Diseases Of The Abomasum For Vet. Student By Ali Sadiek

Diseases of The Abomasum By Dr. Ali H. Sadiek Prof. of Internal Veterinary Medicine and Clinical Laboratory Diagnosis Dept. of Animal Medicine Faculty of Veterinary Medicine Assiut University- Assiut, EGYPT

E-mail: [email protected]

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Diseases of Abomasum Diseases of Abomasum includes: • Left Displacement of Abomasum (LDA) • • •

Right Displacement of Abomasum (RDA) Abomasal ulcers. Impaction of Abomasum.

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Abomasal reflux.

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:Abomasal displacement  DA Occurs more frequently in highproducing, heavily fed adult dairy cattle, within first 6 weeks of calving and possibly under stress.  Prevalence in well managed herd ~ 0.2 – 2.5%  It is ch. by: gradual loss of appetite, passage of soft, scanty, may black feces, pinging” of the abdomen, ketonuria, dehydration and metab. alkalosis

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Types of Displaced abomasum 1-Left Displaced Abomasum (LDA): • The most common type (90 %) • The great curvature of the abomas. passes under the rumen between the rumen and the left abdominal wall and lies in the left lower flank.

2-Right displacement (RDA) 10% • The abomas. is displaced to the right and lying between the liver and the right abdominal wall. • It is always associated with some degree of torsion of the pylorus.

3-Anterior displacement (ADA); • The clinical picture is very similar to LDA but the abomasum or the major part of it, displaced interiorly and comes to lie between the reticulum and the diaphragm. Ali Sadiek

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Left Displaced Abomasum (LDA)

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LDA Rumen

Percussion Auscultation line

Distended LDA

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How the Abomasum Displaced

DA Ali Sadiek

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How the Abomasum Displaced

Direction of Displacement Ali Sadiek

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Causes of LDA: Multifactorial Abomasal atony and Excess gas production – High grain/low roughage diets [VFA] Gas accumulation Distention • Roughage stimulates rumination & Increases salivary buffer action Contributing factors for Ab. Atony and displac. 1- Hypocalcemia and Milk fever smooth muscle tone and motility • 4.8 x risk of developing LDA than normocalcemic

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Contributing factors for Abom. Atony and DA

2- Metritis, retained placenta, severe mastitis • Endotoxins and endogenous pyrogens depress motility • Result in hypocalcemia

3- Electrolyte disturbances 4-Lack of exercise/confinement

5- High producing diary cows – Large abdominal cavities – Genetic selection

more room DA

6- Finally, subclinical and clinical ketosis increase the risk of DA

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Clinical signs. 1-General symptoms of indigestion  Sudden decreased appetite  Sharp decrease in Milk yield.

2-Soft pasty scanty black feces, may diarrhea. 3-Obvious bulge may be observed and palpated behind the last rib in the left Para-lumbar fossa” “slab-sided” abdomen 4-Muffling of ruminal sound. 5-Rectal palpation, the rumen is felt small while the abomasum is palpable to its left or may be felt so high in the right Ali Sadiek

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Clinical signs. 6-Auscultation at each intercostals space: Reveal the characteristic tinkling or splashing sounds (church belling) Steal band effects on Auscult / Percus. • Tympanic swelling -gives resonant sound on percussion (gasses + fluid). Ali Sadiek

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Auscultation -percussion space

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(Clinical Signs (continued 7-Variable degrees of second. ketosis. 8- Fatty liver 9- Deteriorat, loss of weight and death (20 %) 10- Signs of Mild hypocalcemia (Atonic

rumen, cold ears, widely dilated pupils).

11-DA is usually complicated by : – Dehydration. – Metabolic Alkalosis. – Hypochloremia. – Hypokalemia Ali Sadiek

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Diagnosis of DA • Age: older lactating dairy cattle. • Timing: 90% during first 6 wks postpartum • Nutrition: Dry cow rations of High grain/ low roughage Concurrent disease:

40% of DA’s have retained placenta, mastitis, or metritis Ali Sadiek

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Clinical pathology • • • • • • • •

Normal CBC, or increased PCV, Hb & protein Metabolic alkalosis (slight) Hypo: Ca, K, Cl Ketosis (mild) Dehydration Hypoglycemia ? Hyperbilirubinemia Puncture of displaced objects: No protozoa, pH (2) Ali Sadiek

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Differential Diagnosis • LDA – 1ry ketosis (non-pinging LDA)

• RDA – 1ry ketosis (non-pinging RDA) – Other Right-sided pings: • Uterus, cecum, peritoneum, colon, rectum • “off feed” ping

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Therapeutic Goals • Return Abomasum to proper position • Create a permanent attachment • Correct electrolyte, acid-base, & hydration deficits • Treat other concurrent diseases

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Non-Surgical Technique: Rolling • Cast cow with ropes into right lateral recumbency • Roll onto back & extend the rear legs • Roll in a 90-degree arc for 3 minutes, ending in left lateral recumbency • Bring the cow to sternal position & allow to stand • Ascult. the left thorax to ensure LDA is relieved

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Rolling Technique • Advantages – Quick & easy technique – No invasive surgery

• DISADVANTAGES – >50% relapse. – If RDA or RTA are present, can exacerbate problems

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Surgical Techniques- Roll & Toggle • +/- Tranquilization or Sedation • Cast cow onto right side & roll onto back • Clip & scrub operational site: – Area of loudest “ping” – 4-7 inches behind Xiphoid

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Surgical Techniques: Right Flank Omentopex • Paravertebral/Inverted L/ Line Block • 20 cm vertical incision in right paralumbar fossa • Left arm moves over top of rumen to left side of abdomen, locates abomasum Ali Sadiek

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Right Flank Omentopexy • Feel abomasum for adhesions • Deflate gas • Bring arm under rumen, grab top of abomasum & scoop back to ventral position

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Right Flank Omentopexy • Pull out omentum through incision until pylorus can be seen • Mattress sutures through peritoneum, omentum, & muscle • Continuous sutures on inner layers of muscle incorporating omentum

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Right Flank Omentopexy • Advantages: – High success rate in experienced surgeons – Standing procedure – Can perform exploratory

• Disadvantages: – Omentum can tear & redisplacement – Cannot see abomasum to evaluate – Need long arms to reach across abdomen! Ali Sadiek

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Abomasal Ulcer It occurs in adult cows and calves and ch. by:

• Acute bleeding, indigestion, melana • It may penetrate abomasal membrane leading to: 1- Acute pain 2- Acute local peritonitis. 3- Diffuse peritonitis and death

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Probable Causes Stress of parturition, High lactation, excessive feeding on grains. Ingestion of F. bodies, or tough food. Associate BVD, DA, A. Torsion, Vagus indigestion. Probably genetic predisposition Ali Sadiek

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Pathogenesis Ulcers

▼ Excess H+, Pepsin onto the wounded epithelium ▼ Damaged epith and wall ▼ pain and bleeding. Types of Abomasal Ulcer: 1- Non penetrating Ulcer. 2- Ulcer causing blood loss. 3- Penetrating Ulcer with Acute Local peritonitis 4- Penetrating Ulcer with Acute diffuse peritonitis Ali Sadiek

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Clinical signs Varies acc. to type and consequence of ulcer Acute abdominal Pain. Black tarry feces (Melana) may continue for 4-6 days, then animal may recover or die within 24 hrs with acute bleeding. Signs of anemia and Tachycardia Death rate (25, 100, 50, 100 %) in types 1, 2, 3, 4 respect. Bouts of diarrhea may occurs. Sudden loss of appetite Shock and Death in 7 hrs if acute local or diffuse peritonitis occurs. Ali Sadiek

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Lab. Findings and Diagnosis • Occult test: To detect hidden blood in stool • Neutrophilia ► Peritonitis • Acute anemia: ▼ PCV, Hb, RBCs Diagnosis: • History of High lact. Heavily fed cows. • Clinical signs is sufficient (melana, anemia, abd. Pain)

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Treatment : • Blood transfusion, fluid therapy (if PCV < 12 %) • Vit. K & Ca • Caolin and pectin • Antacids (100 g Mg silicate daily). • Surgical inteference is gaurded.

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Abomasal impaction • Associate V. indigestion. • Feeding on fine ground grains, sandy feed. • In suckling calves (Excess casein in milk )

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:It Ch. Clinically by • • • •

Abd. Distension (Lower right abd.) Ruminal atony Constipation and absence of feces. Loss of appetite & weight

• On auscult: ping over rumen similar to that of DA. • salivation Ali Sadiek

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Diagnosis and treatment • Rectal palpation may help in sever omaso-abomasal impaction • Laparotomy reveals distended hard abomasum • Treatment: unfavorable. • Animal may die due to dehydration, Metabolic alkalosis, hypokalemia, hypochloremia. Ali Sadiek

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Abomasal impaction

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