Left and right displaced abomasum and abomasal volvulus: comparison of clinical, laboratory and ultrasonographic findings in 1982 dairy cows

BACKGROUND

Although left and right displacement of the abomasum and abomasal volvulus are well-known disorders of cattle, a comparative evaluation of the clinical, laboratory and ultrasonographic findings of these types of abomasal displacements has not been undertaken. Therefore, the objective of this study was to compare these conditions in a large population of cows. The medical records of 1982 dairy cows with left displaced abomasum (LDA, n = 1341), right displaced absomasum (RDA, n = 338) and abomasal volvulus (AV, n = 303) were searched for the results of clinical, laboratory and ultrasonographic evaluations.

RESULTS

The main clinical findings were an abnormal demeanour in 48.2% of the cows, reduced rumen motility in 89.7% and decreased intestinal motility in 61.1%. Ballottement and simultaneous auscultation and percussion and simultaneous auscultation were positive on the left side in 96.9% of the cows with LDA and on the right in 98.5% of the cows with RDA and in 99.3% of the cows with AV. Ultrasonography was useful for diagnosing LDA in 97.9% of the cows and RDA/AV in 90.2% of the cows. The laboratory findings characteristic of abomasal reflux syndrome varied in severity; 83% of the cows had hypokalaemia, 67% had increased rumen chloride concentration, 67% had an increased base excess and 50% had haemoconcentration. Based on the clinical signs, a definitive diagnosis was made in 75.0% of the cows with LDA and in 22.5% of the cows with RDA/AV. Ultrasonography was required for a definitive diagnosis in another 22.0% of the cows with LDA and in 53.0% of the cows with RDA/AV. Laparotomy or postmortem examination was required for reliable differentiation of RDA and AV.

CONCLUSIONS

LDA, RDA and AV differ with respect to the severity and the frequency of several abnormal clinical, laboratory and ultrasonographic findings as well as the methods required for a diagnosis.

[The use of ultrasonography for diagnosing the cause of colic in cows. A review]

Ultrasonography is a very useful technique for diagnosing the cause of colic in cows. It allows visualisation of abnormal reticular contour and occasionally of abnormal contractility in cows with reticuloperitonitis. In right-displaced abomasum, the dilated abomasum can be detected between the right abdominal wall and the liver. Fluid ingesta are seen ventrally and a gas cap of varying size dorsally. Dilated loops of small intestines that are almost always static are the main diagnostic criterion for ileus of the small intestine, but the cause of the ileus can only rarely be determined. Cholestasis can almost always be diagnosed by imaging a dilated biliary system. With obstruction at the level of the hepatic portal, only the intrahepatic biliary ducts are dilated, while a dilatation of the entire biliary tract, including the gallbladder, occurs in the case of an obstruction near the duodenal papilla. Urinary tract diseases cause colic in cows when concrement or inflammatory products become lodged in a ureter. The importance of ultrasonography in the diagnosis of diseases causing colic in cows varies. For example, with colic attributable to ileus of the small intestines, cholestasis or urinary tract disease, ultrasonography is a very useful diagnostic tool. On the other hand, for diagnosis of left or right displacement of the abomasum or caecal dilatation, ultrasonography is generally not required, but it is helpful in difficult cases to confirm or rule out a tentative diagnosis and to avoid an unnecessary exploratory laparotomy.

Ultrasonographic imaging of abomasal curd in preruminant calves

The aim of this study was to determine whether ultrasonography could be used to evaluate curd formation in the abomasum of preruminant calves. Holstein-Friesian calves were fed one of three milk replacers: clotting (five calves), non-clotting (four calves) and pH-dependent clotting (clots form at pH 5.5, but not at pH 6.5; six calves). Ultrasonography was performed until 6h after feeding the milk replacers. In calves fed the clotting milk replacer, a large clot of curd was visualised by ultrasonography as a clearly outlined echogenic image and whey as an anechoic image. In calves fed the non-clotting milk replacer, abomasal contents were visualised as a uniform, entirely echogenic image, indicating the absence of curd formation. In calves fed milk replacer with pH-dependent clotting properties, several small curds and whey were visualised by ultrasonography. It was concluded ultrasonography can be used to visualise abomasal curd and to distinguish the presence and absence of curds in the abomasum of calves.

Comparison of two oral electrolyte solutions and route of administration on the abomasal emptying rate of Holstein-Friesian calves

Dehydrated calves with diarrhea are routinely given an oral electrolyte solution (OES) by suckling or esophageal intubation. An important issue related to rehydration therapy is the rate of OES delivery to the small intestine. It is widely assumed that the glucose content of the OES does not impact the speed of resuscitation and that fluid administered by esophageal intubation provides a similar resuscitative response to that obtained by suckling. The aims of this study were to compare the abomasal emptying rate in calves suckling an OES containing a high or low glucose concentration and in calves administered a high-glucose OES by suckling or esophageal intubation. Seven male Holstein-Friesian calves were given the following treatments in random order: 2 L of a commercially available high-glucose OES ([glucose] = 405 mM) by suckling or esophageal intubation or 2 L of a commercially available low-glucose OES ([glucose] = 56 mM) by suckling. Abomasal emptying rate was determined by acetaminophen absorption, ultrasonography, and glucose absorption. High-glucose OES rapidly increased plasma glucose concentration after suckling but produced a slower rate of abomasal emptying than did low-glucose OES. Esophageal intubation of high-glucose OES produced the same initial change in abomasal volume as did suckling, but delayed the rate of OES delivery to the small intestine. Our results suggest that suckling a low-glucose OES provides the fastest rate of abomasal emptying and plasma volume expansion, whereas a high-glucose OES provides the most appropriate oral solution for treating hypoglycemic calves.

Ultrasonographic assessment of change in abomasal position during the last three months of gestation and first three months of lactation in Holstein-Friesian cows

OBJECTIVE

To determine changes in abomasal position and dimensions during the last 3 months of gestation and first 3 months of lactation via transabdominal ultrasonography and determine whether surgical correction of left-displaced abomasum (LDA) by right flank omentopexy alters abomasal position within the abdomen in Holstein-Friesian cows.

DESIGN

Observational study.

ANIMALS

20 heifers and 20 cows with no history of an LDA and 7 cows that had been treated for LDA via right flank omentopexy during an earlier lactation. Procedure-Ultrasonographic measurements were obtained 8 times during the last 3 months of gestation and first 3 months of lactation. Abomasal length, width, and volume were calculated from these measurements.

RESULTS

The abomasum was always wider than it was long and located predominantly to the right of the midline. The presence of a right flank omentopexy had no effect on the measured parameters. Abomasal length decreased and width increased during the last 3 months of gestation, resulting in a more transverse orientation of the abomasum within the abdomen. These changes appeared to be in response to cranial expansion of the gravid uterus. The abomasum returned to a more caudal and right sagittal position within 14 days after parturition.

CONCLUSIONS AND CLINICAL RELEVANCE

Abomasal dimensions, position, and volume change markedly during the last 3 months of gestation and first 3 months of lactation. Results permit detection of abnormal abomasal position in ill cows and indicate that the preferred location for abomasopexy is 20 cm caudal to the xiphoid process and 5 to 10 cm to the right of the ventral mid-line.

[Short communication: ultrasonographic examination of the abomasal position in dairy cows during the peripartal period]

The objective of this study was to document the abomasal position during the peripartal period by ultrasonographic measurement to get more data about the topographic dynamic. In 12 dairy cows the abomasal position was measured daily from the 5th day before calving up to the 5th day after calving by a transabdominal ultrasonographic examination (5 MHz convex transducer). The abomasal position was described by means of 3 measured distances: (a) the distance between the cranial margin of the abomasum and the xiphoid cartilage, (b) the distance between the right margin of the abomasum and the median line and (c) the distance between the left margin of the abomasum and the median line. Prepartal the abomasal position was different from the position during the postpartal period. Its position was more cranially (p < 0.05) and more right laterally (p < 0.05). The left margin was not detectable at the left side of the mid-line ante partum. Directly after calving the left margin of the abomasum was found left of the linea alba (p < 0.05). These results show that there is a great influence of the gravid uterus on the abomasal position. The abomasum is positioned more cranially and more right lateral during the end of pregnancy. This position changes immediately after calving.

Ultrasonographic measurement of abomasal volume, location, and emptying rate in calves

OBJECTIVE

To develop and validate an ultrasonographic method for measuring abomasal volume, location, and emptying rate in suckling calves.

ANIMALS

9 male Holstein calves < 40 days of age.

PROCEDURE

Before and after calves were fed different volumes of milk replacer or 2 L of oral electrolyte solutions, ultrasonographic measurements of abomasal dimensions (width, length, and height) were obtained by applying a 3.5-MHz sector probe to the ventral aspect of the abdomen in the transverse and sagittal planes. Abomasal volume was calculated from the ultrasonographic measurements by modeling the abomasum as an ellipsoid and by use of a power exponential equation to calculate the half-time of abomasal emptying (t1/2).

RESULTS

Preprandial abomasal volume was 20 to 137 mL. All 3 abomasal dimensions increased during feeding and after suckling, and the abomasum was symmetrically located about the midline of the ventral aspect of the abdomen. Strong linear relationships were identified between ultrasonographic and suckled volumes, between ultrasonographic and scintigraphic heights, and between ultrasonographic and scintigraphic lengths. Ultrasonographic t1/2 was linearly related to scintigraphic t1/2; the latter is regarded as the gold standard measure of gastric emptying rate.

CONCLUSIONS AND CLINICAL RELEVANCE

Ultrasonographic evaluation of the abomasum appears to provide a practical, rapid, noninvasive, and accurate method for determination of abomasal volume, location, and emptying rate in suckling calves.

Determination of abomasal emptying rate in suckling calves by use of nuclear scintigraphy and acetaminophen absorption

OBJECTIVE

To develop nuclear scintigraphic and acetaminophen absorption methods for measuring abomasal emptying rate in suckling calves.

ANIMALS

9 male Holstein-Friesian calves < 30 days old.

PROCEDURE

Calves were fed 2 L of milk replacer, fresh cow's milk, or an isoosmotic (150mM) solution of NaCl, NaHCO3, or sodium acetate containing technetium TC 99m-diethylenetriamine-pentaacetic acid (370 MBq) and acetaminophen (50 mg/kg). Right lateral scintigraphic images and venous blood samples were obtained periodically after feeding. Two power exponential equations were fitted to the scintigraphic data, and 3 pharmacokinetic models were fitted to the acetaminophen concentration-time data.

RESULTS

Data from 32 feedings were analyzed, with half emptying time for scintigraphic evaluation ranging from 29 to 202 minutes. Siegel's modified power exponential equation provided a better description of the scintigraphic data than did Elashoff's power exponential equation. The first derivative of Siegel's modified power exponential formula provided the best pharmacokinetic model for the acetaminophen absorption data. Time to maximal acetaminophen concentration (Tmax) provided the most accurate index of abomasal emptying rate from the acetaminophen concentration-time data.

CONCLUSIONS AND CLINICAL RELEVANCE

Abomasal emptying rate is best determined in healthy suckling calves by use of Siegel's modified power exponential equation to model the scintigraphic data. Pharmacokinetic calculation of Tmax from the acetaminophen absorption curve provides an alternative method for determining abomasal emptying rate in healthy suckling calves that is accurate, inexpensive, practical, and safe. However, it is unclear whether diarrhea would alter the acetaminophen absorption curve in calves.

Assessment of the effects of erythromycin, neostigmine, and metoclopramide on abomasal motility and emptying rate in calves

OBJECTIVE

To determine and compare the effects of erythromycin, neostigmine, and metoclopramide on abomasal motility and emptying rate in suckling calves.

ANIMALS

6 male Holstein calves (15 to 40 days of age).

PROCEDURE

Calves were monitored for 1 hour before being fed milk replacer (60 mL/kg; time, 0 minutes) and then were monitored for another 3 hours. Calves received 6 treatments in randomized order: erythromycin (8.8 mg/kg, IM) at -30 minutes; low-dose erythromycin (0.88 mg/kg, IM) at -30 minutes; erythromycin (8.8 mg/kg, IM) at -30 minutes and neostigmine (0.02 mg/kg, SC) at -30 and 90 minutes; neostigmine (0.02 mg/kg, SC) at -30 and 90 minutes; metoclopramide (0.1 mg/kg, IM) at-30 and 90 minutes; and placebo (2 mL of saline [0.9% NaCl] solution, SC) at -30 minutes. Abomasal volume was calculated from ultrasonographic measurements of abomasal width, length, and height. Abomasal motility and emptying rate were assessed by measuring luminal pressure and change in abomasal volume over time.

RESULTS

Administration of erythromycin (8.8 mg/kg) increased the frequency of abomasal luminal pressure waves and the mean abomasal luminal pressure and decreased the half-time of abomasal emptying by 37%. Administration of metoclopramide, neostigmine, and low-dose erythromycin (0.88 mg/kg) did not alter abomasal motility, mean luminal pressure, or emptying rate.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that administration of erythromycin at the labeled antimicrobial dose (8.8 mg/kg, IM) exerted an immediate, marked prokinetic effect in healthy suckling calves, whereas administration of metoclopramide or neostigmine did not alter abomasal motility or emptying rate.

Position of the abomasum in dairy cows during the first six weeks after calving

The position of the abomasum in six cows was examined by ultrasonography at regular intervals for six weeks after they had calved. Its position was established by determining the distance between the margin of the left side of the abomasum and the ventral midline at two sites. During the last weeks of pregnancy, the abomasum was positioned in a small region of the left ventral side of the abdominal cavity. At parturition it was positioned high on the left side and then descended. The abomasum was furthest from the midline immediately after parturition. Its position was related to the interval after calving, the cow's feed intake, and the pH and osmotic pressure of the rumen fluid. There was considerable variation between the cows in the position of the abomasum, which was in part due to analytical variation, and in individual cows it had a circadian rhythm.

The effects of vagotomy on the abomasum in calves: radiography and protein gene product 9.5 immunohistochemistry

Abomasal disorders of calves with total vagotomy, operated on at 1 week old, were investigated with radiography and protein gene product (PGP) 9.5 immunohistochemistry. Radiographic findings indicated abomasal atony with dilatation in all calves 2 weeks after vagotomy, while 4 weeks after vagotomy abomasal dilatation was detected in 2 calves and another 2 calves showed dilatation and impaction. The densities of PGP 9.5-immunoreactive nerves in the tunica muscularis decreased significantly in the corpus region of the greater curvature 2 weeks after vagotomy and in the pyloric region of the lesser curvature 4 weeks after vagotomy, and it was at its lowest 4 weeks after vagotomy in all regions examined. In conclusion, abomasal dilatation and/or impaction in vagotomized calves confirmed by radiography were related with a decreased frequency of nerves in the tunica muscularis of the abomasum.

Comparison of abomasal emptying in neonatal calves with a nuclear scintigraphic procedure

The purpose of the present study was to demonstrate that nuclear medicine technology allows observation of the effect that milk clotting has on abomasal emptying in the living neonatal calf. Scintigraphic evaluation of abomasal emptying was carried out in 6 healthy male Holstein calves. The calves were fed 10% of their body weight daily as whole cow's milk that was divided equally and consumed as 2 feedings via a nipple bottle. One day before the nuclear scintigraphic procedure, the calves were randomly fed whole cow's milk, or an oral rehydration solution (ORS) containing bicarbonate and high levels of soluble fibre was fed for 3 consecutive feedings an hour before the portion of milk. For each calf, both feeding programs were repeated twice at a one-week interval. Immediately following administration of the 99mTC-sulfur-colloid-containing milk, the calves were imaged with the gamma camera positioned lateral and ventral to the abomasum. Additional right lateral and ventral views of the abomasum were collected at 15, 30, 45, 60, 90, 120, 150, 180, 210, and 240 min after administration of the radionuclide. Blood glucose determination were performed at one-hour intervals for 7 h after feeding milk to evaluate milk digestibility in both feeding programs. No significant differences in the results of the glucose absorption test or in the radionuclide counts of the abomasum were found between both feeding programs. Scintigraphic evaluation of abomasal emptying was found to be a useful technique for visualization of milk clotting and to test the effect of an ORS on milk digestibility.

Ultrasonographic findings in cows with left displacement of the abomasum

Forty-eight cows with left displacement of the abomasum (LDA) and three clinically healthy control cows were examined ultrasonographically from the 11th and 12th intercostal spaces on the left side. In the controls, the rumen was immediately adjacent to the left abdominal wall, whereas in the cows with LDA the rumen was generally immediately adjacent to the left abdominal wall ventrally, but displaced by the abomasum more dorsally. The ultrasonographic findings were generally consistent in the cows with LDA. The ingesta that were visualised ventrally in the abomasum appeared echogenic to hypoechogenic and, in a few cows, the abomasal folds were visible as elongated, echogenic, sickle-shaped structures. The dorsal abomasal gas cap was characterised by reverberation artifacts from the abomasal surface.

Percutaneous ultrasound-guided abomasocentesis in cows

The goal of this study was to determine the optimal location for ultrasound-guided centesis of the bovine abomasum and to assess the safety of the procedure. In the first part of this study, the technique was applied to 50 clinically healthy cows which were slaughtered within two hours of the procedure. The abomasum and peritoneum were then examined for lesions. In all but one cow, the location for abomasocentesis was 10 to 27 cm caudal to the xiphoid and on the ventral midline or up to 10 cm to the right of it. No peritoneal lesions were observed in any of the cows. In all cases, the site of centesis was visible as a localised haemorrhage on the serosal surface of the abomasum. In 41 of the cows, a haematoma was visible on the mucosal surface of the abomasum. In the second part of the study, 10 cows were monitored clinically for 10 days after abomasocentesis, to assess the safety of the procedure. The appetite, general behaviour, attitude and rectal temperature of the cows remained normal. The haematocrit, total and differential leucocyte counts, and the concentrations of total solids and fibrinogen were determined daily and remained within their normal ranges. At slaughter minimal changes, such as localised reddening and adhesions between the site of the puncture in the abomasum and the abdominal wall, were visible in three of the cows.

Ultrasonographic examination of the abomasum of 50 cows

The purpose of this study was to determine the position, appearance and dimensions of the abomasum of 50 healthy cows by ultrasonography. The ventral abdominal region caudal to the xiphoid process was examined with a 3.5 MHz linear transducer. The abomasum could be visualised from both sides and from the ventral midline of 47 of the cows. The abomasum could be clearly differentiated from adjacent organs because of its contents, which appeared as a heterogeneous, moderately echogenic structure with echogenic stippling. However, the wall of the abomasum appeared, if at all, as a narrow echogenic line. Parts of the abomasal folds were visible occasionally as echogenic structures within the abomasum. Slow movement of the feed in the abomasum was also often visualised. The pylorus was positively identified in only one cow. The cranial margin of the abomasum was situated up to 15 cm caudal to the xiphoid process. The abomasum was between 7.4 and 42.9 cm long, and its maximal extent, measured from the ventral midline to the left, was from 5.0 to 26.0 cm in the cranial region and from 5.0 to 16.0 cm in the caudal region. From the ventral midline to the right, it was from 5.0 to 33.0 cm in the cranial region and from 28.0 to 36.0 cm in the caudal region. The minimal dorsoventral dimension of the abomasum ranged from 0.7 to 7.2 cm, and its maximal dorsoventral dimension ranged from 3.6 to 11.1 cm.

Radionuclide imaging of abomasal emptying in sheep

A liquid radionuclide tracer was administered to nine sheep in order to visualise the abomasum with a gamma camera computer system. The aim was to develop a method of studying gastric emptying, with minimal surgical intervention. Oral administration of the tracer gave good images of the whole complex stomach, but quantifying abomasal emptying was not possible because of the superimposition of the stomach compartments. When the reticular groove reflex was stimulated with oral copper sulphate the radionuclide bypassed the reticulorumen, allowing quantitative analysis of abomasal activity. However, the repeatability of the reflex activation was low. Radionuclide administered directly into the abomasum produced good images of abomasal outflow and provided digital data which were analysed quantitatively. A wide range of emptying rates was observed, generally with a stepped pattern.

[Sonography as a tool in the diagnosis of displacement of the abomasum]

43 Holstein-Friesian cows were investigated by sonography for the occurrence of a displacement of the abomasum. 26 animals suffered from a displacement of the abomasum. The results of sonography of these diseased and of healthy animals are described. After sonography all animals were subjected to an exploratory laparotomy in order to check the validity of the sonographic diagnosis. The results and the diagnosis obtained by laparotomy were compared to the sonographic findings.

Left abomasal displacement and ulceration in an eight-week-old calf

Left displacement of the abomasum was diagnosed radiographically in an 8-week-old female Friesian calf. At surgery, a 4 cm ulcer was repaired and an abomasopexy performed during closure of the abdomen. Recovery from surgery was slow, and regurgitation of rumen contents occurred. Despite medical treatment, the calf died 4 days later. Left abomasal displacement is a well documented disease of dairy cattle (Robertson 1968; Coppock 1974; Martin et al 1978a; Poulsen 1976), but in young calves the condition is rare (Dirksen 1981). This report describes a case of left abomasal displacement with ulceration in an 8-week-old female Friesian calf.

Abomasal size and emptying time in healthy lambs and in lambs affected by watery mouth

Contrast radiography (barium sulphate suspension fed by stomach tube) was used to assess abomasal profile area (a reflection of tone in the abomasal wall) and the rate of abomasal emptying in healthy lambs aged four to 144 hours and in lambs affected by watery mouth. In healthy lambs abomasal profile area increased from 15.1 +/- 0.56 cm2/kg at four hours of age to 23.1 +/- 1.07 cm2/kg at 24 to 48 hours (P less than 0.001). There was no change up to 48 to 72 hours but after this age there was a substantial decrease to 12.8 +/- 0.76 cm2/kg at 120 to 144 hours (P less than 0.001). The rate of abomasal emptying decreased as abomasal profile area increased. Complete emptying of the abomasum was observed within three hours of feeding in the majority of lambs aged four hours (seven out of eight) and 120 to 144 hours (13 out of 16) but only in a minority of lambs aged 24 to 48 hours (one out of 11). In lambs affected by watery mouth (mean age [+/- se] 33 +/- 2.8 hours, n = 34) abomasal profile area was greater and the rate of abomasal emptying was slower than in healthy lambs aged 24 to 48 hours. These findings confirm the previous suspicion that watery mouth is associated with an impairment of gut motility. Abomasal emptying time was prolonged in lambs aged four hours when either ewe or cow colostrum was included with the contrast medium. A similar effect was observed in lambs aged 24 to 48 hours when cow colostrum was included. The castration of lambs aged four hours with rubber rings immediately before the administration of contrast medium had no effect on the rate of abomasal emptying.

A radiological study of gastric (abomasal) emptying in calves before and after vagotomy

1. Gastric emptying has been studied in the conscious, standing calf by lateral radiography and fluoroscopy of radiopaque meals instilled into the abomasum before and after vagotomy. 2. Bilateral cervical vagotomy proved to be the only certain way of achieving total vagal transection. By instillation of milk into the abomasum through a cannula calves were maintained in normal, healthy condition for up to 36 days after vagotomy. 3. Motility of the antrum was not impaired by vagotomy so that some movement of gastric chyme to the duodenum occurred within minutes of instillation into the abomasum. Complete transference of the test meal was, however, delayed after vagotomy. 4. The greatest effect of vagotomy appeared to be on the abomasal body so that inadequate amounts of chyme were transferred to the antrum for pumping to the duodenum. 5. Delay in passage of contrast material through the intestine was related to delay in gastric emptying although vagotomy may have affected the intestine directly. 6. Following vagotomy the abomasum showed a resumption of normal motility and emptying after 7-29 days. This effect of vagotomy is similar to that seen in the simple stomach and is probably due to the establishment of intrinsic gastric control.

Contrast study of the gastrointestinal tract in the goat (Capra hircus)

Radiographic anatomy of the gastrointestinal tract of the goat (Capra hircus) was studied. Intraluminal contrast medium was used to evaluate the mucosal surfaces of stomach and intestines, and extraluminal contrast medium was used to evaluate the serosal surfaces of organs in the peritoneal cavity.