case report - oabp education/2009/fall/morrow.pdf · protein in the diagnosis of traumatic...

Case Report

Christie MorrowOVC 2010

Outline

1. Background & Significance

2. Signalment & History

3. Physical Examination

4. Diagnostics

5. Treatment Options

6. Necropsy

7. Prevention

BackgroundBackground

• Non-discriminatory eating habits

• 70% wires, 30% steel

• Occur due to compression of rumen &reticulum late gestation, parturition,mounting during estrus

• Prevalence

Significance

• Severe loss in production

• High mortality rate

• Of those clinically affected

25% incurable complications

Remainder recover with intervention orspontaneously

HistoryHistory

• Second lactation Holstein

• Off-feed 3 weeks prior to calving

• Uneventful calving

• Off-feed & poor doing at 28 DIM

Pneumonia diagnosed

Treatment: TMS IM for 5 days

• Follow-up visit 1 week later with noimprovement

Physical ExaminationPhysical Examination

• T-39.8ºC P-? R-44

• Bilateral fluid noise over heart

• Submandibular & brisket edema

• BCS 2/5

• ↓ rumen rolls & sounds

• CRT > 2secs

• Mucus membranes: pale & moist

• Positive withers pinch

Differential DiagnosesDifferential Diagnoses

• Traumatic reticuloperitonitis

• Lymphosarcoma

• Heart disease

• Chronic lung disease/pleuritis

• Abomasal ulcers

• Kidney disease

• Liver disease

• Protein losing enteropathy

Diagnostics

• CBC & Biochemistry Panel

• Total plasma protein (>10g/dl)

• Abdominocentesis

• Radiographs

• Metal detector

• Ultrasound

Treatment

• Magnet

• Confinement

• Broad spectrum parenteral antibiotics

• Rumenotomy

Necropsy

• Diffuse peritonitis with increased turbidperitoneal fluid

• Adhesions between reticulum &diaphragm

• Adhesions between pericardial sac &diaphragm

• Diffuse pleuritis & pleural effusion

• Pericarditis

Necropsy

• Pericarditis with large amount of foulsmelling pericardial fluid

• 9.5 cm wire found penetrating fromreticulum through diaphragm and intopericardial sac

• Magnet found attached to wire inreticulum

Necropsy

PERITONEAL CAVITY

Necropsy

HEARTLUNG

THORACIC WALL

Necropsy

Necropsy

Conclusion

• Traumatic reticulopertionitis andpericarditis

• Subsequent congestive heart failure

Prevention

• Routine magnet placement in heifers

• Magnets on harvesting & feedingmachinery

• Avoid areas with lots of metal debris

References1 Ducharme NG, Fubini SL. Farm Animal Surgery. Saunders, St. Louis, Missouri, 2004.184-

185.

2 Kahn CM, Line S. Merck Veterinary Manual, www.merckvetmanual.com. WhitehouseStation: Merck & Co. Inc, 2008.

3 Cavedo, AM., Latimer, KS., Tarpley., HL. Bain, PJ. Traumatic Reticuloperitonitis (HardwareDisease) in Cattle. University of Georgia, Athens, GA. 2004.

4Dubensky RA, White ME: The sensitivity, specificity and predictive value of total plasmaprotein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244,1983.

5Fubini SL, Yeager AE, Mohammed HO, Smith DF. Accuracy of radiography of the reticulumfor predicting surgical findings in adult dairy cattle with traumatic reticuloperitonitis: 123cases (1981-1987). JAVMA. 1990 Oct 15;197(8):1060-4.

6Ramprabhu R, Dhanapalan P, Prathaban S. Comparative Efficacy of Diagnostic Tests in theDiagnosis of Traumatic Reticuloperitonitis and Allied Syndromes in Cattle. IsraelJournal of Veterinary Medicine.

7Smith BP. Large Animal Internal Medicine, Third Edition. Mosby, Inc. 2002; 747-753.

8Rebhun WC. Diseases of Dairy Cattle. Lippincott Williams & Wilkins. Media, PA. 1995:113-116.

Acknowledgements

• Listowel Veterinary Clinic

• OABP

• Pfizer

Questions?