Diseases of the Abomasum for Vet. Student by Ali Sadiek

11Ali SadiekAli Sadiek

Diseases of The AbomasumDiseases of The Abomasum

ByByDr. Ali H. SadiekDr. Ali H. Sadiek

Prof. of Internal Veterinary Medicine and Clinical Prof. of Internal Veterinary Medicine and Clinical Laboratory DiagnosisLaboratory Diagnosis

Dept. of Animal MedicineDept. of Animal MedicineFaculty of Veterinary Medicine Faculty of Veterinary Medicine

Assiut University- Assiut, EGYPTAssiut University- Assiut, EGYPT

E-mail: [email protected]: [email protected]

22Ali SadiekAli Sadiek

Diseases of AbomasumDiseases of Abomasum

Diseases of Abomasum includes:Diseases of Abomasum includes:

1.1. Left Displacement of Abomasum (Left Displacement of Abomasum (LDALDA))

2.2. Right Displacement of Abomasum Right Displacement of Abomasum ((RDARDA) )

3.3. Abomasal ulcers.Abomasal ulcers.

4.4. Impaction of AbomasumImpaction of Abomasum. .

5.5. Abomasal reflux.Abomasal reflux.

Ali SadiekAli Sadiek 33

Abomasal displacementAbomasal displacement::DA Occurs more frequently in high-

producing, 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


Types of Displaced abomasum1-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.


Left Displaced Abomasum (LDA)Left Displaced Abomasum (LDA)


LDALDA

Distended LDADistended LDA

RumenRumen

Percussion Auscultation linePercussion Auscultation line


How the Abomasum DisplacedHow the Abomasum Displaced

DADA


How the Abomasum DisplacedHow the Abomasum Displaced

Direction of DisplacementDirection of Displacement


Causes of LDA: MultifactorialCauses of LDA: Multifactorial

Abomasal atony and Excess gas production– High grain/low roughage diets

[VFA] Gas accumulation Distention• Roughage stimulates rumination & Increases

salivary buffer actionContributing 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


Contributing factors for Abom. Atony and DAContributing 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 more room DA

– Genetic selection6- Finally, subclinical and clinical ketosis increase the risk

of DA


Clinical signs.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


Clinical signs.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).


Auscultation -percussion spaceAuscultation -percussion space


Clinical Signs (continued)Clinical Signs (continued)7-Variable degrees of second. ketosis.8- Fatty liver9- 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


Diagnosis of DADiagnosis 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


Clinical pathologyClinical 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)


Differential DiagnosisDifferential 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


Therapeutic GoalsTherapeutic Goals

• Return Abomasum to proper position

• Create a permanent attachment

• Correct electrolyte, acid-base, & hydration deficits

• Treat other concurrent diseases


Non-Surgical TechniqueNon-Surgical Technique: Rolling: 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


Rolling TechniqueRolling Technique

• Advantages– Quick & easy technique– No invasive surgery

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

problems


Surgical TechniquesSurgical Techniques- Roll & Toggle- 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


Surgical TechniquesSurgical Techniques: Right Flank Omentopex: Right Flank Omentopex

• Paravertebral/Invert-ed 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


Right Flank OmentopexyRight Flank Omentopexy

• Feel abomasum for adhesions

• Deflate gas • Bring arm under

rumen, grab top of abomasum & scoop back to ventral position



• 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



• 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!


Abomasal UlcerAbomasal 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


Probable CausesProbable 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


PathogenesisPathogenesis 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 peritonitis4- Penetrating Ulcer with Acute diffuse peritonitis


Clinical signsClinical signsVaries 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 TachycardiaDeath rate (25, 100, 50, 100 %) in types 1, 2, 3, 4 respect.Bouts of diarrhea may occurs.Sudden loss of appetiteShock and Death in 7 hrs if acute local or diffuse peritonitis occurs.


Lab. Findings and DiagnosisLab. 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)


TreatmentTreatment : :

• Blood transfusion, fluid therapy (if PCV < 12 %)

• Vit. K & Ca

• Caolin and pectin

• Antacids (100 g Mg silicate daily).

• Surgical inteference is gaurded.


Abomasal impactionAbomasal impaction• Associate V. indigestion.

• Feeding on fine ground grains, sandy feed.

• In suckling calves (Excess casein in milk )


It Ch. Clinically byIt 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


Diagnosis and treatmentDiagnosis 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.


Abomasal impactionAbomasal impaction

Diseases of the Abomasum for Vet. Student by Ali Sadiek

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