vaginal discharge
Ruminal bloat – clinical presentation of the animal (especially distended abdomen)
Temperature – if pyrexia would more likely indicate infection
HR, RR, MM colour etc. – dehydration, stress, systemic illness etc.
You arrive at the farm and take some more detailed history…
Cow was down for 12 hours after calving, responded to farmer treatment with iv calcium borogluconate
She’s in her 4th lactation, and the farmer says she’s normally a “good milker”
Your clinical exam reveals…
Unhappy looking cow
Ears/head down, hollow paralumbar fossa
TPR normal
Decreased rumen turnover
You listen for 4 minutes but only hear one contraction
NAD on vaginal and rectal examination
No evident lameness or mastitis
NAD on auscultation of heart & lungs
A “ping” sound on percussion auscultation of the right hand side
How do the results of the clinical exam change your DDx list? – modify your list and ranking to reflect this.
RDA high on DDx list now based on ‘ping’ audible on right hand side
Abomasal volvulus (AV) can be complication of RDA but this cow is not showing signs of critical illness (very sick cow –> would expect tachycardia/tachypnoea etc.)
Caecal dilation/displacement/torsion – also audible ‘ping’ may be seen on right hand side of the cow dorsally
RDA ‘ping’ more likely to be audible cranially within the right side of the abdomen, whilst caecal displacement/torsion more likely to be further caudally on the right side of the abdomen
How would you distinguish your top DDx of RDA?
Ex lap
You diagnose a right displaced abomasum (RDA)
What are the treatment options?
Assess response to conservative treatment (e.g. Butylscopolamine/metamizole [Buscopan Compositum] +/- NSAIDs)
Exploratory laparotomy/deflate and pexy the abomasum
The farmer would like to know the approximate cost (time + medicines) of each option:
Assess response to conservative treatment (e.g. Butylscopolamine/metamizole [Buscopan Compositum] +/- NSAIDs)
Exploratory laparotomy/deflate and pexy the abomasum
Conservative treatment
Time (£100-120/hr) - £50 time
£80/100ml bottle Meloxicam à 20mg/ml, 2.5ml/100kg à 17.5ml Meloxicam
About £16/injection à £48 total treatment for 3 days
Buscopan (£50/100ml) – 5ml/100kg à 35ml/dose
£17.50/injection x 4 = £70/day x 3 days = £310 total treatment
Total approx. cost around £420
Surgical treatment
Total cost around £200-300
What do you think a typical farm animal practice would charge for your time on farm?
Typically around £100-120/hr
Is there anything in this cow’s history that might be a predisposing factor for an RDA?
- Large calf
- 4th parity cow
- High-yielding dairy cow
- Hypocalcaemia after calving – reduced smooth muscle contraction may have aided in displacement of abomasum
Mr Umpleby mentions that this is the ninth RDA he has had treated in the last 12 months
What is the incidence rate of RDA in the herd?
9/300 cows = 3/100 cows = 3% incidence rate
Well above the average/target
What areas would you need to look at to help the farmer reduce this incidence?
- Dry cow nutrition management
- Breeding bull/AI considerations (i.e. genetics)
- Check incidences of other periparturient diseases (e.g. ketosis, mastitis, metritis) and see if any of these require changes in management
