Traumatic reticulo pericarditis

Question 1

Aetiology and pathogenesis

Answer 1

• Sharp linear metallic FB ingested
  ◦ Typically wires from tyres used to weigh down silage cover
  ◦ Associated with clamp silage feeding
• FB penetrates reticular wall -> into pericardial sac (through diaphragm)
  ◦ Not always cranial direction!!!

Question 1

Effects on heart function

Answer 1

• Cardiac tamponade
• Reduced cardiac output
  ◦ Forward failure
• Progresses to CHF
  ◦ Backward cardiac failure
  ◦ C/s related to this (e.g. oedema)

Question 2

History

Answer 2

• Typically non-specific
  ◦ Milk drop
  ◦ Non-specific illness 1-2 weeks prior to exam that appeared to resolve before recurring
  ◦ Inappetence

Question 3

Presenting signs - early stages

Answer 3

• Pain
  ◦ Abducted elbows
  ◦ Withers positive
  ◦ Arched back
  ◦ Firm palpation
• Rubbing/friction sounds on auscultation
• Tachycardia
• Pyrexia +/- associated BRD signs
• In the early (acute) stages, heart sounds can change daily

Question 4

Presenting signs - later stages

Answer 4

• Muffled heart sounds (bilateral)
  ◦ Regular rhythm
  ◦ Splashing, squeaking, rubbing sounds
• Difficulty palpating apex beat
• +/- pyrexia
• Signs related to congestive heart failure
  ◦ Jugular distension, ventral oedema, tachycardia, dyspnoea, injected scleral vessels
• In the later (chronic) stages, heart sounds tend to be consistent

Question 5

How would you diagnose?

Answer 5

Ultrasound

Question 6

Treatment

Answer 6

• Early stages (i.e. before fibrinous septic pericarditis has developed)
  ◦ Magnet
  ◦ Broad-spec antibiotics (e.g. amoxicillin, oxytetracycline)
• Late stages (septic pericarditis has developed)
  ◦ Prognosis = poor to hopeless
  ◦ PTS on welfare grounds
  ◦ Pericardiotomy/percardiostomy and drainage are reported
  ‣ Poor outcomes

Question 7

Prevention

Answer 7

• Due diligence regarding silage (and other feed) management
• Magnets