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