Obstruction of the Ascending Colon in Cattle: I. Clinical Presentation and Surgical Management

Obstruction of the spiral loop of the ascending colon (spiral colon) due to adhesions causing extraluminal constriction was diagnosed in 8 cows during a 2-year period. The adhesions resulted from intraperitoneal injections in 7 cows and from previous intra-abdominal surgery in the 8th. Surgical correction was performed in 4 of the cows by uniting the bowel proximal and distal to the obstruction, thus creating an intestinal bypass. Approximately half of the large intestine was bypassed in this manner in 3 cows; all but a portion of the descending colon and rectum was bypassed in the 4th. Each of the cows survived surgery, although 1 died 30 days later, possibly as a result of a second obstruction caused by further adhesions. Appetite, general physical condition, and milk production returned after celiotomy and intestinal bypass. Feces were loose after operation but gradually firmed to near-normal consistency in 3 of the cows.     

Myoelectric activity in the intestine of cows with strangulating obstruction of the distal small intestine

Myoelectric activity in 2 cows instrumented with permanent electrodes in the ileum, cecum, proximal loop of the ascending colon (PLAC), and spiral colon was analyzed after an obstruction developed in the distal small intestine. Results were compared with patterns from a group of 7 normal cows. Myoelectric activity in the ileum immediately orad to the occlusion was characterized by abolition of the migrating myoelectric complex (MMC) and a constant pattern of strong spike bursts of long duration. Cyclic activity was present in all parts of the large intestine, and propagation of phase III activity was evident from proximal to distal. A slight degree of disorganization in phase III propagation was restricted to the spiral colon. Activity cycles tended to be shorter in the cecum and PLAC of both cows with colic than in normal cows, and the intensity of spiking activity was generally lower. Changes in duration of the MMC in the spiral colon (bovine colonic MMC, bcMMC) were inconsistent, but the intensity of spiking activity tended to be lower in phases I and II of both cows compared to controls. The organization of phase III in several spindles typical of the bovine spiral colon was not disrupted, but phase IV of the bcMMC occurred only infrequently. Organized cyclic activity occurred in the large intestine of both cows despite complete disruption of the small intestinal MMC, indicating the presence of mechanisms able to initiate and regulate coordinated myoelectric patterns in the large intestine independent of the small intestine.     

Myoelectric activity of the spiral colon in dairy cows

OBJECTIVE: To describe myoelectric activity of the spiral colon in healthy cows. ANIMALS: 7 lactating Simmental X Red-Holstein crossbred cows. PROCEDURE: Cows were implanted with 7 pairs of bipolar silver electrodes (4 in the spiral colon and 1 each in the cecum, distal part of the ileum, and proximal loop of the ascending colon [PLAC]). Myo-electric activity was recorded during 4 days for each cow. Patterns were analyzed, using computer-based methods. RESULTS: Myoelectric activity of the spiral colon was closely associated with motility of the ileum and PLAC and showed the typical organization of migrating myoelectric complexes (MMC). The MMC in the bovine spiral colon (bcMMC) had a mean +/- SD duration of 188.6 +/- 30.8 minutes and was divided into 4 phases. Phases I and II lasted 11.3 +/- 1.4 and 159.4 +/- 33.3 minutes, respectively. Phase III (duration, 5.4 +/- 1.2 minutes) was characterized by 5.2 +/- 0.9 regular spindles (35.4 +/- 5.4 seconds) and 1 final elongated spindle (137.2 +/- 56.4 seconds). Phase III most commonly (73.8 +/- 16.1%) was followed by phase IV (duration, 173 +/- 3.6 minutes). Propagation velocity of phase III was 4.4 +/- 0.5 cm/min, and 13.6% of bcMMC were incompletely propagated through the spiral colon. CONCLUSIONS: Myoelectric activity of the bovine spiral colon is composed of a recurring cyclic pattern similar to MMC of the small intestine. Data of colonic myoelectric activity in healthy cows will serve as a basis for studies on cecal dilatation and dislocation in cattle.     

Quantitative mRNA analysis of muscarinic acetylcholine receptors in the intestine of dairy cows with spontaneous caecal dilatation-dislocation

Muscarinic receptors mediate acetylcholine-induced muscular contractions. In this study, mRNA levels of muscarinic receptor subtypes 2 and 3 (M(2) and M(3)) in the ileum, caecum, proximal loop of the ascending colon (PLAC) and external loop of the spiral colon (ELSC) were determined by quantitative polymerase chain reaction in seven cows with caecal dilatation-dislocation (CDD) and seven healthy control cows. Levels of M(2) were significantly lower in the caecum, PLAC and ELSC and levels of M(3) were significantly lower in the ileum, caecum, PLAC and ELSC of cows with CDD compared to healthy cows (P<0.05). Down-regulation of M(3) may play a role in the pathogenesis of CDD.     

Clinical management and surgical repair of atresia coli in calves: 66 cases (1977-1988).

The medical records of 66 calves with atresia coli were reviewed; 64 calves were examined at the New York State College of Veterinary Medicine, and 2 calves were examined at the New Bolton Center. In each case, the site of the atresia was within the spiral loop of the ascending colon. In 1 of these calves, a segment of jejunum was also atretic. Absence of feces, progressive weakness, and abdominal distension were the most common clinical signs observed. Other congenital abnormalities were detected in 12 (18%) of 66 calves. Of the 66 calves examined, 5 were euthanatized or died on admission, and 61 had an exploratory celiotomy performed. Eight calves were euthanatized or died during the surgery. In the remaining 53 calves, surgical treatment consisted of enterotomy followed by meconium evacuation, resection of the proximal blind end (in 30 calves), and restoration of intestinal continuity. Restoration of intestinal continuity was done either by side-to-side anastomosis of the proximal to distal blind ends (5 calves), or by side-to-side or end-to-side anastomosis of the proximal blind end to the descending colon (48 calves). Of the 66 calves seen, 27 (41%) were discharged from the hospital, and 11 of these reached reproductive age (11 calves were lost to follow-up before they were 2 years old). From the 11 calves reaching reproductive age, 33 calves were born, one of which may have had atresia coli. The owners should anticipate that long-term survivors likely will have loose feces and normal offspring, but may not grow as well as otherwise expected.     

Myoelectric activity in the intestines of healthy dairy cows during the recovery period after implantation of permanent electrodes

OBJECTIVE: To describe myoelectric patterns in the intestines of cows after electrode implantation. ANIMALS: 7 lactating Simmental-Red Holstein cows. PROCEDURE: Cows were implanted with 7 pairs of bipolar silver electrodes (1 each in the ileum, cecum, and proximal loop of the ascending colon (PLAC) and 4 in the spiral colon). Myoelectric activity was monitored during 10 periods within the first 3 weeks after surgery. Recordings from the first 2 weeks were compared with recordings from the third week, which was considered a steady-state condition. RESULTS: Significant changes over time were detected for 18 of 57 variables, including 3 variables describing myoelectric activity of the ileum, 6 variables of the cecum, 6 variables of the PLAC, and 3 variables of the spiral colon. Compared with values for the steady-state condition, 16 variables differed significantly for the 14-day period after surgery (7 variables until day 11, 2 variables until day 8, 4 variables until day 5, 1 variable until day 3, and 2 variables until day 2 after electrode implantation). None of the variables had significant changes that lasted only 1 day after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Significant changes were observed for several variables of myoelectric activity in all intestinal segments until as late as 11 days after electrode implantation, whereas a steady-state condition was reached 14 days after surgery. Effects of drugs, manipulations, or nutrition regimens on myoelectric activity of the bovine digestive tract should be evaluated no sooner than 2 weeks after electrode implantation.     

Colonic atresia in cattle: A prospective study of 43 cases

This prospective study was initiated to document the success rate obtained in the treatment of colonic atresia in calves, identify factors that influence survival rate, and to report the histopathological appearance of the proximal blind end of the ascending colon. Forty-three calves with intestinal obstruction due to colonic atresia were admitted to the Ontario Veterinary College between September 1982 and May 1986. Parameters recorded prospectively in this study included age, breed, sex, history, vital signs, acid-base and electrolyte status, location of intestinal atresia, medical and surgical management, and outcome. The typical history and clinical signs included failure to pass meconium or feces, decreased appetite, and progressive depression and abdominal distension. The most common site of colonic atresia was the midportion of the spiral loop of the ascending colon (n = 25). Of the 43 calves, three (7%) were euthanized at surgery, 21 (49%) died in the hospital, and 19 (44%) survived and were discharged from the hospital. Four of the surviving calves died subsequent to discharge giving an overall long-term (mean 15.9 months) survival rate of 35%. No significant risk factors were identified, although experienced surgeons showed a trend towards increased survival rate.     

Gross Anatomy of the Intestine in the Giraffe (Giraffa camelopardalis)

We describe the macroscopic anatomy of the intestine of the giraffe (Giraffa camelopardalis). The small intestine was divided into duodenum, jejunum and ileum as usual. The caecum was attached to the ileum by a long ileocaecal fold, and to the proximal ansa of the ascending colon by a caecocolic fold. The ascending colon was the most developed portion of the gross intestine and had the most complex arrangement with three ansae: the proximal ansa, the spiral ansa and the distal ansa. The proximal ansa completely encircled the caecum, describing a 360° gyrus, and represented the widest portion of the intestine. The spiral ansa was formed by three and a half centripetal gyri, a central flexure and three centrifugal gyri. The last centrifugal gyrus left the spiral and described nine flexures of different form and direction over the left side of the mesentery. The two portions that formed each of these flexures ran parallel to each other. The last part of this gyrus ran parallel to the jejunum. When compared with domestic cattle, giraffe had a comparatively short small intestine and a comparatively long large intestine, with a resulting small ratio of small:large intestine. Reasons are presented why this should be considered a peculiarity of cattle‐like ruminants rather than a different representative of a browser–grazer dichotomy in general.     

Uptake of ferritin by follicle-associated epithelium in the colon of calves.

Uptake of macromolecules (e.g., ferritin) by M cells in follicle-associated epithelium in small and large intestine was investigated in three healthy, conventionally raised, 2- to 3-week-old, female Holstein Frisian calves. A 2.5% solution of ferritin was injected into the ligated loops in mid-jejunum, in terminal ileum, in the ascending colon adjacent to the ileocecal junction, and in the proximal loop of the ascending colon containing gut-associated lymphoid tissue. After exposure times that ranged from 82 to 165 minutes, ferritin was detected in M cells of domes in the small intestine, as well as in cells in follicle-associated epithelium of proprial lymphoid nodules and lymphoglandular complexes of colon that morphologically resembled M cells of small intestine. Ferritin was found in apical invaginations, apical vesicles, multivesicular bodies, basal vesicles, and adjacent intercellular spaces. In addition to ferritin, apical vesicles, multivesicular bodies, and intercellular spaces contained 50-nm membrane-bound particles. More ferritin was endocytosed by M cells of the small intestine than by M cells of the large intestine. In the large intestine, higher amounts of ferritin were found in M cells of follicle-associated epithelium overlying proprial lymphoid nodules than in M cells of follicle-associated epithelium in the depth of lymphoglandular complexes. Based on these results, we concluded that M cells of follicle-associated epithelium in the colon of calves provide a route for antigen uptake into the intestinal lymphoid system.     

Gut-associated lymphoid tissue in the large intestine of calves. I. Distribution and histology

Gut-associated lymphoid tissue (GALT) in the large intestine was characterized in 12 calves (10 to 84 days old) obtained at necropsy (7, group A) or healthy animals (5, group B). Patches of mucosal lymphoid follicles were in all calves at ileocecal entrances (ICE), 23-42 cm distal to the ICE in the proximal loop of the ascending colon (proximal colon [PC] patch), and in the terminal rectum. PC patches varied from 8 to 30 cm in length. Solitary lymphoid follicles were found in the cecum of three calves, between the ileocecal entrances and the PC patch in four calves, adjacent to the PC patch in all calves, and in the ampulla recti. GALT occupied 7.8% of the large intestinal wall in animals of group A: 0.6% at the ileocecal entrance, 4.8% in the proximal colon, and 2.4% in the rectum. There were two different types of mucosal lymphoid follicles in group B: propria nodules with lymphoid follicles predominantly in the lamina propria, and lymphoglandular complexes with lymphoid follicles in the submucosa. In three 3-, 6-, and 7-day-old, germfree calves, distinct follicle-associated epithelium covered propria nodules and covering folds in depths of the lymphoglandular complexes; it was characterized by numerous intraepithelial cells and lack of goblet cells.     

Arterial Vascularization of the Gastrointestinal Tract of the Pampas Deer (Ozotoceros bezoarticus,Linnaeus, 1758)

Based on gross dissection of fifteen adult animals (11 females, 4 males), we described the arterial supply of the stomach and intestines of the pampas deer (Ozotoceros bezoarticus), a South American endangered species. The coeliac artery emitted the splenic, left gastric and hepatic arteries. The splenic artery directed towards the spleen, and the right ruminal artery, which is its only collateral directed towards the stomach, being the main artery of the rumen. The left gastric artery gave origin to the left ruminal, the reticular and the left gastroepiploic arteries. The left gastroepiploic artery originated the reticular accessory artery. Both arteries, gastric and left gastroepiploic, anastomosed their right counterparts derived from the hepatic artery on the curvatures of the abomasum. The cranial mesenteric artery irrigated the second half of the duodenum until the beginning of the descending colon. The thickest branch emitted by the cranial mesenteric artery was the ileocolic artery, which was destined to the ascending colon, caecum and ileum. The colic branches and the right colic arteries were irradiated on the right surface of the spiral loop of the ascending colon and distributed to both centripetal and centrifugal coils of the ascending colon; the colic branches were also anastomosed with the last jejunals and ileals and with the right colic arteries. There were no variations in the origin of any of the main branches derived from the coeliac and cranial mesenteric arteries. This species had a basic pattern of arterial distribution similar to small domestic ruminants.     

Spiral colon bypass in a geriatric Vietnamese potbellied pig

An 8-year-old potbellied pig was evaluated for anorexia, decreased fecal production, signs of depression, inappetence, and abdominal distension. During hospitalization, a tooth root impaction and abscess were diagnosed, and abdominal radiography revealed severely distended, gas-filled large and small intestines. Exploratory laparotomy revealed a stricture of the proximal centripetal loop of the spiral colon and megacolon of the proximal portion of the spiral colon and cecum. A side-to-side spiral colon anastomosis was performed to create a partial bypass of the spiral colon. The success of this procedure suggests that spiral colon bypass is a treatment option for spiral colon stricture formation in potbellied pigs. Spiral colon stricture formation should be considered as a differential diagnosis in geriatric potbellied pigs that are anorectic, have abdominal distension, and have decreased fecal production.     

The topography and gross anatomy of the gastrointestinal tract of the Cape dune mole-rat (Bathyergus suillus)

The Cape dune mole-rat, Bathyergus suillus, is the largest truly subterranean rodent in the world and is restricted to sandy soil areas of the southern and South-western Cape Province. These animals are herbivorous, feeding mostly on the below ground portions of grass and geophytes. The present study was undertaken to explore whether there are any gross anatomical gastrointestinal adaptations associated with the herbivorous diet of the Cape dune mole-rat and to provide a basis for further investigations into the nutrition and ecology of this animal. The stomach was unilocular (simple) and the entire internal aspect displayed macroscopically visible glandular epithelium. The caecum was voluminous and arranged into a spiral of approximately one and a half turns. The tip of the caecum resembled a vermiform appendix and lay against the left lateral abdominal wall. The ascending colon consisted of proximal and distal portions, arranged in a large double loop and attached to each other by a fat-filled mesenteric fold. The looped, folded ascending colon filled the right side of the abdominal cavity, lying against the right dorsal, lateral and ventral abdominal wall. The internal structure of the ascending colon revealed a shallow groove, lined on either side by a row of papillae. The simple, glandular stomach in conjunction with a prominent caecum and a greatly enlarged ascending colon suggests that this animal is a hindgut fermenting herbivore, rather than a caecal fermenter, as is the case in most rodent species.     

Effects of erythromycin on myoelectric activity of the spiral colon of dairy cows

The effects of erythromycin on myoelectric activity of the spiral colon of dairy cows were investigated in a prospective study. Four Simmental x Red-Holstein crossbred cows of similar body weight and condition with seven pairs of bipolar electrodes implanted in the intestine (one each in the distal ileum, caecum and proximal colon, and four in the spiral colon) were included. Erythromycin lactobionate (1 mg kg(-1)) and 0.9% sodium chloride solution (NaCl) were administered to each cow in a random order. Erythromycin was diluted with NaCl and both treatments were administered slowly intravenously over a period of 5 min 1 h after onset of a phase III of the bovine colonic migrating myoelectric complex (bcMMC). A 3-6-day washout period was scheduled between trials. Significant differences between the results of the treatments were observed for spike duration in phase I as well as for spike duration and duration of spiking activity during phase II of the second bcMMC, which were significantly higher after erythromycin treatment than after NaCl. These findings suggest an indirect effect of erythromycin on colonic motility in cattle.     

The venous supply of the cecum, ileum, and the proximal loop of the ascending colon in the ox

The present study describes in detail the venous supply to the bovine cecum, ileum, and the proximal loop of the ascending colon. The cecum was supplied by branches from the cecal and accessory cecal veins. The accessory cecal vein was observed in the majority of the specimens examined. The cecal and accessory cecal veins were joined by 7–10 short oblique anastomoses. The ileum was supplied by the ileal branches of the cecal vein, and from the mesenteric ileal and first ileal (cranial mesenteric) veins. The ileal branches of the cecal vein formed a row of antimesenteric ileal arches in the ileal part of the ileocecal fold. The mesenteric ileal vein, in some cases, detached a collateral branch. The first ileal and the mesenteric ileal veins anastomosed on the ventral surface of the ileum. The initial loop of colon was supplied by branches from the ileocolic vein. In the majority of specimens, the common colic, a branch of the cranial mesenteric vein, supplied the first colic branch to the third part of the initial colon. In such cases, the ileocolic vein gave off only the second and third colic branches. However, in one case, the proximal loop of the ascending colon was supplied by three colic branches of the ileocolic vein and by the first colic branch of the common colic vein. In specimens in which the common colic vein was absent, the colic branches to the initial colon were all given off by the ileocolic vein. The third (or fourth) colic branch of the ileocolic vein and the first cecal branch of the cecal vein united on the lateral surface of the ileocecocolic junction to form an ileocecocolic arch. The veins on the medial surface of the ileocecocolic junction did not form an arch. The colic and ileal lymph nodes were supplied by twigs from the colic branches of the ileocolic vein and first ileal vein of the cranial mesenteric, respectively. The small cecal lymph nodes seen only in the specimen from the calf were supplied by fine branches from the cecal vein.     

The Arterial Supply to the Ileum, Cecum and Proximal Loop of the Ascending Colon in the Ox*

This study describes in detail the arteries supplying the ileum, cecum and proximal loop of the ascending colon in the ox important to the veterinary surgeon treating disorders of these segments of the intestinal tract. The ileum was vascularized by the mesenteric ileal artery (from the ileocolic), the first ileal artery (from the cranial mesenteric) and by the ileal branches of the cecal artery which, by means of their anastomoses, form a row of antimesenteric arches in the ileal part of the ileocecal fold. The termination of the ileum was also supplied by twigs from the ileocecocolic arch. The ileum appears to be the most vascular part of the small intestine. The cecum was supplied mainly by the cecal branches of the cecal artery. The proximal end of the cecum was also vascularized by branches from the ileocecocolic arch. The proximal loop of the colon was vascularized by the three colic branches of the ileocolic. The first colic branch supplied the third part of the loop, the second colic branch supplied the first and the second parts of the loop and the third colic branch supplied the first part and, together with the first cecal branch of the cecal artery, formed the ileocecocolic arch at the dorsolateral surface of the ileocecocolic junction. The terminal branches of the arteries to the ileum, cecum and proximal loop of the colon detached lateral branches in the tunica muscularis which anastomosed with similar branches from neighboring arteries in an arcuate manner in the tunica submucosa. The terminal branches from both sides terminated in the free border, releasing branches which anastomosed with each other in the tunica submucosa. The colic lymph nodes were supplied by the colic branches of the ileocolic artery, die two largest nodes being perforated by some of the branches of the first two colic branches. The ileal lymph nodes were supplied by the ileal arteries of the cranial mesenteric. They were also perforated by these arteries. Cecal lymph nodes were seen only in the specimen from the calf. They were much smaller than the colic and ileal nodes and were supplied by the first two or three cecal branches of the cecal artery and also by twigs arising directly from the cecal artery.     

Variability in the localization of cryptosporidia in the intestines of spontaneously infected calves

31 to 37 localities were examined in the small and large intestines of 48 calves spontaneously infected with cryptosporidiosis. It was found that cryptosporidia occurred the most frequently in the distal part of small intestine, within the range of six metres of small intestine, in front of the ostium ileocecale (OIC); at the ileocecal valve the incidence of cryptosporidia dropped rapidly. In none case were the protozoans revealed in duodenum and in the adjacent four to six metres of proximal jejunum. The small intestine was invaded by cryptosporidia in a variable manner, in some cases a major part was continuously invaded, in other cases only one or two metres of distal jejunum without any changes in the ileum and vice versa. Approximately half the calves had cryptosporidia in the cecum, fewer cryptosporidia were found in the transverse colon. Cryptosporidia in the rectum were found in about 25% of cases. Some calves had cryptosporidia only in the large intestine. The intensity of the mucous membrane invasion varied: mass incidence of cryptosporidia was found only in caudal parts of small intestine, with high variability of the extent and with sudden cases of negative findings. In the large intestine only the cecum was invaded more intensively and in a diffusive manner, in the transverse colon and in the rectum the groups of parasites were usually found at the openings and in the wall of Lieberk uhn 's crypts.     

Strangulating obstruction caused by intestinal herniation through the proximal aspect of the cecocolic fold in 9 horses

OBJECTIVE: To report the clinical and surgical findings and outcome for horses with strangulating obstruction caused by herniation through the proximal aspect of the cecocolic fold. STUDY DESIGN: Retrospective study. ANIMALS: Nine horses. METHODS: Medical records were reviewed for clinical signs, surgical findings and technique, and outcome. Cadaver ponies and necropsy specimens were also used to study the regional anatomy of the cecocolic fold. RESULTS: The ileum and distal jejunum were strangulated in 8 horses, whereas in 1 horse the small intestine and the left ascending colons were incarcerated in a rent in the cecocolic fold. Two horses were euthanatized at surgery, 6 horses had a small intestinal resection (mean length, 3 m; range, 1.5-6.4 m) and an end-to-side jejunocecostomy, and the entrapment was reduced without resection in the horse that had small intestine and ascending colon incarceration; cecocolic fold defects were not closed. One horse was euthanatized 36 hours after surgery because of endotoxemia. Six horses were discharged; 4 were available for long-term follow-up, of which 2 were euthanatized, and 2 were euthanatized 12 and 18 months after surgery because of colic signs. Variations in thickness of the cecocolic fold were observed in specimens obtained from necropsy of other horses and ponies. CONCLUSIONS: Reasons for this defect are unknown, although observed anatomic differences in cecocolic fold thickness may contribute to the development of defects. CLINICAL RELEVANCE: Reduction of the entrapped bowel is easiest when traction is placed on the bowel at a 90 degrees to the base of the cecum. Intestinal incarceration through rents within the proximal part of the cecocolic fold should be considered as a differential diagnosis for strangulating obstruction in horses.