[Frequency and diagnostic reliability of laboratory variables in cows with traumatic reticuloperitonitis and abomasal ulcers]. / Häufigkeit und diagnostische Zuverlässigkeit von Laborbefunden bei Kühen mit Reticuloperitonitis traumatica und Labmagengeschwüren.

OBJECTIVE: A number of laboratory abnormalities occurs in cows with traumatic reticuloperitonitis (TRP) as well as in those with abomasal ulcers (U; classified as type 1 to 5). The goal of our study was to compare the frequency of individual laboratory variables of cows with traumatic reticuloperitonitis and cows with abomasal ulcers and determine the diagnostic significance of individual laboratory variables. MATERIAL AND METHODS: The present study included 182 healthy control cows, 503 cows with TRP, 94 cows with U1, 145 cows with U2, 60 cows with U3, 87 cows with U4 and 14 cows with U5. Hematocrit, total leukocyte count, concentrations of total protein, fibrinogen, urea, potassium and chloride, base excess and rumen chloride concentration were analyzed. The frequency distributions of all variables for all groups of cows were compared and the diagnostic reliabilities (diagnostic sensitivities and specificities, predictive values, positive likelihood ratios [LR+]) were calculated. RESULTS: Values outside the reference interval occurred in 2 to 24 % of control cows (rumen chloride 2 %, urea 6 %, serum chloride 11 %, hematocrit 13 %, base excess 18 %, fibrinogen 20 %, total protein 21 %, total leukocyte count 22 % and potassium 24 %), which made differentiation of healthy and ill cows difficult. Therefore, the variables best suited for distinguishing healthy and affected cows were rumen chloride and blood urea concentration. This was also supported by an LR+ of 14 to 27 for rumen chloride > 30 mmol/l and 6 to 15 for blood urea > 6.5 mmol/l in cows with abomasal ulcers. Urea also displayed a high diagnostic specificity and was suited for differentiation of healthy and diseased cows. The urea concentration was > 8.5 mmol/l in only 0.5 % of controls, and the LR+ for a urea concentration > 8.5 mmol/l ranged from 11 in cows with TRP to 128 in cows with U2. Except for cows with TRP, azotemia was significantly more frequent in affected cows than in controls. Cows with U2 (70 %) had urea concentrations > 8.5 mmol/l significantly more frequently than cows of the other groups. Even though the groups of diseased cows differed significantly with respect to several variables, no variables were identified to reliably differentiate the various groups. CONCLUSION: Different disorders in cows cannot be differentiated based on single laboratory variables. CLINICAL RELEVANCE: For a definitive diagnosis the history, clinical findings and results of additional diagnostic techniques such as radiography of the reticulum, ultrasonography and abdominocentesis are required. In many cases, a definitive diagnosis can only be made via exploratory laparotomy and/or postmortem examination.

Haematological findings in 158 cows with acute toxic mastitis with a focus on the leukogram.

BACKGROUND: In cows with acute toxic mastitis (ATM), the leukogram aids in the assessment of the severity of disease. The goal of our study was to compare the leukogram of 158 cows with ATM (cases) and 168 clinically healthy cows (controls). We hypothesised that the leukograms of surviving and non-surviving cows differ and that there are variables of the leukogram with sufficient prognostic potential to be used in the decision to treat or not to treat a cow with ATM. The cows were examined clinically and underwent haematological and biochemical examination of blood and bacteriological culture of milk samples. RESULTS: All cows with ATM had a poor appetite or anorexia, and 34 cows (21.5%) were recumbent. A single quarter was affected in 119 cows (75.3%), two quarters in 37 cows (23.4%) and three quarters in two cows (1.3%). Bacteriological culture showed Gram-negative pathogens in 100 cows (63.3%), Gram-positive in 15 (9.5%) and yeast in 4 (2.5%). The median total leukocyte count of cases was 4300 cells/µL (interquartile range = 2300-8200/µL), which was significantly lower than 8000 cells/µL (6525-9300/µL) in controls. Except for band neutrophils and metamyelocytes, the counts of all components of the leukogram were lower in cases compared with controls. Significantly more cows with ATM had leukopenia (60.1 vs. 4.1%) or leukocytosis (10.1 vs. 3.0%) than controls. Diseased cows had significantly lower segmented neutrophil counts than controls (860 vs. 2598 cells/µL), and 69.5 and 17.3%, respectively, had counts below the reference interval. Cases had increased band (77.3%) and metamyelocyte (25.0%) counts compared with controls (0.6 and 0%, respectively). In diseased cows, eosinopenia occurred in 66.4% (controls, 1.8%), monocytopenia in 40.6% (4.2%) and lymphopenia in 60.2% (1.8%). Twenty-one diseased cows (16.4%) had a regenerative and 57 (44.5%) had a degenerative left shift. The median neutrophil-to-lymphocyte ratio was 0.97 in diseased cows and 0.63 in controls. Toxic changes in neutrophils including cytoplasmic basophilia and vacuolisation were seen in 101 (91.8%) of 110 blood smears of diseased cows. The leukogram of the surviving and non-surviving cows did not differ significantly, and the hypothesis was rejected. CONCLUSIONS: ATM results in severe changes in the leukogram particularly leukopenia, lymphopenia, and degenerative left shift. The hypothesis that the leukograms of surviving and non-surviving cows differ was rejected. The leukogram has not sufficient prognostic potential to be used in the decision to treat or not to treat a cow with ATM.

Diagnostic reliability of clinical signs in cows with traumatic reticuloperitonitis and abomasal ulcers.

BACKGROUND: Clinical signs of traumatic reticuloperitonitis and abomasal ulcer are often similar making the disorders difficult to differentiate. The goal of our study was to compare the frequency of individual clinical signs of cows with traumatic reticuloperitonitis and cows with abomasal ulcers and determine their diagnostic significance. The frequency of the findings "rectal temperature, heart rate, respiratory rate, demeanour, signs of colic, arched back, abdominal guarding, bruxism, scleral vessels, rumen motility, foreign body tests, percussion auscultation, swinging auscultation and faecal colour" of cows with traumatic reticuloperitonitis (TRP, n = 503) and cows with type 1 (U1, n = 94), type 2 (U2, n = 145), type 3 (U3, n = 60), type 4 (U4, n = 87) and type 5 (U5, n = 14) abomasal ulcer were compared, and the reliability indices "diagnostic sensitivity and specificity, positive and negative predictive values and positive likelihood ratio" were calculated. A total of 182 healthy cows served as controls (control group). RESULTS: None of the cows in the control group had colic, rumen atony or melena, 99% had no abnormalities in demeanor and appetite and did not have a rectal temperature of ≤38.6 or >  40.0 °C, a heart rate >  100 bpm or a respiratory rate >  55 breaths per min, and 95% did not have an arched back or bruxism. The control group was therefore ideal for comparative purposes. Many signs such as mild increase in rectal temperature, scleral congestion and positive foreign body test were non-diagnostic because they occurred in healthy as well as in ill cows. Likewise, differentiation of cows with TRP and abomasal ulcer was not possible based on single clinical variables; a detailed history and a comprehensive assessment of all clinical findings were required for this. CONCLUSIONS: The findings of the present study serve as a guide for the veterinarian in the differentiation of cows with traumatic reticuloperitonitis and abomasal ulcer.

Ultrasonographic documentation of type-3 abomasal ulcer in a cow with left displacement of the abomasum.

BACKGROUND: Ultrasonographic documentation of perforated abomasal ulcer has not been published till now. This report describes the clinical, ultrasonographic and postmortem findings in a Jersey cow with type-3 abomasal ulcer and left displacement of the abomasum (LDA). CASE REPORT: The main clinical findings were abnormal demeanour, rumen atony and tympany, positive foreign body tests, positive auscultation and simultaneous ballottement on the left side, abdominal guarding and loss of negative pressure in the abdominal cavity. The tentative diagnosis was peritonitis and LDA. Abdominal ultrasonography produced images typical of LDA, and in one location between the abdominal wall and abomasum there was a layer of fibrin, a fibrin clot, a break in the abomasal contour, suggestive of a perforated ulcer, and partial obstruction of this gap with fibrin. The diagnosis of perforated abomasal ulcer with subsequent peritonitis was confirmed during postmortem examination. CONCLUSIONS: The examination of this case shows that under certain circumstances, ultrasonographic imaging of a perforated abomasal ulcer in a cow is possible. Antemortem diagnosis of type-3 abomasal ulcer is preferable to relying on exploratory laparotomy and/or post-mortem examination.