Bovine GI Therapy

What is AMDUCA?

Allows for vets to use extralabel uses of drugs

What are the food animal specific regulations of AMDUCA?

1. No approved animal drug that is labeled for that use

2. Prior to prescription vet must

   1. Diagnosis

   2. Withdrawal periods

   3. Ensure identity of treated animal is maintained

   4. Ensure withdrawal times are enforced

What does melena indicate?

Upper GI bleed

What is ulceration?

Penetration of mucosa and extension through submucosa, muscularis externa and serosa

What is erosion?

Discrete mucosal defects without penetration of muscularis mucosa

What are the types of abomasal ulcers?

Type 1: non-perf, minimal intraluminal hemorrhage

Type 2: non-perf with severe blood loss

Type 3: Perforating, local peritonitis

Type 4: perforation, diffuse peritonitis

What are some normal protective mechanisms of the abomasum?

Mucous barrier

Blood flow

Gastric motility

Prostaglandins

Pyloric sphincter

What imbalances can lead to ulcers?

Mucosal epithelial trauma

Decreased luminal pH

Decreased blood flow

Decreased prostalgandins

What are predisposing factors to ulcers in calves?

Stress

Microorganism invasion

Abrasion

Mineral deficiency

What are predisposing factors to ulcers in adults?

Stress

Diet

Lymphosarcoma

Drugsq

How can you diagnose an abomasal ulcer?

Fecal occult blood test

Abdominocentesis

Abdominal US

Abomasocentesis

How do you treat abomasal ulcers?

Reduce stress

Restore appetite

Enhance protective mechanisms of mucosa by manipulating pH to alkalotic

provie RBCs if needed

How can you neutralize acid?

Oral antacids like aluminum hydroxide or magnesium hydroxide

How can you prevent acid secretion?

H2 receptor antagonists

PPIs

Prostaglandin analogs

How do you protect damaged mucosa?

Sucralfate

What is the difference between aluminum hydroxide and magnesium hydroxide?

Aluminum binds pepsin AND bile acids, Mg only binds bile acids

How do H2 receptor antagonists work and give examples?

Competitive antagonism of histamine receptors on parietal cells

Cimetidine, Ranitidine, Famotidine

How do PPI work and give examples?

Bind and block K+/H+ ATPase on parietal cells

Omeprazole

Pantoprazole

WHat is the problem with cimetidien and ranitidine?

Must be given every 8 hours

Why are oral treatments not good for adult ruminants?

Diluted in rumen

What IV H2 antagonists and PPIs can be given?

Ranitidine

Pantoprazole

What is the etiology of abomasitis?

C. perfringens Type A

Sarcina

What are C/S of abomasitis?

Milk fed calves

2-4 weeks

Acute onset bloat, anorexia

Depression or recumbency

Shock

Diarrhea

Colic

Abdominal distension

How do you diagnose abomasitis?

Blood gas with acidosis and lactatemia

Chem: azotemia, hypochloremia

CBC: immature and toxic neutrophils

Abomasal US

What supportive care do you want for abomasitis?

IV fluids warm environment

What drugs do you want for abomasitis?

Pro-Pen G (good Gram +)

Antitoxin for C. per f C and D

What is the goal of antibiotic treatment?

Treat bacteremia

Decrease amount of coliform bacteria in SI

How do you pick an antibiotic?

Route, spectrum, MOA, drug elimination

What Abx are labeled for FDA calf diarrhea?

Oxytet, amoxicillin, chlortet, neomycin, streptomycin, sulfamethazine BUT there is no -peer revied info showing label doses work in natural infection

When should you use ABs for diarrhea calf?

Systemic signs like depression, fever, yooung, comorbidity

When should you not use antibiotics for a diarrhea calf?

Normal appetite, activity, temp, hydration