LDA, RDA, RTA

LDA clinical signs

o Decreased feed intake (grain before forage)

o Drop in milk production

o Scant feces

o High pitched ring over 9th-13th rib

o Concurrent postpartum disorders

LDA predisposing factors

o High energy ration

o Low forage content

o Ketosis

o Hypocalcemia

o Ruminal acidosis

o Over conditioned cattle

o Genetics

What to look for on farm when have LDA cases

o Net energy being fed

o How are the cows eating? Are they sorting, chewing cud?

o Particle size of feed

o When and where feed is being delivered

o Transition diets!

LDA prognosis

return to function is high in short term but low in long term

LDA medical treatment

o Restore abomasal motility with calcium, intestinal stimulants, fluid therapy, therapeutic trailer ride, beer/jog?

o Resolved LDA in <5% of cases

o Do these things if you need to buy some time before you can cut

LDA surgical approaches

-right paralumbar omentopexy

-right paralumbar pyloropexy

-left paralumbar abomasopexy

-roll and toggle

-ventral abomasopexy

-laprascopic abomasopexy

Steps to right paralumbar omentopexy

• Enter abdominal cavity and explore

• Find gas filled abomasum between rumen and left body wall

• Deflate dorsally with 14G needle

• Sweep abomasum under rumen to correct position

• Identify greater omentum and dorsocaudally until pylorus is visualized

• Tac in omentum near pylorus into first abdominal closure

Advantages of right paralumbar omentopexy

• Can fix RTA, RDA, and LDA

• Can be done prophylactically

• Easy access for abdominal exploration

• Standing procedure

Disadvantages of right paralumbar omentopexy

• Has potential to redisplace in bigger cows (omentopexy>pyloropexy)

• Deflation of abomasum is blind

• Long reach needed

Right paralumbar pyloropexy

Hold pylorus with forceps and incorporate at least three bites of the pylorus and the omentum into the first layer of abdominal wall (suture bites should NOT penetrate lumen of pylorus or duodenum)

Steps to left paralumbar abomasopexy

• Prepare an area 15-25cm caudal to xiphoid and right of midline

• Suture 8cm of abomasum along greater curvature

• Place sutures through abdominal wall

• Deflate abomasum (assistant pulls on sutures while surgeon deflates)

• Surgeon checks for strangulation of intestines/abomasum

• Assistant ties sutures outside of body cavity

Advantages of left paralumbar abomasopexy

• Easy to visualize abomasum

• Secure fixation

• Standing procedure

Disadvantages of left paralumbar abomasopexy

• Need an assitant

• Need a long reach

• Not good for abdominal exploration

Roll and toggle steps

• Sedate

• Cast to dorsal recumbency

• Determine location of abomasum in proper location

• Place trocar with cannula through body wall into abomasum

• Insert toggle through cannula

• Repeat the above steps 3-4 inches caudal from first spot and tie the suture ends

Roll and toggle advantages

• Cost effective

• Efficient

• Success rate >80%

Roll and toggle disadvantages

• Casting

• No visualization of abomasum or abdominal cavity

• Will not work as a prophylactic

Steps to ventral abomasopexy

• Make incision 3-4in off midline in ventral paramedian area

• Thorough abdominal explore

• Place 4-6 mattress sutures through musculature of body wall, peritoneum, ventral fundus of abomasum

Advantages of ventral abomasopexy

• Good visualization

• Secure fixation

Disadvantages of ventral abomasopexy

• Bloat, regurgitation

• Heavy sedation

• Assistant needed

Laprascopic abomasopexy allows for

direct visualization of toggle-pin placement

RDA right paralumbar approach

o Follow procedure for pyloro-omentopexy for LDA

o Gas must be removed

o Push abomasum cranially and ventrally

RTA common clinical signs

o Sudden onset

o Complete anorexia

o Complete cessation of lactation

o Dehydration 10-12%

o Increased HR >100bpm

o Large ping and splash in right side of abdomen

RTA right paralumbar approach

To replace the abomasum, place your left land under the abomasum, then lift and push cranially and dorsally