Case report: Abomasal ulcer secondary to congenital pyloric and duodenal stenosis in a 3-day-old heifer.

Abomasal ulcers, an economic concern for all calf-raising farms, are usually silent until perforation occurs, at which time management is complicated and often unrewarding. This case study describes perforating ulcer in a 3-day-old Brahman heifer, occurring secondary to a congenital narrowing of the pylorus and proximal duodenum and leading to marked abomasal distention, leakage, and eventual peritonitis and sepsis.

Primary type 3 abomasal ulceration in cattle and buffalo: clinico-biochemical parameters, treatment, and prognostic indicators.

Background: The clinical findings, laboratory alterations, and prognosis of primary type 3 abomasal ulcer (AU3) are poorly reported in the literature. Aims: To describe clinical findings, hemato-biochemical changes, and peritoneal fluid changes in bovines suffering from primary AU3, and to monitor responses to medical treatment and outcomes. Methods: The study included 32 bovines (20 cattle and 12 buffaloes) diagnosed with primary AU3 along with a control group. Results: Common clinical findings were depressed demeanor, anorexia, dehydration, scanty feces, melena, mushy atonic rumen, tachycardia, and tachypnea. Colic was observed in 56.3% of animals. The mean hemoglobin, hematocrit, platelet count, and lymphocyte count were lower (P≤0.05), while WBC and neutrophil count were higher than the values of the control group (P≤0.05). The levels of BHBA, NEFA, glucose, total bilirubin, AST, CK, LDH, BUN, creatinine, and lactate were higher (P≤0.05), while cholesterol, total protein, albumin, sodium, potassium, chloride, and calcium were lower than the values of the control group (P≤0.05). The rumen chloride concentration was increased. The left shift was observed in a higher percentage of nonsurvivors than survivors (P≤0.05). The nonsurvivors had higher levels of bilirubin, CK, LDH, BUN, creatinine, and rumen chloride (P≤0.05), and lower levels of total protein, albumin, and globulin (P≤0.05). Conclusion: Type 3 abomasal ulcers occurred during the various stages of lactation as well as in pregnant animals. The response to medical treatment was fair, long time survival rate was good, and there was no recurrence. There was no effect on fetal survival or milk yield in the subsequent lactation.

The pharmacokinetics and pharmacodynamics of esomeprazole in sheep after intravenous dosing.

Abomasal (gastric) ulceration is a morbidity in sheep, and currently, there is a paucity of pharmacokinetic and pharmacodynamic data for gastroprotectant drugs reported for this species. The proton pump inhibitor esomeprazole has been used in small animal and human patients for gastroprotection via increasing the gastric pH. The objective of this study was to report the pharmacokinetic parameters and pharmacodynamic effect of esomeprazole in sheep after single intravenous dosing. Four healthy adult Southdown cross ewes had blood collected over a 24 h time period after single intravenous dosing of esomeprazole at 1.0 mg/kg. Abomasal fluid was sampled over 24 h before and after esomeprazole administration. Plasma samples were analyzed for concentrations of esomeprazole and the esomeprazole metabolite, esomeprazole sulfone by high performance liquid chromatography. Pharmacokinetic and pharmacodynamic data were evaluated with specialized software. Esomeprazole was rapidly eliminated after IV administration. Elimination half-life, area under the curve, initial concentration (C0), and clearance were 0.2 h, 1,197 h*ng/mL, 4,321 ng/mL, and 0.83 mL/h/kg, respectively. For the sulfone metabolite elimination half-life, area under the curve and maximum concentration were 0.16 h, 22.5 h*ng/mL, and 65.0 ng/mL, respectively. Abomasal pH was significantly elevated from 1 to 6 h after administration and remained above 4.0 for at least 8 h after administration. No adverse effects were noted in these sheep. Esomeprazole was rapidly eliminated in sheep, similar to goats. Abomasal pH was increased, but future studies will be necessary to develop a clinical management approach to the use of esomeprazole in sheep.

Type 2 abomasal ulceration in cattle and buffalo: energy and lipid metabolic status, clinico-biochemical parameters, treatment, and prognostic indicators.

Twenty nine animals (22 cattle and 7 buffaloes) having type 2 abomasal ulcer (AU2) were studied in this prospective investigation, along with a control group (n = 20). Signalment, history, clinical signs, and laboratory alterations were determined. Blood, rumen fluid, abomasal fluid, and fecal samples were collected at the time of presentation. Depressed behavior, anorexia, dehydration, melena, sparse feces, and mushy rumen with substantially reduced or nonexistent motility, tachycardia, and tachypnea were common clinical findings. Colic was observed in 58% of animals. While the neutrophil count was significantly greater, the mean of lymphocytes, hemoglobin, erythrocyte count, and hematocrit were all lower (p < 0.05) than the corresponding control values. In comparison to the control values, the levels of BHBA, NEFA, lactate, bilirubin, BUN, creatinine, LDH, CK, GGT, ALP, and AST were significantly higher but levels of proteins, cholesterol, Na, K, Cl, and calcium were lower (p < 0.05). In comparison to the control values, the other hemato-biochemical parameters did not differ substantially (p < 0.05). The rumen and abomasal pH were within the reference range while rumen chloride concentration was increased in majority of animals. Higher percentage (p < 0.05) of non-survivors showed left shift and toxic alterations in neutrophils than the survivors. As compared to the survivors, the non-survivors had higher (p < 0.05) BHBA, triglycerides, total bilirubin, AST, ALP, LDH, and lactate, and lower (p < 0.05) fibrinogen and calcium. The response to medical treatment was fair, long time survival rate was good, and there was no recurrence. The follow-up period was 28 months. After treatment, both the current and the subsequent lactation's milk production were unaffected.

Evaluation of Two Fecal Occult Blood Tests for Detecting Non-Perforating Abomasal Lesions in Cattle.

Non-perforating abomasal lesions occur with a high prevalence in slaughtered dairy cattle. Ante mortem diagnosis is a challenge, but the presence of occult blood in feces is suggested as a diagnostic criterion. The lower detection limit of Hemo-Fec® (Med-Kjemi, Asker, Norway) and Hemoccult II® SENSA® (Beckman Coulter, Brea, California, USA) for fecal occult blood were estimated. The Hemo-Fec® and Hemoccult II® SENSA® could detect 1-2 mL and 2-4.5 mL of blood in 1000 g of feces, respectively. Therefore, the Hemo-Fec® test was selected to access hemoglobin degradation in the rumen to establish if blood from outside the gastrointestinal tract could result in false-positive tests and an observational study to estimate the diagnostic sensitivity and specificity. Rumen microbiota did not degrade hemoglobin in a 1% blood concentration in vitro during 48 h of fermentation. The Hemo-Fec® test was only able to detect cattle with ≥4 acute lesions (diagnostic sensitivity: 0.40 [95% confidence interval (95% CI): 0.32-0.48] and ≥4 chronic lesions (sensitivity: 0.44 [95% CI: 0.35-0.52]). The Hemo-Fec® test had no diagnostic potential to detect superficial erosions or scar tissue in abomasa. Furthermore, the specificity was 0.71 [95% CI: 0.68-0.75%], and a positive test is thus not equivalent with abomasal lesions in cattle.

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.

Local peritonitis and omental bursitis as sequelae of abomasal ulceration in buffaloes (Bubalus bubalis): clinical findings and outcome of treatment.

Abomasal ulcers are difficult to diagnose clinically with limited therapeutic approach to combat the disease. Omental bursitis (OB) and local peritonitis (LP) are known sequelae of abomasal ulcer in cows. In this study, differentiation between OB and LP in regard to clinical symptoms, biochemical analyses and the response to treatment in Buffaloes was done. Twenty buffaloes (Bubalus bubalis) were admitted with a history of intermittent appetite, wasting and mild abdominal distension during the period between March 2016 and August 2018. All cases were female (12 recently calved, 2 pregnant, 6 non-pregnant) aging from 3 to 9 years and weighing 350-600 kg. For comparison, 10 apparently healthy non-pregnant female buffaloes were used as controls. Abdominal ultrasonography confirmed the presence of 11 OB and 9 LP in admitted cases. Laboratory analysis revealed hyperproteinemia and hypoalbuminemia in OB. Hypokalemia and hypochloremia were detected in both OB and LP. Ultrasonography showed hypo-anechoic content with echoic stippling surrounded by echogenic wall in OB, whereas echogenic strands interspersed with anechoic fluid was reported in LP. Intra-lesional lavage by normal saline was applied several times under ultrasongraphic guidance followed by gentamicin 10% intramuscular and H2 antagonist intravenous for 5 days as well as parenteral and enteral fluid therapy. Seven cases of OB clinically improved, whereas no improvements were found in LP cases. OB secondary to abomasal ulcer has a good prognosis in contrast to LP. Ultrasonography provides a useful diagnostic tool and therapeutic guidance for such diseases.

Effect of non-perforating abomasal lesions on reproductive performance, milk yield and carcass weight at slaughter in Danish Holstein cows.

Non-perforating abomasal lesions are common in Danish Holstein cows, but the impact on production has not been studied. Our objective was to compare milk yield, carcass weight, days to first service and initiation of breeding among cows with different non- perforating abomasal lesion types and locations to cows with no such lesions. The occurrence, type and localisation of non- perforating abomasal lesions were characterised at slaughter in Danish Holstein cows, and first insemination dates (n = 592), milk yield (n = 999) and carcass information (n = 1,317) was also available. Production and reproduction data were retrieved from all other cows from the herds of origin. This information was used to evaluate the expected production performance in the herds. Of the 1,317 cows investigated at slaughter, 572, 428, 677, and 91 cows had at least one lesion Subtype 1a (mucosal erosion), 1b (acute deeper lesion), 1c (chronic deeper lesion) or 1d (scarring following a lesion), respectively. Cows with lesion Subtype 1c and lesions in the pyloric part of the abomasum were generally found to be culled later in lactation than their herd mates. Milk yield and days to first service were not associated with any lesion types. The occurrence of lesion Subtype 1c and lesions in the pylorus were associated with a higher weight at slaughter compared to cows without lesions of this subtype or in this location. Most Subtype 1c lesions was found in the pylorus. Initiation of breeding before 150 days in milk was positively associated with the number of lesions in the corpus of the abomasum. We discovered two sources of selection bias. First, cows with lesions had a higher carcass weight but also remained in the herds for longer after calving than cows without lesions. This would give them more time to overcome the period of negative energy balance in early lactation. Second, although the causes of culling were not known, cows with no lesions generally had a relatively low milk yield and could have been culled for this reason.". While non- perforating abomasal ulcers may have an effect on the production and reproduction data, the observational data presented show no evidence of such a relationship. It may be necessary to employ other study designs to identify any effects that might exist, but if the relationship cannot be demonstrated in a dataset of this magnitude, it is not deemed to be of practical relevance.

Prevalence of abomasal lesions in Danish Holstein cows at the time of slaughter.

Abomasal lesions in cattle are challenging to diagnose because the clinical signs are often subtle and nonspecific. An increasing number of studies suggests that abomasal lesions are commonly found in cattle of all ages, but the number of recent prevalence studies in dairy cows is limited. The main objective of this study was to estimate the prevalence of abomasal lesions in a population of Danish Holstein dairy cattle in Denmark. An abattoir survey of 1,327 dairy cows apparently suitable for slaughter was performed in 2016 and 2017. Abomasal lesions are usually classified using a standardized protocol with the following types: abomasal ulcer type I: erosions and nonperforating ulcers; type II: ulcers with arterial bleeding; type III: perforating ulcer with localized peritonitis; and type IV: perforating ulcer with diffuse peritonitis. A further subdivision of the nonperforating abomasal ulcers type I were classified as subtype Ia: erosions; subtype Ib: small ulcers with localized hemorrhage; subtype Ic: ulcers with a crater-like appearance; and subtype Id: retention of the mucosa due to tissue loss with either radial wrinkles converging at a central point or perforations of the spiral folds. Type I abomasal lesions were found in 84% of the examined cows. No ulcers with arterial bleeding (type II) or perforating ulcers with diffuse peritonitis (type IV) were found, but one perforating abomasal ulcer (type III) was observed. The total number of lesions found was 7,418 and when the lesion subtypes were evaluated individually the majority of subtypes Ia and Ic were found in the pyloric area (85 and 94%, respectively), whereas lesion subtypes Ib and Id dominated the fundus/corpus area (71 and 67%, respectively). When considering lesion subtypes according to parity, there was a high prevalence of subtype Ib across the 3 groups of parity (51, 58, and 55% for parity 1, 2, and ≥3, respectively). The prevalence of lesion subtype Id seemed to increase with increasing parity, and the prevalence of lesion subtype Ia seemed to decrease with increasing parity. The prevalence of abomasal lesions was higher than that shown in similar studies of cattle at the time of slaughter. However, the expectedly most painful cases were rare, with only one perforating and no arterial bleeding ulcers found. The etiology of the different subtype I lesions is still unknown, and further investigations are needed to establish the possible influence these lesions might have on welfare and production.

Clinical, laboratory and ultrasonographic findings in 87 cows with type-4 abomasal ulcer.

BACKGROUND: This study evaluated the clinical, laboratory, ultrasonographic and pathological findings in 87 cows aged 2 to 10 years (4.5 ± 1.5 years) with type-4 abomasal ulcer. RESULTS: The most common clinical findings were in decreasing order compromised health status accompanied by partial or complete anorexia (100%), abdominal guarding (81%), congested scleral vessels (77%), ruminal atony (73%), tachycardia (68%), tachypnoea (65%), positive foreign body tests (58%), decreased skin surface temperature (53%), fever (49%), reduction in negative intraabdominal pressure assessed transrectally (39%), poorly subdivided plant fragments in faeces (35%) and arched back (28%). The principal haematological abnormalities were hypokalaemia (72%), haemoconcentration (69%), azotaemia (56%), metabolic acidosis (49%), hyperfibrinogenaemia (45%), leukopenia (35%) and hypoproteinaemia (29%). Other abnormalities were aciduria (56%), haematuria (44%), increased chloride concentration in rumen fluid (34%) and abnormal peritoneal fluid (98%). Of 75 examined cows, 65 (87%) had ultrasonographic evidence of local or generalised peritonitis. On postmortem examination all cows had a type-4 abomasal ulcer and generalised peritonitis. In addition, 36 cows had type-1 ulcers, 6 had type-2 ulcers and one cow had a type-3 ulcer. DISCUSSION: The clinical signs in cows with type-4 abomasal ulcer are associated with generalised peritonitis. An increased haematocrit, indicating shock-induced haemoconcentration is characteristic in contrast to cows with traumatic reticuloperitonitis. Ultrasonography is useful for visualising and assessing generalised peritonitis. CONCLUSIONS: The diagnosis of type-4 abomasal ulcer based on clinical signs alone is difficult and therefore requires additional diagnostic procedures including the determination of the haematocrit and plasma protein concentration, abdominal ultrasonography and analysis of peritoneal fluid. In most cases, these steps lead to a correct diagnosis and allow timely euthanasia of the cow to prevent further suffering and unnecessary treatment costs. METHODS: The cows underwent a clinical, laboratory, ultrasonographic and postmortem examination.

Surto de compactação primária de abomaso em bovinos leiteiros associado ao consumo de silagem de girassol / Outbreak of primary abomasal impaction in dairy cattle associated with consumption of sunflower silage

Um surto de compactação primária de abomaso associada ao consumo de silagem de girassol ocorreu num rebanho bovino leiteiro do estado de Minas Gerais, do qual seis de 21 vacas secas em fase final de gestação e que recebiam silagem de girassol morreram. Os bovinos que adoeceram apresentaram distensão abdominal, fezes ressecadas e escassas e, nos bovinos que morreram, eram pastosas, escuras e fétidas; nesses havia também desidratação acentuada e palidez de mucosas. Três bovinos foram necropsiados e os achados patológicos eram constituídos principalmente por distensão acentuada do abomaso associada a grande quantidade de conteúdo alimentar ressecado coberto por coágulos de sangue. No abomaso havia úlceras, com perfuração da parede em um dos bovinos. A alimentação de bovinos de maior exigência nutricional com silagem de girassol de características indesejáveis como única fonte de volumoso foi o principal fator para a compactação de abomaso nos casos apresentados.

An outbreak of primary abomasal impaction associated with consumption of sunflower silage occurred in a dairy cattle herd from the state of Minas Gerais. Six of 21 dry cows in late pregnancy fed with sunflower silage died. Cattle that became ill presented abdominal distension and scant and dried feces. In the animals that died, severe dehydration, pale mucous membranes, dark, sticky and stinking feces were seen. Three cows were necropsied and the main pathological findings consisted of severe abomasal distension associated with a large quantity of dried alimentary content covered by bloody clots. Ulcers were found in abomasum, with perforation in one cow. Feeding cattle with high nutritional needs, with sunflower silage of undesirable characteristics as unique source of roughage was the main cause for the abomasal impaction.

Serum concentrations of haptoglobin and serum amyloid A in water buffaloes (Bubalus bubalis) with abomasal ulcer.

To evaluate the serum concentrations of haptoglobin (Hp) and serum amyloid A (SAA) in water buffaloes with abomasal ulcers, the abomasums of 100 randomly selected water buffaloes were examined after slaughter. Type I abomasal ulcers were found in 56 out of 100 buffaloes. Serum concentrations of Hp and SAA were measured. There was no significant difference between affected and non-affected buffaloes in the serum concentrations of Hp and SAA. The serum concentrations of Hp and SAA had no significant correlation with age and the serum SAA revealed no significant correlation with the number of abomasal ulcers. A significant correlation was found between the serum Hp and the number of abomasal ulcers (r =0.29, p = 0.04). There was no significant difference in the serum concentrations of Hp and SAA between buffaloes with different ulcer locations in the abomasums. Although more work on a larger number of animals is required in this area, it seems that the measurement of the serum Hp can be used to predict the abundance of type I abomasal ulcers.