Surgical diseases of the small intestine

Evaluation of the therapeutic efficacy of rumen transfaunation

Transfaunation is supposed to stimulate normal rumen function and has been used as an ancillary treatment for indigestion. Although it is widely recommended, there are little research data on the efficacy and the necessary volume.

The objective of the prospective clinical trial was the evaluation of the therapeutic efficacy of two different transfaunation volumes which can be obtained under practical conditions.

Forty‐five cattle suffering from indigestion were included in the study. A scoring system for the classification of rumen fluid was used. Scores were given in accordance with the importance of the parameter as an indication of microbial dysfunction. Animals with disturbed rumen fluid composition and activity were randomly assigned into 3 groups. Group 1 received 1 L of rumen fluid, group 2 received 5 L of rumen fluid and group 3 (control group) received 5 L of body temperature water. Rumen fluid analysis was repeated on days 1 and 4 after transfaunation. The feed intake of the animals was recorded.

After the transfaunation of 1 L and 5 L, the rumen fluid score improved significantly from day 0 to days 1 and 4. Rumen fluid samples in the control group showed no significant improvement from day 0 to day 1.

No significant differences were observed between the two treatment groups. But significant differences between the improvement of group 1 and the control group on days 1 and 4 and significant differences between group 2 and the control group on day 1 were detected. Small volumes of rumen fluid are easily obtainable by stomach tubes fitted with suction pumps. In summary, the transfaunation of as little as 1 L of rumen fluid caused significant improvement in the activity of rumen flora in cows suffering from indigestion.

Prognostic value of preoperative plasma l-lactate concentrations in calves with acute abdominal emergencies

Acute abdominal emergencies in calves due to abomasal disorders, gastrointestinal ileus, or peritonitis are characterized by a rapid disease progression and usually require immediate surgical intervention. Those conditions are associated with a guarded prognosis, and the aim of the present study was to assess the prognostic relevance of preoperatively measured plasma l-lactate concentrations (l-LAC) in a large study population of calves with a broad spectrum of acute abdominal emergencies. For the purpose of this study, the medical records of 587 calves admitted to a veterinary teaching hospital over a 10-yr period were analyzed retrospectively. Plasma l-LAC was measured as part of a routinely performed biochemistry panel before initiation of surgical intervention. Hyper-l-lactatemia (plasma l-LAC >2.2 mmol/L) was evident in 75% of calves, and the overall survival rate until hospital discharge was 31%. Calves with a negative outcome were younger (median: 3.4 vs. 6 wk) and had higher plasma l-LAC (median: 4.96 vs. 3.09 mmol/L) than calves with a positive outcome. At the individual diagnosis level, l-LAC was associated with mortality in calves with a diagnosis of mesenteric torsion, right-sided dilated abomasum, small intestinal volvulus, or paralytic ileus, but not in calves suffering from peritonitis, malformations, abomasal volvulus, bloat, or small intestinal intussusceptions. Considering the whole study population, the area under the receiver operating characteristic (ROC) curve for plasma l-LAC was 0.66 [95% confidence interval (CI): 0.61-0.70]. A classification tree analysis indicated that l-LAC >8.84 mmol/L and age categories of <3 wk and <1 wk were independent predictors of mortality. The area under the ROC curve of this model was 0.75 (95% CI: 0.71-0.79) and the resulting sensitivity and specificity for the prediction of nonsurvival at the optimal probability cut-point of 0.62 were 67.7 and 76.6%, respectively. In conclusion, hyper-l-lactatemia is common in calves suffering from acute abdominal emergencies. Markedly increased plasma l-LAC is associated with an increased mortality risk, but it is not possible to reliably predict the outcome of affected calves based on a single, preoperative measurement. However, a clinically important finding of this study was that the ability to predict a negative outcome is improved when the age of the calf is considered in addition to plasma l-LAC.

Duodenal ileus caused by a calf feeding nipple in a cow

Background

The aim of this report was to describe duodenal obstruction caused by a rubber foreign body in a cow.

Case Presentation

The clinical, biochemical and ultrasonographic findings in a five-year-old Swiss Braunvieh cow with duodenal ileus caused by a calf feeding nipple are described. The main clinical signs were anorexia, ruminal tympany, decreased faecal output and abomasal reflux syndrome. Ultrasonographic examination revealed reticular hyperactivity and a dilated duodenum. A diagnosis of duodenal ileus was made and the cow underwent right-flank laparotomy, which revealed a dilation of the cranial part of the duodenum because of obstruction by a pliable foreign body. This was identified via enterotomy as a calf feeding nipple. The cow was healthy at the time of discharge four days after surgery and went on to complete a successful lactation.

Conclusions

To our knowledge, this is the first description of duodenal obstruction by a calf feeding nipple. This is an interesting case, which broadens the spectrum of the causes of duodenal ileus, which is usually caused by obstruction of the duodenum by a phytobezoar.