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

• 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• 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• 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

• 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

• 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

• 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

• 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

• 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

• “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

• 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)

• Suffolk sheep• Anorexia, weight loss, abdominal enlargement• Abomasum is enlarged and palpable• DDx:

– 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