Case Description—4 adult Holstein dairy cows were examined for anorexia and decreased milk production.
Clinical Findings—Clinical signs included abdominal distension, normal to decreased ruminal motility, and decreased fecal output. Hypochloremia and high BUN concentration were also noted on serum biochemical analysis. Transabdominal ultrasonography revealed abnormal thickening of the abomasum with pyloric thickening and loss of the typical layered appearance of the pyloric wall. Results of cytologic examination of fine-needle aspirates of the abnormal portion of the abomasum were compatible with a diagnosis of lymphoma in 3 cows.
Outcome—The diagnosis of lymphoma involving the abomasum was confirmed by exploratory laparotomy, necropsy, or slaughterhouse reports. Two cows were euthanatized, 1 died 5 days after the diagnosis, and 1 was sent to the slaughterhouse, but the carcass was discarded because of generalized lymphoma.
Clinical Relevance—Transabdominal ultrasonography is a noninvasive portable test that can be useful for the diagnosis of lymphomatous infiltration of the pyloric portion of the abomasum, which may result in obstruction. This can be especially useful to avoid unnecessary treatments when no typical signs of enzootic lymphoma are present. Percutaneous fine-needle aspiration of the abnormally thickened abomasal wall should be performed. These procedures can enable diagnosis of this neoplasm, which has a relatively poor prognosis, thus avoiding the unnecessary costs incurred by exploratory laparotomy.
Procedures—For each cow, thoracoscopy was performed in both the left and right hemithoraxes with a 24-hour interval between procedures. Cows were sedated and restrained in a standing position for each thoracoscopic examination. Examination of each hemithorax lasted for 30 minutes. Arterial blood gas variables, heart rate, and respiratory rate were assessed at predetermined times before, during, and after the procedures to monitor cardiovascular and pulmonary function. Thoracic ultrasonography was performed immediately and at 24 hours and 1 week after each thorascopic examination to evaluate the extent of residual pneumothorax.
Results—Insertion of the laparoscope into the pleural cavity at the ninth intercostal space 15 cm ventral to the transverse processes of the thoracic vertebrae provided optimal visibility of structures in both the left and right hemithoraxes. Most structures of the pleural cavity were equally visible from both sides except the esophagus and the dorsal branch of the vagus nerve, which were best observed in the left hemithorax, and the pericardium, which was best observed in the right hemithorax. Mild increases in heart and respiratory rates and moderate decreases in arterial oxygen saturation and Pao2 were detected during the procedures.
Conclusions and Clinical Relevance—Standing thoracoscopy was well tolerated in healthy adult dairy cattle and needs to be evaluated in cattle with pulmonary disease.
Objective—To identify changes over time in relative expression of matrix metalloproteinase-2 (MMP-2) and -9 (MMP-9) in synovial fluid from healthy calves and calves with experimentally induced septic arthritis.
Animals—12 Holstein calves.
Procedures—In 7 calves, Escherichia coli was injected in the right tarsal joint on day 1. Joint lavage was performed on day 2, and calves were treated with ceftiofur from days 2 through 21. Synovial fluid samples were collected on days 1 (before inoculation), 2 (before joint lavage), 3, 4, 8, 12, 16, 20, and 24. In the remaining 5 calves, joint lavage was performed on day 2 and synovial fluid samples were collected from the left tarsal joint. Relative expression of MMP-2 and MMP-9 was determined by means of gel zymography.
Results—On day 1, MMP-2 was detected in all synovial fluid samples but MMP-9 was not detected. In calves with septic arthritis, values for relative expression of MMP-9 monomer and dimer were significantly increased on days 2 through 20 and days 2 through 24, respectively, and relative expression of MMP-2 was significantly increased on days 3 through 20. There were significant linear associations between relative expression of the monomer and dimer forms of MMP-9 and between neutrophil count and relative expression of the MMP-9 monomer and dimer forms.
Conclusions and Clinical Relevance—Results indicated that relative expression of MMP-9 and MMP-2 increased in synovial fluid from calves with experimentally induced septic arthritis, with relative expression remaining high for several days after infection.
OBJECTIVE To describe clinical findings and diagnostic test results and identify potential prognostic indicators for calves with septic arthritis.
DESIGN Retrospective case series.
ANIMALS 64 calves with septic arthritis.
PROCEDURES The medical record database for a veterinary teaching hospital was searched to identify calves ≤ 6 months old that were treated for septic arthritis between 2009 and 2014. Data evaluated included signalment, history, physical examination and diagnostic test results, treatment, and outcome. Descriptive data were generated, and calves were assigned to 2 groups (neonatal [≤ 28 days old] or postneonatal [29 to 180 days old]) on the basis of age at hospital admission for comparison purposes.
RESULTS 64 calves had 92 infected joints; 17 calves had polyarthritis. Carpal joints were most frequently affected followed by the stifle and tarsal joints. Forty-nine bacterial isolates were identified from synovial specimens for 38 calves, and the most commonly identified isolates were catalase-negative Streptococcus spp (n = 14) and Mycoplasma bovis (9). Calves in the neonatal group had a shorter interval between onset of clinical signs and hospitalization and were more likely to have an infected carpal joint than calves in the postneonatal group. Outcome was positive for 35 calves. Synovial fluid total nucleated cell count was positively associated with a positive outcome.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that empirical antimicrobial treatment for calves with septic arthritis should target gram-positive catalase-negative cocci and M bovis and that synovial fluid total nucleated cell count might be a useful prognostic indicator.
CASE DESCRIPTION A 4-hour-old 6.3-kg (13.9-lb) female alpaca cria was evaluated because of severe respiratory distress and difficulty nursing since birth.
CLINICAL FINDINGS The cria had open-mouth breathing and cyanotic membranes, with no airflow evident from either nostril. Supplemental oxygen was delivered, and the patient was anesthetized and intubated orotracheally; a CT evaluation of the head confirmed bilateral membranous obstruction of the nasal cavities, consistent with complete bilateral choanal atresia.
TREATMENT AND OUTCOME Choanal atresia was treated with an endoscopically assisted balloon-dilation technique, and temporary tracheostomy was performed. Stenosis recurred, requiring revision of the repair and intranasal stent placement 3 days after the first surgery. The tracheostomy tube was removed the next day. Complications during hospitalization included mucoid obstruction of the tracheostomy tube, granulation tissue development in the trachea near the tracheostomy site, mucoid stent obstruction, aspiration pneumonia, and presumed partial failure of passive transfer of immunity. The stents were removed 2 weeks after admission, and the cria was discharged 3 days later. The owner was advised that the animal should not be bred. At last follow-up 3 years later, the alpaca was doing well.
CLINICAL RELEVANCE Surgical treatment with a balloon-dilation technique and placement of nasal stents with endoscopic guidance were curative in this neonatal alpaca with bilateral membranous choanal atresia. Computed tomography was useful to determine the nature of the atresia and aid surgical planning. Because a genetic component is likely, owners should be advised to prevent affected animals from breeding.
To evaluate the association between serum phosphorus concentration and the outcome of postpartum downer cows.
Postpartum downer dairy cows presented over a 22-year period.
In this cross-sectional study (1994 to 2016), medical records of all postpartum downer cows presented to a referral large animal hospital were reviewed. The association between serum inorganic phosphorus concentration and survival was assessed using a multivariable logistic regression.
907 postpartum downer dairy cows were included and classified as hypophosphatemic (mild: > 2.25 to < 3.25 mg/dL, moderate: > 1.50 to ≤ 2.25 mg/dL, and severe: ≤ 1.50 mg/dL), normophosphatemic (≥ 3.25 and ≤ 8.76 mg/dL) or hyperphosphatemic (> 8.76 mg/dL). Hypophosphatemia was observed in 19.4% of the cows (n = 176). Of those, 54.5% (n = 96) were also hypocalcemic. Overall, 58.4% cows (n = 530) survived after hospitalization. Hypophosphatemia was not significantly associated with the outcome of postpartum downer cows (mild: OR = 1.0, 95% CI: 0.6 to 1.8; moderate: OR = 0.5, 95% CI: 0.2 to 1.1; severe: OR = 1.0, 95% CI: 0.4 to 2.4).
Low serum phosphorus concentration was frequently observed with hypocalcemia and was not associated with the outcome of postpartum downer cows.
To describe the clinical and clinicopathologic characteristics, treatment, and outcome for cattle that developed a retroperitoneal abscess (RA) following paralumbar fossa laparotomy (PFL).
32 Holstein cows with RA.
The record database of a veterinary teaching hospital was searched to identify cattle that were treated for an RA between January 1995 and March 2017. Cattle with an RA > 30 cm in diameter located 3.5 cm subjacent to the skin that had undergone a PFL < 3 months before examination for the RA were evaluated. Information extracted from the record of each cow included signalment; physical examination, clinicopathologic, and transabdominal ultrasonographic findings; treatments administered; and outcome. Milk production data were analyzed for the lactations before, during, and after RA treatment.
Common physical examination findings were rumen hypomotility, anorexia, and fever, and common clinicopathologic findings were anemia and neutrophilia. Abdominal palpation per rectum and transabdominal ultrasonography facilitated RA diagnosis and identification of the optimal location for drainage. Thirty of 32 cows underwent surgical drainage of the RA and prolonged administration of systemic antimicrobials. Two cows were euthanized because of concurrent peritonitis, including 1 that underwent surgical RA drainage. Thirty cows were discharged from the hospital alive, and most returned to their previous level of milk production.
CONCLUSIONS AND CLINICAL RELEVANCE
Although uncommon, RA should be suspected in cows that develop anorexia and fever within 3 months after PFL. Cows with RA often returned to their previous level of milk production, but treatment was generally prolonged and costly.
Objective—To characterize duodenal sigmoid flexure volvulus (DSFV) and determine the prognosis for affected cattle undergoing surgery.
Design—Retrospective case series.
Animals—29 dairy cattle.
Procedures—The medical records were analyzed for history, signalment, clinical signs, medical management, surgical findings, and outcome.
Results—29 cattle were determined to have DSFV between December 2006 and August 2010. Twenty cattle had had an omentopexy or pyloropexy performed 1 day to 2 years before initial evaluation. Cattle were afebrile, tachycardic, and moderately dehydrated, with a small zone of percussion with a ping at the 10th to 12th right intercostal spaces and associated succussion. Biochemical changes were a severe hypokalemic (mean ± SD, 2.9 ± 0.5 mmol/L; median, 3.1 mmol/L; range, 2.08 to 3.92 mmol/L), hypochloremic (mean, 69.7 ± 11.1 mmol/L; median, 71.7 mmol/L; range, 49.1 to 94.1 mmol/L) metabolic alkalosis (mean total CO2, 44.5 ± 7.4 mmol/L; median, 45.3 mmol/L; range, 31.5 to 59.6 mmol/L) and hyperbilirubinemia (mean, 32.4 ± 29.0 μmol/L; median, 20.5 μmol/L; range, 7.8 to 107 μmol/L). Surgical findings for DSFV included an empty descending duodenum adjacent to a dorsally displaced and dilated cranial segment of the duodenum, distended abomasum and gallbladder, and a tight volvulus at the base of the duodenal sigmoid flexure. Manual reduction was considered successful if the descending duodenum filled after cranial duodenal massage. Twenty-two patients were successfully treated; the remaining 7 died or were euthanized within 4 days after surgery.
Conclusions and Clinical Relevance—A condition clinically resembling abomasal volvulus but affecting the duodenal sigmoid flexure has been recognized in dairy cattle. When a focal, dorsal right-sided ping and succussion are present combined with severe hypokalemic, hypochloremic metabolic alkalosis and high bilirubin concentration, DSFV should be suspected, especially when there is a history of prior abomasal fixation. After surgical correction, the prognosis is fair to good.