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

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Case Report Christie Morrow OVC 2010

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Page 1: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Case Report

Christie MorrowOVC 2010

Page 2: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Outline

1. Background & Significance

2. Signalment & History

3. Physical Examination

4. Diagnostics

5. Treatment Options

6. Necropsy

7. Prevention

Page 3: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

BackgroundBackground

• Non-discriminatory eating habits

• 70% wires, 30% steel

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

• Prevalence

Page 4: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Significance

• Severe loss in production

• High mortality rate

• Of those clinically affected

25% incurable complications

Remainder recover with intervention orspontaneously

Page 5: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

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

Page 6: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

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

Page 7: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Differential DiagnosesDifferential Diagnoses

• Traumatic reticuloperitonitis

• Lymphosarcoma

• Heart disease

• Chronic lung disease/pleuritis

• Abomasal ulcers

• Kidney disease

• Liver disease

• Protein losing enteropathy

Page 8: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Diagnostics

• CBC & Biochemistry Panel

• Total plasma protein (>10g/dl)

• Abdominocentesis

• Radiographs

• Metal detector

• Ultrasound

Page 9: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Treatment

• Magnet

• Confinement

• Broad spectrum parenteral antibiotics

• Rumenotomy

Page 10: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Necropsy

• Diffuse peritonitis with increased turbidperitoneal fluid

• Adhesions between reticulum &diaphragm

• Adhesions between pericardial sac &diaphragm

• Diffuse pleuritis & pleural effusion

• Pericarditis

Page 11: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

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

Page 12: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Necropsy

PERITONEAL CAVITY

Page 13: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Necropsy

HEARTLUNG

THORACIC WALL

Page 14: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Necropsy

Page 15: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Necropsy

Page 16: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Conclusion

• Traumatic reticulopertionitis andpericarditis

• Subsequent congestive heart failure

Page 17: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Prevention

• Routine magnet placement in heifers

• Magnets on harvesting & feedingmachinery

• Avoid areas with lots of metal debris

Page 18: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

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.

Page 19: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Acknowledgements

• Listowel Veterinary Clinic

• OABP

• Pfizer

Page 20: Case Report - OABP Education/2009/Fall/Morrow.pdf · protein in the diagnosis of traumatic reticuloperitonitis. Can J Comp Med 47:241-244, 1983. 5Fubini SL, Yeager AE, Mohammed HO,

Questions?