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Y4 - Large animals > Disease of the abomasum > Flashcards

Disease of the abomasum Flashcards

1
Q

What are common problems of the abomasum?

A
  • Dilation + displacement =
  • Left sided displacement (LDA)
  • Right sided dilation + displacement
  • Abomasal ulcers
  • Geo-sedimentum abomasi (sand)
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2
Q

What are risk factors for abomasal problems?

A
  • Usually seen in early lactation
  • Traditionally in housed but also seen at grass
  • “imbalance of fibre and concentrate” – SARA
  • Associated with ketosis and FMS
  • Hypocalcaemia (clinical & sub-clinical)
  • Concurrent inflammatory disease
  • Cow comfort, lameness etc etc
  • i.e. Anything that reduces DMI
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3
Q

What is the most common abomasal disorder?

A

LDA - twisted stomach

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4
Q

What are clinical signs of Left displaced abomasum

A
  • Reduced milk yield - not as marked or sudden as a wire
  • Not reaching expected yield - parlour monitoring
  • Ketosis
  • Selective appetite - prefers fibre
  • Usually 0-4weeks post calving
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5
Q

What are Ddx for LDA?

A
  • Vagal indigestion
  • Peritonitis
  • Gas in rumen (starved cattle / bloat)
  • ‘Swingers’ (transport)
  • May get LDA + another condition
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6
Q

What are abomasal sounds?

A
  • Spontaneous - tinkling + gurgling
  • Ping - tap / flick rib hard + map out area of pings
  • Absence of rumen sounds over displaced abomasum
  • Fat cows = no ping
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7
Q

How can you roll a cow to try fix a LDA?

A
  1. Cast - right lateral recumbency
    - then roll to dorsal
    - then roll over to left lateral
    - ping to see if moved – can repeat
  2. Good quality roughage
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8
Q

What are advantages / disadvantages of rolling cows?

A
  • Advantages =
  • cheap
  • non invasive
  • concurrent disease
  • Disadvantages =
  • Least successful
  • ulcer rupture
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9
Q

What is toggling?

A
  • Place sutures where abomasum naturally lies.
  • Clip up before casting.
  • Avoid getting you head kicked in!
  • Avoid major abdominal blood vessels – mark with pen?
  • Ample labour
  • Put trochar in to get rid of distension + tie to the side?
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10
Q

What are advantages / disadvantages of toggling?

A
  • Advantages =
  • Cheap
  • Minimally invasive
  • Relatively straight forward
  • Quick
  • Disadvantages =
  • Going blind
  • do not see if abomasum has ulcers / adhesions
  • fistula formation
  • risk of getting kicked
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11
Q

What are surgical methods to fixing LDA’s?

A
  • L + R sided approach - 2 operators
  • L side (Utrecht)
  • R side
  • R paramedian approach - cow is cast
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12
Q

What is the left to right / bilateral flank approach?

A
  • Paravertebral incision 5cm caudal to last rib
  • both slide hand down wall of abdomen and shake hands
  • Decompress abomasum (manual / needle on flutter valve tube)
  • Push abomasum to midline
  • Pull up to R incision
  • Omentopexy
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13
Q

What is the right side approach to a LDA?

A
  • Identify pylorus (‘sows ear’)
  • Pylorus palpated (‘sausage’)
  • Omentopexy using omentum near pylorus
  • Stich omentum by pylorus into wound closure
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14
Q

What is post-op care of LDA’s?

A
  • Antibiotics = pen/strep or Oxytet
  • Treat underlying conditions =
  • Ketosis = propylene glycol
  • Endometritis
  • High fibre diet
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15
Q

Regarding RDA, What is metabolic sequelae of dilatation?

A
  • Pooling of H+ and Cl- in abomasum
  • Upper intestinal obstruction = metabolic alkalosis + hypochloraemia
  • 35-50L in abomasum
  • Dehydration
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16
Q

Regarding RDA, what is metabolic sequelae of displacement + torsion?

A
  • Mucosal damage
  • Cytokine release + endotoxaemia
  • Metabolic acidosis
  • Severe dehydration
17
Q

What is seen in the dilatation + displacement phase of a RDA?

A
  1. Inappetent / depressed.
  2. Reduced faeces.
  3. Dehydrated.
  4. Tachycardia.
  5. Pale MM and dry.
  6. Doughy rumen – total outflow obstruction
  7. Reduced rumen turnover.
  8. Ping (middle to upper 1/3rd right side of abdomen)
  9. Tense viscus felt cranially per rectum
18
Q

What else is seen with torsion?

A
  • Much sicker
  • Severe dehydration
19
Q

What are Ddx for RDA + torsion?

A
  • Abomasal impaction
  • Caecal torsion
  • Traumatic reticulitis
  • Intestinal obstruction
20
Q

What is Tx of RDA?

A
  • Dilatation / displacement =
  • medical = Ca 40%, metoclopramide, Buscopan, fluids
  • Surgical = drain + replace
  • Torsion = slaughter / surgery
21
Q

How is surgery of RDA carried out?

A
  • Give fluids pre-op (5L hypertonic saline)
  • Balanced fluids during surgery
  • Purse string suture, tube + drain
  • Rotate abomasum, watch duodenum, anchor pylorus + stitch up
22
Q

What is post op care?

A
  • Fluid therapy = 50-100L
  • NSAIDs
  • Antibiotics
  • Oral KCl
  • Ca 40%
  • Propylene glycol
23
Q

How can you prevent RDA + LDA’s?

A
  • Better dry cow management
24
Q

What is seen with intestinal conditions?

A
  • 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
25
Q

What are Ddx for intestinal conditions?

A
  • Intestinal obstruction
  • Foreign body,
  • Intestinal volvulus/torsion
  • Intussusception
  • Intestinal incarceration or strangulation
  • Intestinal neoplasia
  • Jejunal haemorrhage syndrome
  • Peritonitis
  • Acidosis
26
Q

How is mesenteric volvulus diagnosed?

A
  • Clinical signs - abdominal discomfort
  • Palpation per rectum – Dilated loops of intestine enough to justify an exploratory laparotomy?
  • Ultrasound
  • Peritoneal fluid tap?
  • Post mortem – may be a series of cases so useful
27
Q

When would you perform surgery with mesenteric volvulus?

A
  • Rapidity of deterioration
  • Severity of colic and its response to analgesia
  • Severity of the abdominal distention
  • Absence of faecal output
  • Heart rate
  • Rectal palpation findings
  • Blood lactate
  • Blood Calcium – if low treat medically initially
28
Q

What is jejunal haemorrhagic syndrome? CS? Tx?

A
  • Clostridium perfringens type A toxin
  • CS = Anorexia + lethargy
    *Tx = Massage clots to move them on - Not v successful
29
Q

What is noted on history of caecal dilatation?

A
  • 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
  • Anorexia
  • Reduced faeces
30
Q

What is aetiology of caecal dilatation + volvulus

A
  1. Excess carbs fermented in caecum =
  2. Increased VFA, reduced pH =
  3. Caecal atony =
  4. Accumulation of ingesta and gas

= dilatation + torsion

31
Q

CS of caecal dilatation + volvulus?

A
  1. Anorexia
  2. Mild abdominal discomfort.
  3. Reduced milk yield.
  4. Reduced faeces.
  5. Ping (right sublumbar fossa)
  6. Dehydration.
  7. Tachycardia.
  8. Abdominal pain
32
Q

On rectal exam how do you tell the difference between distension + volvulus?

A
  • Distension = Long cylindrical, movable organ. Blind end points to pelvic cavity.
  • Volvulus = Points cranial and lateral or medial
33
Q

How would you treat Caecal dilatation?

A
  • Medically = good quality hay, TLC + monitoring hydration + HR (Only if not severe)
  • Surgery = determine if torsion, purse string suture, small incision, milk caecal content out,
  • deflate + correct torsion + suture up
34
Q

What can cause abomasal ulcers?

A
  • Other diseases = BVD
  • NSAID use
  • Lactating dairy cows = early lactation =
  • stress of lactation
  • high levels of grain
  • increased incidence at grass
  • Mature bulls + feed lot cattle =
  • stressful events = transport, surgery, fractures
  • Handfed calves = common at weaning
35
Q

What are different types of secondary cases (LDA/RDA/vagal indigestion)?

A
  • 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, peritonitis localised by greater omentum
  • Type 4 = perforating ulcer, diffuse peritonitis
36
Q

Where do cattle / calves tend to get ulceration + perforation in the GIT?

A
  • Cattle = fundic ulceration
  • Calves = Pyloric ulceration
37
Q

What are CS of fundic/pyloric ulcerations?

A
  1. Abdominal pain.
  2. Melena
  3. Pale MM.
  4. Sudden onset anorexia
  5. Tachycardia
38
Q

What is Tx of pyloric/fundic ulceration + perforation?

A
  • Antacids = magnesium oxide + aluminium hydroxide
  • Blood transfusion / fluids (20ml/Kg BW)
  • Surgical excision - excise / oversew - NO NSAIDs
39
Q
A

Y4 - Large animals (78 decks)

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