FA GI Topics
Cows eat all sorts of stuff. Any foreign bodies usually end up in the reticulum. This includes nails, wire, ropes, etc. The sharp objects can be pushed through the reticular wall, creating a hole in the reticulum that leaks ingesta. The reticulum and heart are separated only by the diaphragm. A nail or similar object will often puncture the diaphragm and sometimes the pericardial sac. Cows with hardware disease may have peritonitis, abscesses from consolidated peritonitis, pleuritis, and/or pericarditis.
Traumatic reticuloperitonitis secondary to hardware is more common in the postpartum period, often related to the straining of parturition. As the cow strains, the metal is pushed out of the reticulum.
- Fever (although they can also be normothermic)
- Dramatic decrease in milk production
- Signs of abdominal pain: bruxism, grunting, hunched stance with abducted elbows
- Distended rumen
- Lifts up when pressure is applied at the xyphoid using a board or the hand pressure test
- Does not scootch with withers pinch
Ueli Braun1* , Sonja Warislohner1, Paul Torgerson2, Karl Nuss1 and Christian Gerspach1Background: The study evaluated the results of clinical examination and haematological and serum biochemical analyses in 503 cattle with traumatic reticuloperitonitis (TRP).
Results: The most common clinical findings were abnormal demeanour and general condition (87%), decreased rumen motility (72%), poorly digested faeces (57%), decreased rumen fill (49%), fever (43%) and tachycardia (26%). In 58% of the cattle, at least one of three tests for reticular foreign bodies (pinching of the withers, pressure on the xiphoid and percussion of the abdominal wall) was positive, and in 42% all three tests were negative. The most common haematological findings were decreased haematocrit in 45% of cattle and leukocytosis in 42%. An increase in the concentration of fibrinogen in 69% of cattle and total protein in 64% were the main biochemical findings. The glutaraldehyde test time was decreased with coagulation occurring within 6 min in 75% of cattle.
Conclusions: In many cases, a diagnosis of TRP is not possible based on individual clinical or laboratory findings because even the most common abnormalities are not seen in all cattle with TRP.
Confirmation is more easily performed with ultrasonography rather than radiographs. Diagnosis on ultrasound is based on signs of peritonitis/pleuritis, abscess formation or other related changes. Sometimes the foreign object can be seen but it depends on how much gas is around it.
Ruptured abomasal ulcers and liver abscesses can present similarly.
Exploratory surgery is often used as a diagnostic test. The reticulum can be palpated from either the right or left side. A right flank exploratory is best if you don’t know the cause of the cow’s issues. If hardware disease is high on the list, a left flank approach provides an option for treatment as well as diagnosis.
Prognosis is guarded due to the challenges in effective treatment. Prognosis is grave if the object has penetrated the diaphragm.
- Conservative – treat medically with antibiotics and rest; allow the infection to wall off. Add a magnet if she doesn’t have one to stabilize the wire. However, in some cases, the magnet may not move into the reticulum. Transfaunate.
- Surgery – Rumenotomy to remove the object and/or drain the abscess. It is important to not make things worse. Start with an exploratory, leaving the reticular area to last. Do not explore after contamination is encountered or rumenotomy performed. Tacking the rumen up or using a rumen board or shroud is needed to minimize the risk of peritonitis from leaking rumen contents. Abscesses must be cranial to be worth draining (an ventral abscess won’t drain up into the rumen; drainage of an abscess on the medial aspect risks damaging the vagal nerve.) Ensure one magnet and transfaunate.
- Cull – not a bad idea for some cows
As much foreign material should be kept out of feed troughs as possible. Cows may be pretreated with a magnet to catch metallic objects as they move into the reticulum.