Unit 2 - Abomasal Ulcers, HBS, & Peritonitis Flashcards
What is a type I abomasal ulcer?
Non-penetrating (sub/non-clinical)
What is a type II abomasal ulcer?
Ulcers with profuse intraluminal hemorrhage
What is a type III abomasal ulcer?
Perforation with localized peritonitis
What is ta type IV abomasal ulcer?
Perforation with generalized peritonitis
What cattle are at risk for abomasal ulcers?
High producing dairy cattle, feedlot cattle, veal calves, beef calves
What clinical signs are associated with type II abomasal ulcers that are not associated with tumors?
Melena, anemia, PCV <25%, colic, and acute death
What clinical signs are associated with type II abomasal ulcers that are associated with lymphoma?
Abomasal displacement. anorexia, intraluminal hemorrhage, dark loose stool, pale mucous membranes
What are the other predilection sites for lymphoma?
Heart, abomasum, uterus, lymph nodes, and spine
What are 2 forms of type III and IV ulcers?
Slow perforations and covered my omentum - localized
Acute perforations and no omental covering - generalized
What clinical signs are associated with type III and IV ulcers?
Anorexia, ruminal stasis, distention, abdominal pain, melena, loose/scant feces, and loss of body condition
What diagnostic technique will you use in the case of a type III and IV ulcer to demonstrate peritonitis?
abdominocentesis
In the case of a type III or IV ulcer, what will you ultrasound for?
Fibrin, effusion, and abscesses
What will you see on clin path for a patient with a type III or IV ulcer?
Leukocytosis, neutrophilia, and left shift
How are abomasal ulcers treated?
Reduce stresses Treat concurrent diseases Address dietary issues if present Blood transfusions may be necessary Broad-spectrum abx in peritonitis cases Anti-ulcer medications
What anti-ulcer medications can be used for abomasal ulcer treatment?
Antacid - Mg hydroxide
H2 antagonists - cimetidine, ranitidine
PPI - omeprazole (calves), pantoprazole
What are other names for bovine lymphoma?
Bovine leukosis, enzootic lymphosarcoma, bovine lymphosarcoma, BLV-associated lymphoma
What is the causative agent of bovine lymphoma?
Bovine leukemia virus
What type of virus is the bovine leukemia virus?
An RNA virus that carries RNA reverse transcriptase complex
What cell population does BLV affect?
The B lymphocyte population
BLV viremia is detectible during the first ___ weeks of infection. Development of serological response occurs __-__ weeks after infection. ______ for BLV are lifelong. BLV can cause the development of persistent ______ and/or ______.
2 2-8 antibodies lymphocytosis lymphosarcoma
T/F: Infection of BLV means that lymphoma will develop.
False - lymphoma can develop without infection with BLV (although rare). Lymphoma is found in <5% of BLV-infected cattle
____% of infected animals develop persistent lymphocytosis
30
What is the normal lymphocyte to neutrophil ratio?
2:1
BLV spreads (slow/fast) within herds. Seropositive animals may reach ___% within a herd. (Dairy/Beef) cattle have a higher incidence of BLV.
Slow spread
80%
Dairy - dairy also have a higher incidence of developing lymphoma
How is BLV transmitted (general)?
Horizontal and vertical (transplacental)
How is BLV transmitted horizontally?
Iatrogenic, in-contact animals, milk/colostrum, and blood (transfusions/insects)
What are the four possible outcomes associated with BLV contact?
- Failure to become infected
- Establishment of permanent infection and development of detectable antibody titers
- Establishment of permanent infection and a persistent benign lymphocytosis
- Development of malignant lymphosarcoma with or without persistent lymphocytosis
When is the incidence of development of malignant lymphosarcoma increased?
Around 5-8 years of age
What is the most common presentation of BLV?
Sub-acute/chronic
What are the clinical signs of peracute BLV?
rupture of abomasal ulcer/spleen
What are the clinical signs of sub-acute/chronic BLV?
Loss of condition, anorexia, pallor, muscle weakness, and drop in production
Once signs are evident, what is the course of disease caused by BLV?
2-3 weeks
Lymphosarcoma should be a differential when you have what 2 clinical signs?
posterior paresis and exophthalmos
What necropsy findings are associated with BLV?
Tumors dispersed at the heart, uterus, lymph node, abomasum, and spine (HULAS)
Tumors enclosed in capsular like tissue
Cut surface bulges slightly; cream-colored and friable; central necrosis may be present
What provides a definitive diagnosis of BLV?
Histopath
Ulcers that don’t bleed do what?
perforate
Ulcers that don’t perforate do what?
bleed
What is hemorrhagic bowel syndrome (HBS)?
An acute enteric disease where there is segmental intraluminal hemorrhage and subsequent obstruction of the small intestine
T/F: HBS is more common in beef cattle
False - its them dairy bois
What is the case fatality rate for HBS?
> 85%
What are the speculated causes of HBS?
Multifactorial - C. perfringens type A and Aspergillus fumigatus
How can C. perfringens type A cause HBS?
The alpha and beta 2 toxin cause cleavage of phospholipids and outer cell membranes. This results in a disruption of the microvasculature, uncontrolled bleeding, and impaired mucosal permeability
What are the risk factors for HBS?
Dairy
Early lactation
Second lactation or higher
Nutritional factors
What nutritional factors are risk factors for HBS?
High energy, low fiber Silage TMRs (total mixed rations) Readily digestible CHO - delivers to SI 'Bloom' of C. perfringens for unknown reason
What clinical signs are associated with HBS?
Massive hemorrhage and severe toxemia
Rapid progression - dead or down and dying
Depression, anorexia, and agalactia
Lack of manure production
What PE findings will you find in a patient with HBS?
Cool extremities, hypothermia
Right sided ping, fluid splashing on ballottement of R caudal abdomen
Black berry jam or bloody clots
Abdominal distension
What will you find on CBC and serum chemistry in a patient with HBS?
Leukocytosis and neutrophilia +/- left shift
Hemoconcentration
Elevated BUN
Elevated liver enzymes
Hyperglycemia
Metabolic alkalosis - hypokalemia, hypochloremia, hypocalcemia, hypermagnesemia, and hyperphosphatemia
What is the prognosis for HBS?
Regardless of therapy method it is guarded
T/F: HBS surgical therapy has a higher survival rate over medical therapy alone
True
What is the preferred surgical technique for HBS?
manual breakdown/massage»_space; enterotomy
What medical therapy is recommended for HBS?
Penicillin, C perfringens type C and D antitoxin, aggressive IV fluids, NSAIDs (flunixin), and lidocaine CRI at the equine dosage
What are the classifications of peritonitis?
Acute vs. chronic
Septic vs. chemical
Localized vs. generalized
Primary vs. secondary
What can cause peritonitis?
Traumatic perforation, visceral rupture, abscess formation and spread/rupture, iatrogenic, and miscellaneous
Peritonitis can cause a various degree of _____ pain, altered GI ______, progressive _________, septicemia, and ___toxemia
abdominal
motility
hypovolemia
endotoxemia
What type of response is peritonitis?
inflammatory
Peritonitis causes altered ______.
permeability - this results in ‘leakage’
What clinical signs are associated with peritonitis?
Colic signs
GI stasis, abdominal distension
Reduced manure output (acute), diarrhea (chronic)
Cranial abdominal pain (reluctance to move)
What ancillary tests are useful for cases of supsected peritonitis?
CBC, abdominocentesis, and ultrasound
What abnormalities will be on the CBC in a patient with peritonitis?
Neutropenia (should this be philia…?) with left shift
NEutrophilic leukocytosis and hyperfibrinogemia
Hemoconcentration
What will your abdominocentesis concentrations be in a patient with peritonitis?
Increased protein, neutrophil, and bacteria
How is peritonitis treated?
Antibiotics - broad-spectrum (beta-lactams, tetracyclines)
NSAIDs
Fluid therapy
Plasma and/or whole blood transfusions (preferred)
Transfaunation
Is drainage recommended in cases of peritonitis?
If there is an identifiable and accessible abscess then yes
Why is surgical lavage not recommended for peritonitis in cattle?
You run the risk of spreading infection within the abdomen, you can damage the antibiotics, and there is no advantage to adding abx
