Transcript Diseases of the Forestomachs

Nose Ring Application
Nose Ring Application
Nose Ring Application
Nose Ring Application
Nose Ring Application
Diseases of the Forestomachs
M. S. Gill, D.V.M., M.S.
Ruminant Carbohydrate
Engorgement
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Grain overload
Lactic acidosis
Carbohydrate intoxication
Grain engorgement
Founder
History
• Access to highly fermentable feedstuffs
– by unaccustomed animals, or
– in larger than normal amounts
• May involve several animals in herd
• Rapid clinical course
Clinical findings
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Abdominal pain
Dehydration (6-12 %)
Diarrhea – fluid, fetid
Splashy rumen, bloat
Depression
Lameness
Scleral injection
Clinical findings
• Elevated temp initially, may be
subnormal when presented
• HR = 80-140 bpm
• RR elevated (blow off CO2)
• Rumen fluid analysis
– pH < 5
– sour odor
– protozoa dead, predominance of gram +
Clinical findings
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Metabolic acidosis
PCV
protein
Elevated BUN, creatinine, phosphorous
Increased anion gap
Decreased calcium
Pathogenesis
• Excess CHO ingestion, VFAs, rumen
pH, rumen motility, Strep bovis
proliferates producing lactic acid,
further pH (4-5)
• Acid resistant Lactobacillus spp.
proliferate producing lactic acid
Pathogenesis
• Lactic acid accumulation in the rumen
osmolarity of the rumen fluid drawing more
body water into the rumen (creates the
“splashy rumen”)
• Loss of body water causes dehydration
contributing to acidosis
• Lactic acid is absorbed from rumen as well
as from small intestine & profound lactic
acidosis develops
Pathogenesis
• Acidic rumen pH damages mucosal
surfaces in the forestomachs & intestine
• Blood vessels thrombose & sections of
rumen mucosa & submucosa slough
allowing bacteria to invade
• Bacteria travel to liver via portal circulation
& cause liver abscesses
• Mycotic ruminitis may develop
Pathogenesis
• Histamine levels increase
• Ethanol, methanol, tyramine,
tryptamine production contribute to
CNS depression
• Thiaminase production may result in
development of polio
• Death of Gram – bacteria can cause
endotoxin release
What feeds can cause
carbohydrate engorgement?
• Cereal grains
• Industrial byproducts (brewers grains,
sugars)
• Fruits
• Tubers (potatoes, sugar beets)
What feeds can cause
carbohydrate engorgement?
• Finely ground feeds with large surface
area promote rapid fermentation
• Hay and grass are are not highly
fermentable due to cellulose and large
particle size
• Corn silage usually not a problem because
much of CHO already reduced to VFAs in
ensiling process and also due to large
particle size
Diagnosis
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History
Clinical signs and clinical findings
Rumen fluid analysis
CBC, chem panel, blood gas
Therapy
• Remove rumen
contents
– Kingman tube
– Rumenotomy
– Ice water
administration
– Procaine pen G
(10 million IU,
P.O.)
Therapy
• Fluid and electrolyte replacement IV
• Anti-inflammatory agents –flunixin
meglumine (Banamine)
• Antibiotics
• Antimycotic therapy
• Rumen transfaunation
• Thiamine
• B-complex vitamins
Client education
• Make dietary changes very gradually
– Addition of antibiotics, HCO3-, and
ionophore antibiotics to the feed have
been beneficial but do not replace good
management
• Rumen adaptation may take 6 weeks
Rumenotomy
Rumenotomy
Rumenotomy
Rumenotomy
Rumenotomy
Rumenotomy
Rumenotomy
Rumen tympany (bloat)
• Gas production is a normal occurrence
during rumen fermentation
• Bloat occurs if eructation is prevented for
any reason
Clinical findings
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Distended left paralumbar fossa
Discomfort (grunting, colic)
Open-mouth breathing
Anorexia
Salivation
Anxious
Depressed terminally
Sudden death
Types of bloat
• Primary
– Eructation normal but gas cannot be expelled
• frothy bloat – legumes or grain (Strep bovis)
• Secondary
– Failure of eructation
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esophageal FB’s
vagus indigestion
positional
hypocalcemia
pharyngitis
Diagnosis
• History
• Clinical findings
THERAPY
• Free gas bloat
– Pass a stomach tube (carefully) either
nasogastric or orogastric
– If positional, roll cow into sternal recumbency
– Force exercise
– If hypocalcemia, administer calcium
– Rumen stimulents
– Rumen trocharization for emergencies only
THERAPY
• Frothy bloat
– Reduce surface tension
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Poloxalene – 2 oz.
Household detergent (Tide 2-3 oz.)
Mineral oil
Dioctyl sodium sulfosuccinate (DSS)
*All of the above reduce surface tension allowing
consolidation of tiny bubbles into a free gas bloat
which can be eructated or relieved via tube
THERAPY
• Chronic bloat – typically free gas bloat
associated with high grain diets that may
cause a permanent shift in microflora
– Increase fiber in diet & reduce grain
– Rumen transfaunation
– Temporary rumenostomy in severe cases
• May be 2° to another problem such as
vagus indigestion
Rumen tympany (bloat)
Rumen tympany (bloat)
Rumenostomy
Client education
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Slow adaptation to grain
Limit legume grazing
Poloxalene in feed, molasses, salt or block
Maintain sufficient long stem hay (fiber) in
ration to stimulate good rumen motility
Rumenitis, rumen parakeratosis,
chronic rumen acidosis
• Long-term ingestion of high grain, low
roughage diet
• Poor appetite
• Poor weight gain
• Chronic laminitis
Rumenitis, rumen parakeratosis,
chronic rumen acidosis
• Clinical findings
– Hypomotile rumen
– Elevated liver enzymes
– Rumen protozoa, gram + bacteria
Rumenitis, rumen parakeratosis,
chronic rumen acidosis
• Chronic exposure to high grain diet
• Low rumen pH (5.0-5.5)
• Increased propionic & butyric acid which
stimulates proliferation of rumen papillae
epithelium and even parakeratosis
• Fine particle size, less cud chewing, less
saliva buffering rumen contents
• Damage to rumen leads to liver abscesses
Rumenitis, rumen parakeratosis,
chronic rumen acidosis
• Treatment includes increasing
proportion of long stem hay in the diet
Vagus indigestion syndrome
• Motor disturbances which impair
passage of ingesta from the
reticulorumen and/or abomasum into
the lower GI tract
Vagus indigestion syndrome
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“Vague” signs
Slow loss of production
Slow weight loss
Poor appetite
Scant, pasty feces
Abdominal enlargement - “papple”
shape
• Rumen hyper motility, bradycardia
Vagus indigestion syndrome
Vagus indigestion syndrome
• Classification:
– Lesions anterior to cardia
– Lesions at the cardia
– Lesions at the reticulum
– Lesions distal to the reticulum
Vagus indigestion syndrome
• Treatment involves correction of
underlying problem
• Lymphosarcoma hopeless
• Rumen lavage
• Rumenotomy to remove contents &
‘shrink’ rumen or to treat reticular
abscesses
Vagus indigestion syndrome
Traumatic reticuloperitonitis (TRP,
hardware disease)
• Sudden decrease in appetite & milk
production
• Anterior abdominal pain
• Kyphosis
• Low grade fever (103°)
• Mild leukocytosis with neutrophilia
• Hyperfibrinogenemia
Traumatic reticuloperitonitis (TRP,
hardware disease)
• Diagnostics
– History
– Clinical findings
– Paracentesis
– Reticular radiography
– ultrasound
Traumatic reticuloperitonitis (TRP,
hardware disease)
• Medical treatment
– Antibiotics
– Magnet
• Surgical treatment
– Rumenotomy to approach reticulum
Traumatic reticuloperitonitis (TRP,
hardware disease)
Traumatic reticuloperitonitis (TRP,
hardware disease)
Abomasal ulcers
• Occur in all ages of cattle
• Associated with stress & high concentrate
diets and lymphosarcoma in older animals
• Four categories
– Non-perforating
– Non-perforating with severe blood loss*
– Perforating with localized peritonitis
– Perforating with diffuse peritonitis*
*life threatening
Abomasal ulcers
• Diagnostics
– Fecal occult blood
– Abdominocentesis
– WBC – leukocytosis with neutrophilia, high
fibrinogen
– Serology for BLV
Abomasal ulcers
• Calves
– Usually see perforation with peritonitis
– May be associated with copper deficiency
• Adults
– 1/3 significant hemorrhage
– 1/3 perforating with localized peritonitis
– 1/3 perforating with diffuse peritonitis
Abomasal ulcers
• Treatment
– Dietary changes
– Decrease stress
– Avoid steroid & NSAID use
– Treat concurrent problems
– Blood transfusions
– Antibiotics
– GI protectants
– H2 antagonists
Clinical case
• History:
– Yearling BFM show heifer
– History of mild abdominal pain
– Mild bloat
– Off feed
– Change in feed in last week
• Clinical findings:
– T – 103°
– Leukocytosis, neutrophilia
– Increased fibrinogen
– Abdominocentesis
• Protein > 3.5
• WBC > 10,000
• Neutrophilic inflammation
• Treatment:
– Antibiotics
– Decrease stress
– Dietary change – hay, ryegrass, no grain
– Rumen transfaunation
– Avoid NSAIDS & steroids
Abomasal impaction
• Causes:
– Poor quality roughage for overwintering beef
cows
– Calves fed poor quality milk replacers
– Animals on low fiber diets
– Abomasal volvulus
– Lymphosarcoma
Abomasal impaction
• Clinical signs:
– Takes weeks to develop
– Decreased appetite
– Firm, dry feces
– Rumen enlargement, stasis
– Poor BCS
– Abomasal rupture may occur
Abomasal impaction
• Differentials
– Hydrops
– Chronic peritonitis
– Vagus indigestion
– Omasal impaction
Abomasal impaction
• Poor quality roughage is poorly digested
so fibrous material passes to the
abomasum creating accumulation of
fibrous material in the abomasum which
can not pass through
• May develop post abomasal volvulus due
to vagus nerve dysfunction
Abomasal impaction
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Prognosis poor if advanced (slaughter)
Fluid therapy*, laxatives, metaclopramide to early cases
Terminate pregnancy
Rumenotomy, backflush abomasal contents into rumen
Place NG tube directly into abomasum for post-op
medication
*usually don’t develop metabolic alkalosis & hypochloremia
Abomasal emptying defect (AED)
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Suffolk sheep
Anorexia, weight loss, abdominal enlargement
Abomasum is enlarged and palpable
DDx:
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Malnutrition
Parasitism
Dental attrition
Johne’s
Caseous lymphadenitis
Neoplasia
Chronic pneumonia
Abomasal emptying defect (AED)
• Diagnostics
– Increased rumen chloride (normal = 8-15
mEq/L)
– Ultrasound abomasum – normal diameter is
2-3”, with AED may see abomasal diameter of
6-10”
• Pathophysiology remains unknown
Abomasal emptying defect (AED)
• Treatment:
– Surgery – rumenotomy & backflush rumen
– Metaclopramide – facilitates abomasal
emptying