9. Rumen Tympany, TRP and Ulcers

*What are the CSs for Acute Local Peritonitis?*

1. *Acute / abrupt onset* 2. *Complete anorexia* 3. *Decreased milk production* 4. *Absent ruminations* 5. *Moderate pyrexia & tachycardia* 6. *Evidence of abdominal pain inclding Arched Postrue*

Another name for 'Hardware Dz'?

Traumatic Reticulitis

Which abomasal ulcer type is mostly subclinical?

Type 1

*What are the types of Abomasal Ulcers?*

Type 1: *Non-perforating* & *mild* hemorrhage Type 2: *Non-perforating* & *marked* hemorrhage Type 3: *Perforating* & *localized* peritonitis Type 4: *Perforating* & *diffuse* peritonitis

Which abomasal ulcer type may be *rapidly fatal*? Why?

Type 2 - due to massive bleeding

Which abomasal ulcer type is similar to TRP 'hardware'?

Type 3 - focal contained peritonitis

Which abomasal ulcer type is *highly fatal* and not generally treatable?

Type 4

What is the BEST diagnostic tool for hardware dz? Why?

Ultrasound! - can demo reticular motility

What causes Choke?

Usually FB

How common is Hardware Dz in cattle?

Very common...70% of dairy cows at slaughter have it

What will you see at necropsy in patient with Frothy Bloat?

- Cervical congestion & hemorrhage - Bloat line in esophagus where blood flow stops - Compressed / pale lungs - Perineal / vulvar edema

What are the 4 sites of obstruction that can lead to Choke?

- Cervical esophagus - Thoracic inlet - Base of heart - Cardia of rumen

What Antibiotics can be given for Hardware Dz?

- Effective against anaerobes, particularly *Trueperella pyogenes* - Oxytetracycline, Ceftiofur, Florfenicol - Consider slaughter withdrawals

Describe the pathophysiology of Hardware Dz?

- FB is ingested & gets lodged in the honeycombs of reticulum - May *perforate* during contractions - Lead to peritonitis if perforates serosa - Small linear objects can migrate

Why is Choke an *emergency condition* in ruminants?

- Nowhere for the gas to go - GI/rumen will continue to expand

What do cows with Acute Local Peritonitis tend to do?

- Return to normal in 3-5 days - Pain only for few days

What CSs will you see with Bloat?

- Ruminal distension - Dyspnea - Tachycardia - Anxious and/or belligerent

What are the signs of Type 2 abomasal ulcers?

- Abrupt onset of signs - Pale membranes - Black tarry feces

*Which sequelae of hardware dz is acute & highly fatal and can even cause septic shock? Why is it so dangerous?*

*Diffuse Peritonitis* - die within24-36 hrs - no treatment

*How do you treat a ruminant with Frothy Bloat if they are dying?*

*Emergency Rumenotomy* - Trocar ineffective for frothy bloat (only good for FB bloat)

*What is a major cause of Type 2 Abomasal Ulcers in adult cattle?*

*Lymphosarcoma* (LSA) - > 50% of Type 2 ulcers in adults are LSA

What items typically cause Hardware Dz?

*Metallic wires* >> nails: - processed feeds - hazard grazing

*How can we differentiate Frothy Bloat from Free Gas Bloat?*

*Pass a stomach tube* - still won't eructate if Frothy

*What is the emergency treatment for a Choked ruminant in cardiorespiratory distress?*

*Pass a trochar* - must 1st relieve the bloat - if time: clip hair and do quick scrub

What CSs might you see in a ruminant with Choke?

- *Bloat*: first CS that will be seen if distension due to free gas - *Salivation* - Protruding tongue - Reflux thru nares - Swallowing / Chewing - *Shaking head* - Anxious, aggressive

How can you *medically* treat Frothy Bloat? Where should the medications be applied?

- *Poloxalene* for legume bloat - *Mineral/Vegetable oil* for grain bloat Deposit meds at *cardia* so eructation can occur

*How can Hardware Dz be treated medically?*

- *Reticular magnet* - *Strict confinement* - *Systemic Antibiotics*

*What are the potential sequelae to hardware dz?*

1. *Acute localized peritonitis* 2. *Chronic localized peritonitis* 3. *Perireticular abscessation* - interferes with ingesta transport 4. *Vagal neuritis / indigestion* 5. *Pericarditis / Pleuritis* (uncommon) 6. *Liver / Splenic Abscessation* (rare) 7. *Diffuse Peritonitis* - unable to contain the infxn

What would your hematology findings be in a patient with hardware dz?

1. *Chronic HYPERproteinemia* 2. *Elevated IgG Albumin:Globulin ratio* - Incr albumin - Decr. globulin

Once the ruminant is stable, how do you treat them following choke?

1. *Correct dehydration / acid-base* (acidotic if not swallowing) 2. Antibiotics for pneumonia 3. Anti-inflammatories 4. *Soft diet*

What are the differentials for Peritonitis?

1. *Hardware dz* 2. Abomasal ulcers 3. Liver Abscesses 4. Urogenital perforations

*What surgical procedures can be performed for hardware dz?*

1. *LEFT Sided Exploratory* - examine reticulum last as infxn is there 2. *Rumenotomy* - remove FB - lance perireticular abscess

How do you treat a Free Gas Bloat?

1. *Provide an exit for the gas* 2. Diet management 3. Transfaunation

What complications can arise due to Choke?

1. Aspiration pneumonia 2. Esophageal stricture --> can lead to recurrent choke

How do we dx Traumatic Reticluitis (hardware dz)?

1. Clinical findings (grunt tests) 2. *U/S* - most helpful 3. Rads: expensive 4. CBC 5. Fibrinogen 6. Abdominocentesis

What factors may lead to Frothy Bloat?

1. Diet - grain/feedlot - legume/wheat pasture 2. Rumen Outflow Problem

How does Free Gas Bloat develop?

1. Esophageal compression - ex. mediastinal LNs 2. Motility defect 3. Positioning (ex. lateral) 4. Abnormal rumen environment 5. Neurologic dysfunction

How can Frothy Bloat be prevented?

1. Management issue -> allow adequate time for adaptation to food 2. Ionophors

How can you dx Choke?

1. Pass a tube (1st thing you should do anyway) 2. Palpate pharynx & neck 3. Endoscopy

If the obstruction is in the *thoracic esophagus*, how can you help the ruminant?

1. Push it downward if smooth 2. If sharp or not moving; rumenotomy or rumenostomy

If the obstruction is in the *pharynx or cranial esophagus*, how can you help the ruminant?

1. Remove obstruction 2. Hydropropulsion/lavage loose feed 3. Push obstruction down into the rumen using a *large* sized tube 4. Rumenostomy / Screw-in trocar 5. Esophagostomy

How can Hardware Dz be prevented?

1. Reticular magnets (only 1) 2. Magnets on equipment 3. Farm cleanliness

Signalment for typical Hardware Dz patient?

Adult Dairy Cattle > 2yrs

What is the best way to treat ulcers?

Alleviate stressors

*What is the difference b/w Frothy and Free Gas bloat?*

Frothy Bloat - gas bubbles unable to coalesce Free Gas Bloat - rumen outflow problem leading to buildup of gas

Who does Choke primarily occur in? Why?

Cattle - b/c indiscriminant feeding behavior

How can you differ a cow that has Chronic Peritonitis vs Acute?

Chronic Peritonitis will *not* have a fever and other signs are non-specific

What is the best way to dx abomasal ulcers?

Fecal occult blood positive - U/S is good but only if ulcers are bleeding

Where does Lymphosarcoma tend to occur?

HAULS - Heart - Abomasum - Uterus - LNs - Spine

Who do abomasal ulcers occur in?

Intensely reared cattle --> Veal calves and dairy Most are subclinical

Which bloat condition can lead to death within 2-3 hrs after ingestion?

Legume & Pasture Frothy Bloat

What specific medical treatments are good for abomasal ulcers? How must they be administered?

Must be Injectibles b/c abomasum will break down if oral - Antacids - Proton pump inhibitors - Blood transfusion if bleeding is evere

What do we do if the Traumatic Reticulitis becomes Reticulopericarditis?

Often not treated b/c poor prognosis

What can occur if an abscess forms at the reticulo-omasal junction due to hardware dz?

Omasal Transport Failure - rumen outflow is disturbed --> *Hypermotility and 2ndary frothy bloat* and 'papple' shaped abdomen

As long as the ruminant is not in cardiorespiratory arrest, what would be the first thing you would do to treat Choke?

Pass an orogastric tube - ID obstruction location

What are the differentials for a ruminant that is ADR w/ parietal abdominal pain?

Peritonitis that can be caused by: 1. Hardware 2. Abomasal ulcers 3. Liver abscess 4. Urogenital perforation

What are the two classifications of Bloat?

Primary = Frothy Bloat Secondary = Free Gas Bloat - choke is a type of FG bloat

T/F: Bleeding ulcers don't perforate and perforating ulcers don't bleed

TRUE

How will you treat a Chronic or Recurrent Free Gas bloat condition?

Temporary rumenostomy

How do abomasal ulcers develop?

There is an ongoing battle b/w protective and ulcerogenic mechanisms - *stress*, anorexia, hair and straw are things that add to the ulcerogenic mechanisms --> ulcers

Can hardware dz be treated medically?

Yes - medical or sx