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1.
Background: There has been increased interest in measuring the serum concentration of acute phase reactants such as serum amyloid A [SAA] and haptoglobin [haptoglobin] in periparturient cattle in order to provide a method for detecting the presence of inflammation or bacterial infection.
Objectives: To determine whether [SAA] and [haptoglobin] are increased in cows with displaced abomasum as compared with healthy dairy cows.
Animals: Fifty-four adult dairy cows in early lactation that had left displaced abomasum (LDA, n = 34), right displaced abomasum or abomasal volvulus (RDA/AV, n = 11), or were healthy on physical examination (control, n = 9).
Materials and Methods: Inflammatory diseases or bacterial infections such as mastitis, metritis, or pneumonia were not clinically apparent in any animal. Jugular venous blood was obtained from all cows and analyzed. Liver samples were obtained by biopsy in cattle with abomasal displacement.
Results: [SAA] and [haptoglobin] concentrations were increased in cows with LDA or RDA/AV as compared with healthy controls. Cows with displaced abomasum had mild to moderate hepatic lipidosis, based on liver fat percentages of 9.3 ± 5.3% (mean ± SD, LDA) and 10.8 ± 7.7% (RDA/AV). [SAA] and [haptoglobin] were most strongly associated with liver fat percentage, r s=+0.55 ( P < .0001) and r s=+0.42 ( P = .0041), respectively.
Conclusions and Clinical Importance: An increase in [SAA] or [haptoglobin] in postparturient dairy cows with LDA or RDA/AV is not specific for inflammation or bacterial infection. An increase in [SAA] or [haptoglobin] may indicate the presence of hepatic lipidosis in cattle with abomasal displacement.  相似文献   

2.
We determined the abomasal emptying rates of Holstein-Friesian cows at different stages of lactation, with left displaced abomasum (LDA), or immediately after surgical correction of LDA or abomasal volvulus (AV). D-xylose (0.5 g/kg body weight [BW], 50% solution) was injected into the abomasum in healthy cows (group 1, 4-7 days in milk [DIM], n = 7; group 2, 90-120 DIM, n = 7; group 3, > 300 DIM, n = 7) and in cows with LDA (n = 10; group 4). D-xylose was injected into the abomasum during right flank laparotomy in cows with LDA (n = 22; group 5) and cows with AV (n = 15; group 6). The time to maximal serum D-xylose concentration was used as an index of emptying rate. The abomasal emptying rates for cows in groups 1, 2, and 3 were similar, whereas emptying was slower in cows with LDA and in cows after surgical correction of LDA or AV. The abomasal emptying rate of cows with LDA was slowed to a greater extent immediately after surgery, when compared to the rate obtained before surgery. There was no difference in abomasal emptying rate immediately after surgical correction between cows with LDA or AV. The results indicate that the increased incidence of LDA in the first month of lactation is not associated with an intrinsic decrease in abomasal emptying rate in healthy cows. Our findings also demonstrate that surgical correction further slows the emptying rate in cows with LDA.  相似文献   

3.
The records of 106 cases of right-sided displacement of the abomasum (RDA) and abomasal volvulus (AV) were reviewed. Pre- and postoperative heart rate (> or = 90 BPM), serum BUN (> or = 10 mmol/L), potassium (< or = 3.3 mmol/L) and chloride (< or = 85 mmol/L) were the best indicators for a non-productive outcome. High gamma-GT activity can be used as a preoperative indicator to differentiate AV from RDA. The overall rate of return to a productive life was 74% (81.2% of RDA cases and 67.3% of AV cases).  相似文献   

4.
OBJECTIVE: To compare abomasal luminal gas pressure and volume and perfusion of the abomasum in dairy cows with a left displaced abomasum (LDA) or abomasal volvulus (AV). ANIMALS: 40 lactating dairy cows (25 with an LDA and 15 with an AV). PROCEDURE: Abomasal luminal gas pressure and volume and pulse oximetry values for the caudal portion of the dorsal ruminal sac and abomasal wall were measured during laparotomy. Abomasal perfusion was assessed on the basis of abomasal O2 saturation (pulse oximetry) before correction of the LDA or AV. Abomasal perfusion was also assessed after correction of the LDA or AV by measuring venous O2 saturation in the right gastroepiploic vein and calculating the abomasal oxygen-extraction ratio. RESULTS: Abomasal luminal gas pressure and volume were higher in cattle with an AV than in cattle with an LDA. Abomasal O2 saturation was lower and abomasal oxygen-extraction ratio higher in cattle with an AV, compared with values in cattle with an LDA. In cows with an AV, lactate concentration in the gastroepiploic vein was greater than that in a jugular vein, whereas no difference in lactate concentrations was detected in cows with an LDA. Abomasal luminal gas pressure was positively correlated (r, 0.51) with plasma lactate concentration in the gastroepiploic vein and negatively correlated (r, -0.32) with abomasal O2 saturation determined by use of pulse oximetry. CONCLUSIONS AND CLINICAL RELEVANCE: Abomasal perfusion decreases as luminal pressure increases in cattle with an AV or LDA.  相似文献   

5.
Peritoneal fluid (PF) was evaluated in 40 cows with left displaced abomasum (LDA) and 15 cows with abomasal volvulus (AV). PF was obtained by abdominocentesis at the right ventral abdomen at admission. Simultaneously, a blood sample was taken from the jugular vein. Biochemical and cytological variables in blood and PF specific for ischaemia, inflammation and cell damage were compared. Total protein, albumin, glucose and cholesterol were normal in PF of cows with LDA and AV. Although L-lactate increased in both groups, cows with AV had significantly higher values (LDA: 1.47/0.69/2.68 mmol/l; AV: 6.45/4.55/12.89 mmol/l (median/1. quartile/3. quartile)). D-dimer (LDA: 0.50/0.22/0.88 mg/l; AV: 1.11/0.40/1.85 mg/l) and LDH (LDA: 663/437/943 U/l; AV: 1099/750/1439 U/l) were only increased in PF of cows with AV. The number of leucocytes was normal; however, significantly more peritoneal neutrophils appeared necrotic or apoptotic after AV. PF of cows with abomasal displacement showed distinctive features of ischaemia and inflammation. Characteristics of haemostatic dysfunction and cell damage were mainly evident in PF of cows with AV. The results suggest that anti-inflammatory therapy is indicated in each cow with abomasal displacement. Additionally, medical treatment should be directed to prevent complications of ischaemia and reperfusion in cows with AV.  相似文献   

6.
Left displaced abomasum (LDA) and abomasal volvulus (AV) occur most commonly in postparturient dairy cows. Our main hypothesis was that endotoxemia occurred more frequently in the peripheral blood of cows with LDA or AV than in healthy cows because increased luminal pressure in AV or LDA, or the presence of a hemorrhagic strangulating obstruction in AV, may have injured the abomasal mucosa, thereby facilitating translocation of luminal endotoxin into the circulation. Therefore, our main objective was to compare the prevalence and magnitude of endotoxemia in healthy postparturient cows with the prevalence and magnitude of endotoxemia in cows with AV and LDA. We examined 60 adult dairy cows in early lactation that were diagnosed with AV (n = 15) or LDA (n = 15) or were healthy on physical examination (control group, n = 30). Jugular venous blood was obtained from cows in all 3 groups, and right gastroepiploic venous blood was obtained during surgical correction of AV and LDA immediately after repositioning of the abomasum. Platelet-rich plasma endotoxin concentrations were measured with a chromogenic limulus amoebocyte lysate assay. Endotoxin was detected in jugular vein plasma in 50% (15/30) of control cows; however, the prevalence of endotoxemia was significantly lower (P < .05) in cows with AV (7%, 1/15) or LDA (20%, 3/15). Endotoxin was detected simultaneously in right gastroepiploic and jugular vein plasma in only 1 cow with LDA and 0 cows with AV. Contrary to our hypothesis, we conclude that endotoxemia is infrequently present in postparturient dairy cows with AV or LDA.  相似文献   

7.
OBJECTIVE: To describe ultrasonographic appearance of the liver, small and large intestines, and omasum in cows with right displacement of the abomasum (RDA) and with abomasal volvulus (AV) and to determine whether RDA and AV can be differentiated on the basis of ultrasonographic findings. ANIMALS: 17 cows with RDA, 9 cows with AV, and 10 healthy control cows. PROCEDURES: A linear transducer was used to examine the abomasum, liver, omasum, and small and large intestines from the right side. Results-The liver was imaged less frequently in cows with RDA or AV, compared with control cows. In 9 cows with RDA or AV, the liver could not be imaged. The small intestine was imaged less frequently in cows with RDA or AV than in control cows; in cows with AV, the small intestine could not be imaged in the 8th, 9th, or 10th intercostal space. The large intestine was imaged less frequently in the 11th and 12th intercostal spaces and the cranial region of the flank in cows with RDA or AV. The omasum was also imaged less frequently in the 8th and 9th intercostal spaces in cows with RDA or AV. Cows with RDA or AV could not be differentiated on the basis of ultrasonographic findings. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with control cows, cows with RDA and AV had changes in positioning and therefore extent of ultrasonographic imaging of the liver, omasum, and small and large intestines; however, these findings were not useful in differentiating between cows with RDA and AV.  相似文献   

8.
Very few epidemiologic studies have verified the utility of the right paramedian abomasopexy (RPA) technique in cows with right abomasal disorders. This study aimed to investigate the outcomes and risk factors for non-survival in the herd within 30 days of surgery in cows with right abomasal disorders who underwent the RPA technique. Forty-seven Holstein cows with right abomasal disorders (25 with right abomasal displacement [RDA] and 22 with right abomasal volvulus [RAV]) were included. Twenty-two cows with RDA (22/25, 88.0%) and 10 cows with RAV (10/22, 45.5%) survived at 30 days post-surgery. Multivariate logistic regression analysis indicated that hyponatremia, hypokalemia, and the presence of abomasal volvulus were the major risk factors associated with non-survival.  相似文献   

9.
The objectives of this study were to determine the etiology and types of vagal indigestion (VI) occurring after right displacement of the abomasum or abomasal volvulus (RDA/AV), and the prognosis for each type. Data of cows presented for RDA/AV from a retrospective (n = 288) and a prospective (n = 132) study were used. Vagal indigestion occurred in 39 and 22 cows in each study, respectively. A necropsy was performed in 29 cases. Gastric compartment dilation compatible with VI type III or IV occurred in 23 cases. An abnormal gastric wall was detected in 22 cases. Peritonitis was present in 18 cows. Vagal nerve lesions were present in 5 out of 13 cases studied. Clinical, hematological, and necropsy results suggested a classification of VI with respect to presence or absence of peritonitis. Gastric wall damage, peritonitis and vagal nerve lesions appear important in the etiology. Considering peritonitis occurrence, antimicrobial therapy appears necessary in the treatment of RDA/AV.  相似文献   

10.
OBJECTIVE: To assess signalment, history, results of clinical and laboratory testing, and outcome for beef cattle with a left displaced abomasum (LDA), right displaced abomasum (RDA), or abomasal volvulus (AV). DESIGN: Retrospective study. ANIMALS: 19 beef cattle with an AV, LDA, or RDA. PROCEDURE: Signalment; history; results of physical examination, diagnostic testing, and surgical exploration; and condition of the animal at discharge were obtained from medical records. RESULTS: Fourteen cattle had an AV, 4 had an RDA, and 1 had an LDA. Duration of clinical signs ranged from 1 to 21 days. Eighteen cattle had an AV or RDA; 7 were Brahmans, 12 were males, and median age was 10 months. Abdominal distention was observed in 11 cattle, heart rate of > or = 100 beats/minute was detected in 14, and the abomasum was palpable per rectum in all cattle in which per rectal examination was performed. Leukocytosis, neutrophilia, hyperglycemia, azotemia, hypochloremia, and hypokalemia were common laboratory findings. At surgery, 3 cattle with an AV or RDA had a ruptured abomasum. Of the remaining 15 cattle, 12 survived. CONCLUSIONS: Clinical course in beef cattle with an AV or RDA was more protracted than that typically associated with these conditions in dairy cattle, but survival rate in beef cattle that did not have rupture of the abomasum was similar to that of dairy cattle. CLINICAL RELEVANCE: Abomasal displacement should be considered for beef cattle with abdominal distention. Prognostic indicators recommended for use in dairy cattle may not be useful for beef cattle.  相似文献   

11.
The abomasal luminal pressure was determined during surgery in 54 dairy cows with abomasal volvulus (AV) and another 50 dairy cows with left displaced abomasum. The luminal pressure was high in all cattle with AV and 49 (98%) cattle with left displaced abomasum. Luminal pressure was significantly higher in cattle with AV (median, 11.7 mm of Hg; range, 4.1 to 32.4 mm of Hg) than cattle with left displaced abomasum (median, 8.7 mm of Hg; range, 3.5 to 20.7 mm of Hg). Among cattle with AV, abomasal luminal pressure was significantly higher in cattle that died or were sold for slaughter following surgery (median, 20.6 mm of Hg; n = 8) than in cattle that were retained in the herd (median, 11.0 mm of Hg; n = 46). The luminal pressure was weakly correlated with the preoperative serum alkaline phosphatase activity but not correlated with duration of inappetence before surgery. Calculation of likelihood ratios and construction of a response operating characteristic curve for cattle with AV indicated that a cut-off value of 16 mm of Hg for luminal pressure optimized the distribution of cattle into productive and nonproductive groups. The sensitivity, specificity, positive predictive value, and negative predictive value of a luminal pressure < 16 mm of Hg in predicting a productive outcome were 0.83, 0.75, 0.95, and 0.43, respectively.  相似文献   

12.
Objective: To determine whether preoperative administration of erythromycin or flunixin meglumine altered postoperative abomasal emptying rate, rumen contraction rate, or milk production in dairy cattle undergoing surgical correction of left displacement of the abomasum (LDA). DESIGN: Nonrandomized, controlled clinical trial. ANIMALS: 45 lactating Holstein-Friesian cows with LDA. PROCEDURES: Cows were alternately assigned to an erythromycin (10 mg/kg [4.5 mg/lb], IM), flunixin (2.2 mg/kg [1.0 mg/lb], IV), or control group (n = 15/group). Treatments were administered once 1 hour before surgical correction of LDA. D-Xylose solution (50%; 0.5 g/kg [0.23 g/lb]) was injected into the abomasal lumen during surgery, and venous blood samples were periodically obtained to determine time to maximum serum D-xylose concentration. RESULTS: Abomasal emptying rate was significantly faster in cows treated with erythromycin (mean +/- SD time to maximum serum D-xylose concentration, 149 +/- 48 minutes) than in control cows (277 +/- 95 minutes) but was not significantly different between cows treated with flunixin (230 +/- 49 minutes) and control cows. Cows treated with erythromycin had significantly greater milk production, relative to production before surgery, on postoperative days 1 and 2 than did control cows. Cows in the erythromycin and flunixin groups had a significantly higher rumen contraction rate on the first postoperative day than did control cows. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that preoperative administration of a single dose of erythromycin increased abomasal emptying rate, rumen contraction rate, and milk production in the immediate postoperative period in cows undergoing surgical correction of LDA.  相似文献   

13.
Seventeen cows with right displacement of the abomasum (rda) without abomasal volvulus, nine cows with abomasal volvulus and 10 clinically healthy cows were examined ultrasonographically. A 5.0 MHz transducer was used to scan the eighth to 12th intercostal spaces and the cranial and caudal aspects of the flank on the right side. The position, size and dorsal and ventral margins of the abomasum were determined at each imaging position. In both groups of diseased cows, the ventral abomasum contained fluid ingesta, which appeared hypoechogenic with diffuse echogenic stippling. The abomasal folds could be seen clearly as echogenic sickle-shaped structures within the ingesta. The dorsal abomasal gas cap varied in size and was characterised by reverberation artefacts, which appeared as echogenic lines running parallel to the body surface. Compared with the healthy cows, the abomasum was larger and located significantly closer to the midline of the dorsum in both groups of cows. Compared with the cows with rda, the abomasum in the cows with abomasal volvulus was significantly smaller in the eighth intercostal space and significantly larger in the 11th intercostal space. It was not possible to differentiate between rda and abomasal volvulus on the basis of the ultrasonographic findings.  相似文献   

14.
The objective of this study was to evaluate serum mineral and electrolyte concentrations at the time of on-farm diagnosis of left displaced abomasum, right displaced abomasum, or abomasal volvulus in dairy cows. Data were collected from 104 affected cows and 96 control cows matched with cases, based on herd, parity, and stage of lactation. Cows with abomasal displacement or volvulus had significantly lower calcium, phosphorous, magnesium, potassium, and chloride concentrations and increased anion gap at the time of diagnosis compared with control cows from the same herds. The percentages of cases and controls with total serum calcium concentrations below the lower limit of the laboratory reference range (2.08 mmol/L [8.3 mg/dL]) were 70% and 23%, respectively. Based on the large percentage of cases with hypocalcemia, administering calcium salts at the time of treatment of field cases of abomasal displacement or volvulus may be beneficial.  相似文献   

15.
The case records of 102 cows with abomasal volvulus and 71 cows with right-side displacement of the abomasum (RDA) were examined to determine whether the preoperative base-excess concentration of the extracellular fluid could be used both as a prognostic indicator for post-operative recovery in cattle with abomasal volvulus and as an aid in differentiating between abomasal volvulus and RDA. The survival rate of cows with abomasal volvulus decreased as the base excess concentration decreased (P = 0.08); the lowest survival rate was observed in cows with base excess less than or equal to -0.1 mEq/L. There was a significant difference (0.01 less than P less than 0.025) among base excess ranges between abomasal volvulus and RDA. All cows with preoperative base-excess concentrations less than or equal to -5.0 mEq/L had abomasal volvulus, rather than RDA.  相似文献   

16.
Clinical and surgical findings in 458 dairy cows with right displacement of the abomasum or abomasal volvulus (AV) were analyzed to determine the association between these variables and the outcome (productive, salvaged, or terminal) of the affected cow. Heart rate at initial examination was higher in the salvaged and terminal groups of cows (P less than 0.0001) than in the productive group. The plasma Na+ concentration was lower in the salvaged and terminal groups of cows (P less than 0.0001) than in the productive group. The plasma C1- concentration was lower in the salvaged group of cows than in cows with either productive or terminal outcomes (P less than 0.0001). Anion gap was significantly higher (P less than 0.0001) in the salvaged and terminal groups than in cows classified as productive. On the basis of surgical findings, cattle with right displacement of the abomasum were more likely to survive than cows with AV. Cows that required fluid decompression of the abomasum via abomasotomy were less likely to survive than those in which gaseous decompression was performed. Cows with evidence of vascular compromise of the abomasal wall were less likely to survive than those with normal abomasal serosa. Preoperative heart rate and anion gap had positive correlations with the presence of abomasal necrosis, whereas temperature, venous blood pH, plasma bicarbonate, and base excess concentrations had negative correlations. Cows in terminal stages of AV were likely to have a mixed primary acid-base disturbance, consisting of metabolic alkalosis with superimposed metabolic acidosis. These findings were highly correlated with abomasal necrosis.  相似文献   

17.
The objective of this study was to compare the clinical and laboratory consequences of left and right displacement of the abomasum (LDA and RDA), short- and long-term survival after surgery and the findings in cows, that could not be cured by omentopexy. Data from 564 cases of displaced abomasum (466 LDA, 98 RDA) were analysed retrospectively. Clinical and laboratory findings were compared between the two manifestations of DA. Survival was assessed after 10 days and after 15 months. Necropsy was carried out on cows that died or were killed. On arrival at the clinic, left displacement of the abomasum (LDA) cows had been recognized as diseased for longer. LDA occurred earlier in lactation, and more cows with right displacement of the abomasum (RDA) were pregnant. Overall clinical symptoms were more severe in RDA than in LDA cows. Heart rate was higher, body temperature was lower, inanition, abnormal faeces and ruminal stasis were more frequent in RDA cows. Leucocyte counts were higher, and potassium and chloride levels were lower in RDA cows. Acetonuria was more frequent in LDA cows. More LDA than RDA cows were released from the clinic as cured (82.0% versus 74.5%). However, survival after the early post-surgical period was similar for RDA and LDA cows. At necropsy, diseases of the gastrointestinal system were the predominant finding in RDA cows, while in LDA cows, diseases of the liver and other concurrent diseases were more important.  相似文献   

18.
A hospital-based case-control study was conducted to evaluate and compare risk factors for abomasal volvulus (AV) and left displaced abomasum (LDA) in cattle. Medical record abstracts were derived from 17 North American veterinary schools by the Veterinary Medical Data Program for all cattle admitted between Jan 1, 1977 and Dec 31, 1986, and for those with a diagnosis of AV or LDA. From a total of 108,956 individual cattle records, 1,036 cases of AV and 7,695 cases of LDA were identified, with a ratio of LDA to AV cases of 7.4 to 1. In-hospital mortality was 23.5% for AV and 5.6% for LDA. Age, breed, gender, and season each had significant (P less than 0.05) effects on risk for AV and LDA. Risk for AV and LDA increased with increasing age, with greater risk in cattle aged 4 to 7 years. Dairy cattle were at higher risk of developing AV (adjusted odds ratio, 36.4) and LDA (adjusted odds ratio, 95.2) than were beef cattle. The odds of AV in Brown Swiss cattle were significantly (P less than 0.0001) lower, and the odds of LDA in Guernsey cattle were significantly (P less than 0.0001) higher than those in Holstein cattle. Female cattle were also at higher risk of developing AV (adjusted odds ratio, 3.3) and LDA (adjusted odds ratio, 29.1) than were male cattle. The odds of AV and LDA varied considerably throughout the year, with the lowest number of cases observed in autumn. Seasonal development of AV differed significantly (P less than 0.0001) from that of LDA, with the odds of AV and LDA being highest in January and March, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

19.
OBJECTIVE: To determine the correlation between insulin concentrations and myoelectrical activity of the abomasum in cows with a left displaced abomasum (LDA). ANIMALS: 14 dairy cows with an LDA at the onset of lactation. PROCEDURE: During surgical correction of an LDA, 3 pairs of electrodes were placed in the smooth muscle of the gastrointestinal tract (abomasal body, pars pylorica, and duodenum) of each cow. Electromyographic recordings were obtained once per day for 7 days. Samples were collected and tested to determine concentrations of insulin, glucagon, cortisol, glucose, beta-hydroxybutyrate, and nonesterified fatty acids. RESULTS: All 14 cattle had high glucose and insulin concentrations at the time of admission, independent of ketosis. Concentrations of glucose and insulin decreased slowly after surgical treatment and were associated with a progressive increase in abomasoduodenal myoelectric activity. The 14 cows were allocated into 2 groups (suspected insulin-resistant cattle, n = 7; suspected non-insulin-resistant cattle, 7) on the basis of persistent hyperinsulinemia during the postoperative period. Seven days after surgery, the abomasoduodenal myoelectric patterns were still significantly lower for the insulin-resistant cows, compared with patterns for the non-insulin-resistant cows. CONCLUSIONS AND CLINICAL RELEVANCE: Insulin resistance appears to be common in cows with an LDA. Analysis of results of this study reveals that abomasal atony in cows with an LDA depends on persistence of high serum concentrations of insulin. Results of this study could provide an explanation for a pathogenetic factor of LDAs and the frequent relapses of cattle affected by this condition.  相似文献   

20.
Objective— To determine the effects of preoperative erythromycin or combined dexamethasone/vitamin C treatment on postoperative abomasal emptying rate in cows undergoing surgical correction of abomasal volvulus (AV).
Study Design— Prospective, controlled, clinical study using a convenience sample.
Animals— Lactating Holstein–Friesian cows (n=45) with AV were alternately assigned to 3 groups (n=15): group C: untreated (control); group E: erythromycin (10 mg/kg intramuscularly [IM]); group D: dexamethasone (0.02 mg/kg intravenously [IV]) and vitamin C (10 mg/kg IV).
Methods— Drugs were administered 1 hour before surgical correction of AV. d -xylose solution (50%, 0.5 g/kg body weight) was injected into the abomasal lumen during surgery. Jugular venous blood samples for determination of serum d -xylose concentration were periodically obtained. Time to maximal serum d -xylose concentration (Tmax-model) was pharmacokinetically determined.
Results— Abomasal emptying rate was significantly ( P <0.05) faster in group E (Tmax-model=182±69 min; mean±SD) than in group C cows (Tmax-model=237±64 min). Abomasal emptying rate was similar in group D (Tmax-model=196±47 min) and group C. Both treatments improved postoperative milk yield within 1 day after surgery.
Conclusion— Preoperative injection of erythromycin (10 mg/kg IM) is an effective method for ameliorating postoperative abomasal hypomotility in cows with AV.
Clinical Relevance— Parenteral erythromycin can be recommended for preoperative treatment of cows with AV.  相似文献   

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