Peritoneal fluid analysis in dairy cows with left displaced abomasum and abomasal volvulus

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.     

Factors influencing the survival of dairy cows after correction of left displaced abomasum

OBJECTIVE: To determine factors that influenced culling or death of cows with left displaced abomasum (LDA) subsequent to correction by a roll-and-toggle (R&T) procedure or via laparotomy. DESIGN: Cohort study. ANIMALS: 810 Holstein dairy cows with LDA. PROCEDURES: Data regarding method of repair and risk factors for survival after correction of LDA were collected during a 1-year period. Outcomes were compared at days 14 and 60 after LDA correction for 3 groups of cattle (veterinarians performed R&T [V-R&T], herd personnel performed R&T [H-R&T], and veterinarians performed surgical repair via laparotomy [V-Surg]). RESULTS: Survival rates 14 days after LDA correction for the V-R&T, H-R&T, and V-Surg groups were 87% (286/329), 81% (327/403), and 85% (66/78), respectively. At 60 days after LDA correction, survival rates for the V-R&T, H-R&T, and V-Surg groups were 79% (260/329), 71% (286/403), and 73% (57/78), respectively. Multivariable analysis indicated that factors positively associated with failure to remain in the herd at 60 days after LDA correction included current mastitis status, history of a previous LDA, high preoperative risk, and correction of LDA by herd personnel rather than by a veterinarian. CONCLUSIONS AND CLINICAL RELEVANCE: Correction of LDA by veterinarians via an R&T procedure yielded results that were generally comparable to those for correction by veterinarians via laparotomy. Although survival rates at days 14 and 60 after surgery differed significantly between the V-R&T and H-R&T groups, herd personnel in this study used the R&T procedure to correct LDA and achieved survival rates within the range for those of practicing veterinarians.     

Prevalence of endotoxemia in healthy postparturient dairy cows and cows with abomasal volvulus or left displaced abomasum

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.     

Comparison of abomasal luminal gas pressure and volume and perfusion of the abomasum in dairy cows with left displaced abomasum or abomasal volvulus

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.     

Glucose tolerance test during abomaso-duodenal electromyography in three cows operated for left displaced abomasum

The objective of the study was to analyze glucose metabolism and abomasal myoelectrical activity during an intravenous glucose tolerance test in cows operated for LDA. Three dairy cows, at the onset of lactation, suffering from left displaced abomasum were selected from the animals presented at the clinic. During surgical therapy, one pair of electrodes was placed in the smooth muscle of the abomasal body, the pars pylorica and the duodenum respectively. The animals were subjected to electromyography on five occasions during hospital admittance (Days 1, 2, 3, 5 and 7 post-operative); their insulin, glucagon, glucose, beta-hydroxybutyrate and NEFA levels were then measured. Two days after surgery, the animals were subjected to an intravenous glucose load (300 g glucose in 30 min) during abomaso-duodenal electromyography. The findings indicate that the three animals had glucose metabolism disorders during hospitalization. The abomaso-duodenal myoelectric activity of Cows 1 and 3 was lower than in Cow 2. During the glucose load, the analysis of hormones and metabolites showed that there were different degrees of reactivity and that myoelectric activity differed in the 3 cows. The results of the study suggest that despite the surgical reposition of the abomasum, disorders of abomasal motility persist in different degrees in cows operated for LDA and could be influenced by glucose administrations.     

Use of the D-xylose absorption test to measure abomasal emptying rate in healthy lactating Holstein-Friesian cows and in cows with left displaced abomasum or abomasal volvulus

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.     

Effect of preoperative administration of erythromycin or flunixin meglumine on postoperative abomasal emptying rate in dairy cows undergoing surgical correction of left displacement of the abomasum

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.     

Evaluation of rumen transfaunation after surgical correction of left-sided displacement of the abomasum in cows

OBJECTIVE: To evaluate rumen transfaunation after surgical correction of left-sided displacement of the abomasum (LDA) in cows. DESIGN: Prospective clinical trial. ANIMALS: 20 multiparous cows with LDA. PROCEDURES: Cows with LDA were treated surgically (day 0). On days 0 (immediately after surgery) and 1, 10 cows each received 10 L of rumen fluid (transfaunated group) or 10 L of water (control group) via a stomach tube. Postoperative dietary dry-matter intake and milk yield of each cow were recorded daily for 5 days, beginning immediately after surgery. Blood and rumen fluid samples were collected prior to surgery and on days 1, 3, and 5 after surgery. Serum nonesterified fatty acid and beta-hydroxybutyrate concentrations were measured. Volatile fatty acid and ammonia concentrations and pH of rumen fluid were determined. Urine specimens were collected and tested for ketones at 8 AM and 4 PM. Cows with ketonuria were treated with 50% dextrose solution administered i.v. at the time ketonuria was first detected. Cows with ketonuria were treated twice daily until ketonuria resolved. RESULTS: All cows survived and completed their lactation. Daily and cumulative dry-matter intake and milk yield of cows in the transfaunated group were significantly greater than those of cows in the control group. Cows in the transfaunated group had significantly lower serum concentrations of beta-hydroxybutyrate and significantly lower acetate-to-propionate ratios in rumen fluid on day 1 after surgery, compared with cows in the control group. Cows that received transfaunate required a significantly lower total volume of dextrose administered i.v. than control cows. CONCLUSIONS AND CLINICAL RELEVANCE: Benefits of rumen transfaunation of cows after surgical correction of LDA included a lesser degree of ketonuria, greater feed intake, and higher milk yield, compared with nontransfaunated cows.     

Complications following the use of the closed suturing technique for correction of left abomasal displacement in cows

The closed suturing technique has been introduced as a quick, easy and cheap method of surgical correction of left sided abomasal displacement in cows. It is questionable if good reposition and fixation are always achieved using this technique. The closed suturing technique in four cases of left sided abomasal displacement was investigated. Additionally, six cases treated this way in general practice were investigated. It is concluded that from a surgical point of view the closed suturing technique should be rejected because it is unknown which abdominal structures are being sutured.     

Pyloric obstruction after toggle-pin fixation of left displaced abomasum in a cow

One potential complication of blind abomasopexy techniques, including the toggle-pin technique, is the possibility of creating pyloric outflow obstruction. Cows that have had left displaced abomasum corrected by this method should be observed closely for the first 48 postsurgical hours for signs of deterioration. If pyloric obstruction is suspected and the securing sutures are cut before fibrous adhesions have formed, permanent damage may be minimized.     

Changes in leukocyte populations of cows with milk fever or displaced abomasum after calving

Most of the metabolic diseases of dairy cows occur within the first 2 wk after calving, and cows with a metabolic disease are prone to infectious diseases. Although metabolic diseases are generally recognized as a risk factor for infectious diseases owing to the associated decrease in immune function, the difference in immune status between cows with milk fever (MF) or displaced abomasum (DA) during the lactation period has not been clarified. Therefore, the peripheral blood leukocyte populations in 38 multiparous Holstein cows from 1 herd were analyzed after calving. The cows were divided into 3 groups according to health: 21 cows that remained clinically healthy throughout the experimental period (control group), 9 cows that had MF on the day of calving, and 8 cows with an onset of DA within 4 wk after calving. The T- and B-cell numbers were lowest at week 0, and they increased gradually after calving. There was no significant difference between the 3 groups in the number of each subset of leukocytes on the day of calving, but the number of CD8⁺ T-cells was significantly lower in the MF and DA groups than in the control group at week 1. The numbers of CD4⁺, CD8⁺, and WC1⁺ T-cells tended to be lower in the DA group than in control group from weeks 4 to 12, a tendency not observed in the MF group. These data suggest that when cows have DA around the time of calving, their lymphocyte numbers remain lower until 12 wk after calving.     

Ultrasonographic findings in cows with right displacement of the abomasum and abomasal volvulus

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.     

Influence of fiber form in a complete mixed ration on incidence of left displaced abomasum in postpartum dairy cows.

During the fall of 1982, increased incidence of left displaced abomasum (LDA) was seen in a group of cows fed a complete pelleted ration (3/16 inch) at the university's dairy center during the early postpartum period. Of these, 17.4% developed LDA when fed this experimental ration, whereas only 1.6% of the remaining cows in the herd developed LDA. The latter cows (as a control) were fed loose alfalfa hay, sorghum silage, and an 18% crude protein mix. Most of the fiber in the experimental diet or pelleted diet was alfalfa hay (30% as-fed basis) that was ground through a quarter-inch screen for incorporation into the pellet. Another 10% of the dietary fiber was contributed by cottonseed hulls. Thus, increased incidence of LDA may be associated with short length of the dietary fiber in the pelleted form.     

Minimally invasive field abomasopexy techniques for correction and fixation of left displacement of the abomasum in dairy cows.

To reduce the potential drawbacks associated with laparotomy techniques for correction and fixation of left displaced abomasums (LDA), minimally invasive techniques have been developed. This chapter reviews the toggle pin suture (TPS) and the laparoscopic abomasopexy procedures used in the field for correction and fixation of the abomasum for correction of left-displacement of the abomasum in dairy cows. The importance of case selection cannot be overestimated. By combining laparoscopy with the principle of the TPS procedure, the lack of visual control associated with the TPS procedure is eliminated, while the advantage of the speed of completion and minimal invasiveness provided by both procedures are maintained. Successful LDA treatment includes not only early detection and treatment of the LDA, but also the prevention of secondary ketosis and aggressive treatment of concurrent disease.     

Changes in abdominal dimensions during late gestation and early lactation in Holstein-Friesian heifers and cows and their relationship to left displaced abomasum

The changes in abdominal dimensions and contour during late gestation and early lactation were investigated in 44 Holstein-Friesian cattle, 20 normal heifers and 17 normal cows, and seven cows that had a left displaced abomasum (LDA) surgically corrected by a right flank omentopexy in a previous lactation. Abdominal measurements were made eight times during the six months spanning the last trimester of pregnancy and the first three months of lactation, they included the circumference of the thorax and abdomen, the depth and width of the abdomen, the vertical distance between the ventral abdomen and the descending duodenum, the height at the withers, and the length of the trunk. There were significant changes in these dimensions during the last trimester of pregnancy, immediately after parturition and during the first three months of lactation. The depth of the abdomen and the vertical distance between the ventral abdomen and the descending duodenum were greater in the cows with a previous history of LDA than in those without.     

Bar suture (toggle pin) vs open surgical abomasopexy for treatment of left displaced abomasum in dairy cattle

Fifty-nine dairy cows with left displacement of the abomasum were randomly assigned to receive 1 of 2 treatments. Twenty-eight were treated by right paramedian abomasopexy via laparotomy, and 31 were treated by percutaneous fixation of the abomasum, using the bar suture or toggle pin technique. Comparisons of the 2 groups, at 4 follow-up examinations, yielded no significant differences in return to normal milk production, return to normal feed intake, mortality, culling rate, tissue reaction at the surgical site, or redisplacement up to 60 days into the subsequent lactation.     

Relationships between lactational incidence of displaced abomasum and milk production traits in German Holstein cows

The objective of this study was to analyse the heritabilitiy of the lactational incidence of displaced abomasum (DA) and the relationships of DA with milk production traits in German Holstein cows. Data were recorded between February 1999 and January 2000 in cooperation with five veterinary practitioners. Their veterinary practices were located in the northern part of Lower Saxony. The investigation included 160 dairy farms under the official milk-recording scheme with 9,315 cows. The lactational incidence of the left abomasal displacement amounted to 1.21%, and of the right abomasal displacement to 0.41%, respectively. The linear heritability estimates for the lactational incidences of left and right DA were h(2) = 0.05 +/- 0.012 and h(2) = 0.004 +/- 0.005, respectively. Using the Dempster-Lerner-transformation the corresponding heritabilities were h(2) = 0.53 and 0.09, respectively. Milk losses for the lactation when DA was diagnosed were significant and reached 1016 kg milk, 41 kg fat, 36 kg protein and 0.07% protein. Fat content significantly increased by 0.18%. The analysis could not show significant differences between cows diagnosed with DA and cows not diagnosed with DA in the 305-day milk production traits of the lactation preceding the diagnosis of DA. There was also no indication for an unequal distribution of breeding values for milk performance traits between cows with and without DA. The additive genetic correlations between 305-day milk performance and left DA were low. The results indicated that cows with a high milk production and superior breeding values for milk performance were not exposed to an increased risk for DA.     

A new method for detecting the abomasal position and characteristics of movement at the onset of the left displacement of the abomasum in cows

A new method has been developed by us to observe the movements of the abomasum by using a magnet and digital magnetometer. Four cows with left displacement of the abomasum underwent conventional correction by rolling without tacking. A doughnut-type magnet was sutured to the pyloric region in a routine operation. The same was done in three control cows. The position of the pyloric region was observed with a digital magnetometer from outside the cow's body. The magnets in the pyloric region of the control cows were located at the right side of the abdominal cavity at 10-30 cm anterior to the udder base, and moved slightly in various directions within the span of a day. On the other hand, the magnets in the pyloric region of cows with abomasal displacement moved widely in the abdominal cavity from the normal right side to the abnormal left front side. A large movement of the magnet from the normal right side to the abnormal left side of the abdominal cavity was observed within 12 h of the onset of abomasal displacement.     

Clinical paratuberculosis as a cause for higher culling rate in cows with left displaced abomasum and diarrhoea in a holstein dairy herd

The present report identifies a statistically significant (P < 0.001) higher postoperative culling rate in cows with left displaced abomasum (LDA) exhibiting diarrhoea, compared with cows with LDA and normal faeces from a large Holstein dairy herd (odds ratio = 34). Paratuberculosis was histopathologically confirmed in 77.0% of cows with LDA exhibiting diarrhoea.     

Survival of dairy cows after surgery to correct abomasal displacement: 2. Association of clinical and laboratory parameters with survival in cows with left abomasal displacement

This study examines the association of pre-surgical clinical parameters in cows with left displacement of the abomasum (LDA) with the probability of cure. Data from 466 cases of LDA in which omentopexy was performed were analysed. Cows were classified in three categories according to the outcome of treatment. Cows in the first category were cured, i.e. sent back to the farm for further milk production. Cows in the second category were sent for slaughter because of an unfavourable prognosis concerning productivity. Cows in the third category either died or were salvaged because of poor prognosis concerning survival. Factors were examined for their possible influence on the outcome of treatment by comparing the values of successfully treated cows to those cows that either died or had to be sent for slaughter. Factors that were associated with a favourable prognosis were a short duration of disease, an undisturbed general condition, good appetite, normal faeces, a higher body weight, lower haematocrit, haemoglobin and erythrocyte counts, lower urea, AST and bilirubin, and higher sodium, potassium and chloride concentrations compared with cows with an unfavourable prognosis. Haemoconcentration was associated with higher AST, bilirubin and urea and with low sodium, potassium and chloride. Acetonuria was associated with increased AST and bilirubin and low urea. Low sodium and potassium concentrations were associated with an impaired general condition. It is concluded that a thorough clinical examination with special emphasis on general condition, liver function and dehydration status is of great importance in determining the prognosis of abdominal surgery in cows with LDA.