34. displacement of abomasum

PE findings of LDA / RDA (partial obstruction)

• auscultation of hyper-resonant ping from 9th-13th rib with succussible fluid

• ribcage may appear “sprung”

• palpation of gas-filled structure / rumen pushed to midline

PE findings of right abomasal volvulus (complete obstruction)

• cattle sicker than with DAs

• higher HR (80 to >100)

• hyper-resonant ping from paralumbar fossa to 8th ICS with succussible fluid

• not always palpable via rectal palpation

medical treatment of DA

• correct underlying cause of DA

• promote GI motility — promotility agents

• correct metabolic derangements

  • fluids with electrolyte supplements

  • dextrose

rolling cow technique

• cast on right side, roll to dorsal, then roll to left side slowly

• LDA only

• caution:

  • adhesions

  • contraindicated for pneumonia or ruminal distention

advantages of percutaneous abomasopexy

• quick

• inexpensive

disadvantages of percutaneous abomasopexy

• uncertainty if abomasum (blind procedures)

• LDA cases only

• recurrence

• laceration of milk veins (superficial epigastric veins)

  • mark while cow is still standing

• fistula formation if sutures left >2-3 weeks

what is laparoscopic abomasopexy?

• placement of toggles under laparoscopic guidance

  • 1 or 2-step procedure

• need special equipment & experience to perform surgery

advantages of left flank abomasopexy

• minimal restraint

• best technique for late pregnancy cows with LDA

• adhesions seen can be dissected

disadvantages of left flank abomasopexy

• limited abdominal exploration

• requires long arms in large cows

• risk of lacerating superficial epigastric vein (milk vein)

advantages of right ventral paramedian abomasopexy

• strong adhesion formation

• ability to work with prior adhesions

• approach of choice for abomasal ulcers & impaction

disadvantages of right ventral paramedian abomasopexy

• >1 person needed

• dorsal recumbency complications for cow

  • bloat

  • regurgitation

• limited abdominal exploration

• risk of incisional hernia / abomasal fistula formation

advantages of right flank pyloro-omentopexy

• minimal restraint

• versatile approach

• thorough abdominal exploration

disadvantages of right flank pyloro-omentopexy

• requires long arms in large cows

• high recurrence rate, especially if omentopexy alone

• risk of abomasal outflow obstruction

  • incorrect suture position

  • scar formation around pylorus

• if adhesions on left body wall, cannot replace — need to open up L side too

poor prognostic indicators

• pre-op HR: >80 bpm (simple DA), >100 bpm (volvulus)

• severe concurrent disease

• pre-op bloodwork

  • Cl^-: <79 mEq/L

  • base excess: >32 mEq/L

• compromised abomasum

• post-op: vagal indigestion, poor appetite after 2-3 days