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1.
[目的]探究奶牛十二指肠乙状弯曲扭转(DSFV)的临床特点,以评估手术的临床预后。[方法]回顾性病例系列研究。评估动物:29头荷斯坦牛(28头奶牛,1头公牛)。过程:利用搜集的病例分析病史、特征描述、临床症状、治疗经过、术中所见以及结果。[结果]对2006年12月至2010年8月间29头患有十二指肠乙状弯曲扭转奶牛的评估研究,有20头奶牛在最初评估前1d到两年做过网膜固定术或幽门固定术,奶牛在右侧腹壁第10和12肋间区域和背部听诊与叩诊时有‘钢管音’,伴有心动过速、轻度脱水、体温不高、血液生化指标有严重低血钾(均数mean±标准差SD,2.9±0.5mmol/L;中位数median,3.1mmol/L;全距range,2.08—3.92mmol/L)、低血氯(均数mean,69.7±11.1mmol/L;中位数median,71.1mmol/L;全距range,49.1-94.1mmol/L)、代谢性碱中毒(均数mean total CO2,44.5±7.4mmol/L;中位数median,45.3mmol/L;全距range,31.5-59.6mmol/L)和高胆红素血症(均数mean,32.4±29.0μmol/L;中位数median,20.5μmol/L;全距range,7.8-107μmol/L)。术中所见包括紧靠背部而变位的空的十二指肠后段和鼓气的十二指肠前段,以及紧紧缠绕在十二指肠乙状弯曲部而肿胀的皱胃和胆管。按压十二指肠前段,如果后段仍有胀气,可成功人工整复。评估中,22头奶牛成功治愈,7头在术后4d内死亡。[结论]临床上该病与奶牛皱胃扭转(AV)的症状十分相似,当在右侧背部的病灶区听到"钢管音",并有严重的低血钾和低血氯、胆红素浓度增高、且有皱胃固定术病史者,则基本能够诊断为十二指肠乙状弯曲扭转。手术整复后,临床预后良好。  相似文献   

2.
Twelve Suffolk sheep were examined because of an abomasal emptying problem. Anorexia and weight loss were evident in 11 of the sheep. Ventral abdominal distention was observed in 5 sheep. Laboratory analyses failed to show the hypochloremic, hypokalemic metabolic alkalosis commonly found in cattle with a similar problem. Rumen chloride concentrations in 3 sheep indicated reflux of abomasal contents into the rumen.  相似文献   

3.
Two cases where clinical findings suggestive of proximal ileus resulting in hypokalemic and hypochloremic alkalosis are presented. Ultrasonographs showed distension of the sigmoid flexure along the ventral border of the liver and between the serosal lamellae of the greater omentum in the flank, allowing exact preoperative obstruction localization.  相似文献   

4.
A chronic, partial mesenteric volvulus was found on laparotomy of an adult Bernese mountain dog with a 4-month history of intermittent vomiting, diarrhea, and weight loss. The dog had elevated cholestatic and hepatocellular leakage enzymes, increased bile acids, azotemia, isosthenuria, and a hypokalemic, hypochloremic, metabolic alkalosis. The dog recovered fully following reduction of the volvulus.  相似文献   

5.
Five adult 40- to 50-kg female sheep were surgically fitted with a reentrant cannulae placed in the proximal part of the duodenum just distal to the pylorus. By diversion of abomasal outflow, this model has been shown to produce hypochloremic metabolic alkalosis accompanied by dehydration, hypokalemia, and hyponatremia. Each sheep was subjected to 3 separate, 12-hour IV treatment trials, in each case preceded by a control period of 48 hours, and a diversion period of 36 to 96 hours, during which a hypochloremic (Cl- less than or equal to 60 +/- 2 mEq/L) metabolic alkalosis with hypokalemia and hyponatremia was produced. Treatment 1, consisting of 6 L of isotonic Na gluconate, was designed to replace volume without replenishing the Cl-1 deficit. Although hydration improved, plasma Cl- decreased further, and the sheep became increasingly weak and depressed. Treatment 2, consisting of 2 L of 1.8% NaCl, was designed to replace the Cl- deficit without replacing total volume. Plasma Na+ and Cl- concentrations returned to normal during the 12 hours of treatment; acid-base balance and plasma K+ concentrations returned to normal within 36 hours of treatment. During treatment 3 (control, no treatment), measured metabolic values changed minimally. We concluded that the IV replacement of Cl- without K+ is effective in the correction of experimentally induced hypochloremic metabolic alkalosis in sheep.  相似文献   

6.
Magnesium Oxide Induced Metabolic Alkalosis in Cattle   总被引：1，自引：0，他引：1       下载免费PDF全文
A study was designed to compare the metabolic alkalosis produced in cattle from the use of an antacid (magnesium oxide) and a saline cathartic (magnesium sulphate). Six, mature, normal cattle were treated orally with a magnesium oxide (MgO) product and one week later given a comparable cathartic dose of magnesium sulphate (MgSO4).

The mean percent dry matter content of the cattle feces changed significantly (P<0.001) following administration of both MgO (15.6-8.1) and MgSO4 (17.0-8.7) but there was no significant difference between treatments. The mean rumen pH values changed significantly (P<0.001) following administration of both MgO (7.-8.7) and MgSO4 (7.3-8.3) but there was no significant difference between treatments. However, use of the MgO product caused a more severe (P<0.001) metabolic alkalosis as determined by base excess values. The base excess values remained elevated for 24 hours in the MgO treated group compared to only 12 hours after MgSO4 administration. Following MgO administration, mean hydrogen ion concentration (pH), bicarbonate ion concentration ([HCO3-]) and base excess were 7.44, 33.3 mmol/L and +8.0 respectively compared to 7.38, 27 mmol/L and +3.0 after MgSO4.

Since the oral use of MgO in normal cattle causes a greater and more prolonged metabolic alkalosis compared to MgSO4, MgO is contraindicated as a cathartic in normal cattle or in cattle with abomasal abnormalities characterized by pyloric obstruction and metabolic alkalosis.

  相似文献   

7.
The case records of 102 cows with abomasal volvulus and 71 cows with right-side displacement of the abomasum (RDA) were examined to determine whether the preoperative base-excess concentration of the extracellular fluid could be used both as a prognostic indicator for post-operative recovery in cattle with abomasal volvulus and as an aid in differentiating between abomasal volvulus and RDA. The survival rate of cows with abomasal volvulus decreased as the base excess concentration decreased (P = 0.08); the lowest survival rate was observed in cows with base excess less than or equal to -0.1 mEq/L. There was a significant difference (0.01 less than P less than 0.025) among base excess ranges between abomasal volvulus and RDA. All cows with preoperative base-excess concentrations less than or equal to -5.0 mEq/L had abomasal volvulus, rather than RDA.  相似文献   

8.
OBJECTIVE: To describe clinical findings, surgical treatment, and outcome associated with trichophytobezoar duodenal obstruction in New World camelids. STUDY DESIGN: Retrospective study. ANIMALS: Alpacas (7) and 1 llama. METHODS: Historical and clinical data were obtained from the medical records of New World camelids with a diagnosis of trichophytobezoar duodenal obstruction confirmed by surgical exploration or necropsy. RESULTS: Seven camelids were <1 year old. Abnormal clinical findings included anorexia, reduced fecal output, recumbency, colic, abdominal distension, regurgitation, decreased serum chloride concentration, increased serum bicarbonate concentration, and/or elevated first gastric compartment chloride concentration. Survey abdominal radiographs obtained (4 animals) revealed gastric distension (4) and/or visualization of the obstruction (2). Diagnosis was confirmed at necropsy (1) or surgery (7). Right paracostal celiotomy was performed on all animals and duodenotomy (3) or retropulsion of the trichophytobezoar combined with third compartment gastrotomy (4) was used to remove the obstruction. Six animals survived to discharge and 5 were healthy at follow-up, 8-20 months later. The remaining discharged alpaca was healthy at 12 months but subsequently died of unrelated causes. CONCLUSIONS: Diagnosis of trichophytobezoar duodenal obstruction should be considered in juvenile New World camelids with abdominal distension and hypochloremic metabolic alkalosis. Right paracostal celiotomy can be used for access to the descending duodenum and third gastric compartment for surgical relief of obstruction. CLINICAL RELEVANCE: Duodenal obstruction from bezoars should be considered in New World camelids <1year of age with abdominal distension and hypochloremic metabolic alkalosis. Surgical relief of the obstruction by right paracostal celiotomy has a good prognosis.  相似文献   

9.
Abnormal phosphorus homeostasis occurs in dairy cows with an abomasal displacement or volvulus. The goal of this study was to identify potential mechanisms for hypophosphatemia and hyperphosphatemia in cows with a left displaced abomasum (LDA), right displaced abomasum (RDA), or abomasal volvulus (AV). Accordingly, the results of preoperative clinicopathologic analyses for 1,368 dairy cows with an LDA (n = 1,189), RDA, or AV (n = 179) (data set 1) and for 44 cows with an AV (data set 2) were retrieved. Laboratory values were compared by Student's t-tests, and correlation and regression analyses were performed. Thirty-four percent of the animals from data set 1 (463/1,368) were hypophosphatemic (serum phosphorus concentration ([Pi]) < 1.4 mmol/L), and 9% (122/1,368) were hyperphosphatemic ([Pi] >2.3 mmol/L). Serum [Pi] was significantly lower (P < .05) in cows with an LDA (1.60 +/- 0.53 mmol/L; mean +/- SD) than in cows with an RDA or AV (1.85 +/- 0.68 mmol/L). For cows with an LDA, [Pi] was correlated with serum urea nitrogen concentration ([SUN]) (r = 0.34) and serum concentration of magnesium ([Mg]) (r = 0.20). For cows with an RDA or AV, linear correlations existed between [Pi] and [SUN] (r = 0.45), [Mg] (r = 0.43), and serum chloride concentration ([Cl]) (r = -0.27). Stepwise logistic regression analysis indicated that low [SUN] and the diagnosis of an LDA had the strongest associations with hypophosphatemia. In cows with hyperphosphatemia, [Pi] was most strongly associated with azotemia. In cows with an AV, the strongest correlations with [Pi] were found for [SUN] and serum creatinine. We conclude that hypophosphatemia in cows with an LDA is primarily due to decreased feed intake. In contrast, hyperphosphatemia in cattle with an RDA or AV appears to result from dehydration and decreased renal blood flow.  相似文献   

10.
A prospective study evaluating the prognostic value of surgical and postoperative findings in 80 cattle with abomasal volvulus was performed. Surgical correction of abomasal volvulus was performed in all animals. After surgery, cattle were categorized into 3 groups: productive (acceptable milk production or appetite, n = 59), salvaged (poor milk production or appetite, n = 10), and nonsurvivors (n = 11). Cattle with omasal-abomasal volvulus had a significantly (P less than 0.005) worse prognosis than cattle without omasal involvement. Large abomasal fluid volume, venous thrombosis, and blue or black abomasal color before decompression were all indicative of a poor prognosis. Most cattle had poor or fair appetites the first day after surgery; productive animals had marked improvement in appetite over the next 3 days. All cattle observed to have a good appetite within 3 days after surgery were later determined to be productive animals. The heart rate decreased in all groups after surgery; however, tachycardia (heart rate greater than 80 beats/min) was sustained in cattle that were later salvaged for slaughter. Diarrhea was observed after surgery in 54% of cattle. The duration of diarrhea was significantly shorter (P = 0.009) in productive cattle than in salvaged and nonsurviving cattle. The presence or absence of diarrhea was only of predictive value when considered in conjunction with the estimated abomasal fluid volume.  相似文献   

11.
Four adult, lactating dairy cows were subjected to diversion (loss) of gastric contents through a T-shaped cannula placed in the cranial part of the duodenum just distal to the pylorus. Diversion was continued for 10 to 12 hours, at which point the cows were very weak and depressed. The volume of effluent during this period ranged from 37.3 to 46.8 L, with the largest volume being produced during the first four hours. All cows became dehydrated, with mean packed cell volume and total plasma protein concentration increasing 30% and 19.6%, respectively, but with only a slight increase in plasma creatinine concentration. Plasma Cl- concentrations decreased from a mean of 97.3 mEq/L at the beginning of diversion to a mean of 87.2 mEq/L at eight hours. This was followed by a plateau or slight increase in concentrations over the final hours of diversion. Plasma K+ concentration followed a similar pattern, decreasing from a mean of 3.9 mEq/L to a mean of 2.94 mEq/L at six hours, followed by increasing values until termination of diversion. No changes in plasma Na+ concentration were noted, except for a mild decrease in one cow. Plasma calcium concentrations decreased significantly, reaching 6.6 +/- 0.6 mEq/L at the end of diversion. Venous pH, plasma HCO3- concentration, and plasma base excess concentration increased during the first four to eight hours of diversion, followed by a gradual decline. Although a mild hypochloremic metabolic alkalosis resulted from diversion of abomasal outflow in all cows, substantiated by a mild increase in plasma strong ion difference, the changes observed were not as great as expected.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

12.
The abomasal luminal pressure was determined during surgery in 54 dairy cows with abomasal volvulus (AV) and another 50 dairy cows with left displaced abomasum. The luminal pressure was high in all cattle with AV and 49 (98%) cattle with left displaced abomasum. Luminal pressure was significantly higher in cattle with AV (median, 11.7 mm of Hg; range, 4.1 to 32.4 mm of Hg) than cattle with left displaced abomasum (median, 8.7 mm of Hg; range, 3.5 to 20.7 mm of Hg). Among cattle with AV, abomasal luminal pressure was significantly higher in cattle that died or were sold for slaughter following surgery (median, 20.6 mm of Hg; n = 8) than in cattle that were retained in the herd (median, 11.0 mm of Hg; n = 46). The luminal pressure was weakly correlated with the preoperative serum alkaline phosphatase activity but not correlated with duration of inappetence before surgery. Calculation of likelihood ratios and construction of a response operating characteristic curve for cattle with AV indicated that a cut-off value of 16 mm of Hg for luminal pressure optimized the distribution of cattle into productive and nonproductive groups. The sensitivity, specificity, positive predictive value, and negative predictive value of a luminal pressure < 16 mm of Hg in predicting a productive outcome were 0.83, 0.75, 0.95, and 0.43, respectively.  相似文献   

13.
Impaired abomasal motility is common in cattle with abomasal disorders. The macrolide erythromycin has been demonstrated to be an effective prokinetic agent in healthy calves and in adult cattle with abomasal volvulus or left displaced abomasum. We hypothesized that 2 structurally related macrolides, spiramycin and tulathromycin, would also be effective prokinetic agents in cattle. Six milk-fed, male, Holstein-Friesian calves were administered each of the following 4 treatments: spiramycin, 75 000 IU/kg BW, IM, this dose approximates 25 mg/kg BW, IM; tulathromycin, 2.5 mg/kg BW, SC; 2 mL of 0.9% NaCl (negative control); and erythromycin, 8.8 mg/kg BW, IM (positive control). Calves were fed 2 L of cow’s milk containing acetaminophen (50 mg/kg body weight) 30 min after each treatment was administered and jugular venous blood samples were obtained periodically after the start of sucking. Abomasal emptying rate was assessed by the time to maximal plasma acetaminophen concentration. Spiramycin, tulathromycin, and the positive control erythromycin increased abomasal emptying rate compared to the negative control. We conclude that the labeled antimicrobial dose of spiramycin and tulathromycin increases the abomasal emptying rate in healthy milk-fed calves. Additional studies investigating whether spiramycin and tulathromycin exert a prokinetic effect in adult cattle with abomasal hypomotility appear indicated.  相似文献   

14.
The objective of this study was to evaluate serum mineral and electrolyte concentrations at the time of on-farm diagnosis of left displaced abomasum, right displaced abomasum, or abomasal volvulus in dairy cows. Data were collected from 104 affected cows and 96 control cows matched with cases, based on herd, parity, and stage of lactation. Cows with abomasal displacement or volvulus had significantly lower calcium, phosphorous, magnesium, potassium, and chloride concentrations and increased anion gap at the time of diagnosis compared with control cows from the same herds. The percentages of cases and controls with total serum calcium concentrations below the lower limit of the laboratory reference range (2.08 mmol/L [8.3 mg/dL]) were 70% and 23%, respectively. Based on the large percentage of cases with hypocalcemia, administering calcium salts at the time of treatment of field cases of abomasal displacement or volvulus may be beneficial.  相似文献   

15.
The records of 106 cases of right-sided displacement of the abomasum (RDA) and abomasal volvulus (AV) were reviewed. Pre- and postoperative heart rate (> or = 90 BPM), serum BUN (> or = 10 mmol/L), potassium (< or = 3.3 mmol/L) and chloride (< or = 85 mmol/L) were the best indicators for a non-productive outcome. High gamma-GT activity can be used as a preoperative indicator to differentiate AV from RDA. The overall rate of return to a productive life was 74% (81.2% of RDA cases and 67.3% of AV cases).  相似文献   

16.
Calves were prepared with abomasal and duodenal cannulae to assess the effects on abomasal emptying of duodenal infusates at different rates and different sites. In two calves infusions of isotonic NaHCO3 or 60 mM HCl 30 cm distal to the pylorus were as effective in controlling abomasal emptying as infusions of the duodenum from 5 cm distal to the pylorus, and in three other calves they were as effective as perfusing the whole duodenum including the most proximal 5 cm. Reducing the rate of duodenal infusion of 60 mM HCl from 10 to 2.5 ml/min diminished its effect from total inhibition of gastric emptying to slight or negligible inhibition. The stimulation of gastric emptying by duodenal infusion of isotonic NaHCO3 solution was undiminished by reduced rates of infusion. It is proposed that in the calf receptors which activate and inhibit gastric emptying are present throughout the duodenum.  相似文献   

17.
Physical and clinicopathologic findings from six cows with proximal duodenal obstruction (PDO) and 58 cows with abomasal volvulus (AV) were compared retrospectively. Many of the physical signs were similar in cows with PDO and cows with AV, but the two conditions differed in the type of abdominal distention, and in the findings from rectal examination and abdominal auscultation. Cows with PDO had significantly lower mean values for serum sodium (Na+) and chloride ion (Cl-), and higher mean values for plasma bicarbonate [HCO3-], base excess, carbon dioxide pressure (pCO2), serum phosphate, urea nitrogen, and total protein than AV affected cattle. Cows with PDO showed hyperglycemia (range, 263-990 mg/dl; mean, 618 mg/dl) of unexplained etiology that was significantly higher than blood-glucose concentrations in AV cows (mean, 178 mg/dl). Although all AV cows with anion gap values greater than 32 mEq/l died;PDO cows with equally elevated anion gap survived. The anion gap elevations in PDO and AV cows resulted from accumulation of different anions. Although the site of obstruction of aborad flow of ingesta is similar in both disease conditions, the differences in physical and clinicopathologic findings appear to reflect differences in the degree of reticulo-omasal orifice obstruction and the degree of abomasal vascular compromise.  相似文献   

18.
The purpose of this study was to determine serum urea and creatinine concentrations, the derived urea : creatinine (UC) ratios, haemoglobin concentrations and glomerular filtration rates (GFR) in dogs with haemolytic anaemia and those with experimentally induced anaemia and/or haemoglobinaemia. There were 25 dogs with babesiosis (group 1), 13 control animals (group 2), six dogs with induced haemoglobinaemia and anaemia (group 3), six with induced haemoglobinaemia (group 4), and 14 with immune-mediated haemolytic anaemia (IMHA) (group 5). The median serum urea concentration was 11.18 mmol/L (group 1), 4.3 mmol/L (group 2), 4.3 mmol/L (group 3), 4.35 mmol/L (group 4), and 8.5 mmol/L (group 5). Median serum creatinine was 67 μmol/L (group 1), 75 μmol/L (group 2), 78.5 μmol/L (group 3), 84 μmol/L (group 4), and 82 μmol/L (group 5). Median serum haemoglobin was 1.3g/L (group 1), 0.8 g/L (group 2), 9 g/L (group 3), 3g/L (group 4), and 1.3g/L (group 5). The median UC ratio was 41.35 (group 1), 15.36 (group 2), 14.18 (group 3), 13.6 (group 4), and 14.15 (group 5). GFR was normal in all five groups. Serum urea concentration and the UC ratio were significantly greater in dogs with babesiosis than in those with IMHA, experimentally induced anaemia and/or haemoglobinaemia.  相似文献   

19.
Clinical and surgical findings in 458 dairy cows with right displacement of the abomasum or abomasal volvulus (AV) were analyzed to determine the association between these variables and the outcome (productive, salvaged, or terminal) of the affected cow. Heart rate at initial examination was higher in the salvaged and terminal groups of cows (P less than 0.0001) than in the productive group. The plasma Na+ concentration was lower in the salvaged and terminal groups of cows (P less than 0.0001) than in the productive group. The plasma C1- concentration was lower in the salvaged group of cows than in cows with either productive or terminal outcomes (P less than 0.0001). Anion gap was significantly higher (P less than 0.0001) in the salvaged and terminal groups than in cows classified as productive. On the basis of surgical findings, cattle with right displacement of the abomasum were more likely to survive than cows with AV. Cows that required fluid decompression of the abomasum via abomasotomy were less likely to survive than those in which gaseous decompression was performed. Cows with evidence of vascular compromise of the abomasal wall were less likely to survive than those with normal abomasal serosa. Preoperative heart rate and anion gap had positive correlations with the presence of abomasal necrosis, whereas temperature, venous blood pH, plasma bicarbonate, and base excess concentrations had negative correlations. Cows in terminal stages of AV were likely to have a mixed primary acid-base disturbance, consisting of metabolic alkalosis with superimposed metabolic acidosis. These findings were highly correlated with abomasal necrosis.  相似文献   

20.
Peritoneal fluid (PF) was evaluated in 40 cows with left displaced abomasum (LDA) and 15 cows with abomasal volvulus (AV). PF was obtained by abdominocentesis at the right ventral abdomen at admission. Simultaneously, a blood sample was taken from the jugular vein. Biochemical and cytological variables in blood and PF specific for ischaemia, inflammation and cell damage were compared. Total protein, albumin, glucose and cholesterol were normal in PF of cows with LDA and AV. Although L-lactate increased in both groups, cows with AV had significantly higher values (LDA: 1.47/0.69/2.68 mmol/l; AV: 6.45/4.55/12.89 mmol/l (median/1. quartile/3. quartile)). D-dimer (LDA: 0.50/0.22/0.88 mg/l; AV: 1.11/0.40/1.85 mg/l) and LDH (LDA: 663/437/943 U/l; AV: 1099/750/1439 U/l) were only increased in PF of cows with AV. The number of leucocytes was normal; however, significantly more peritoneal neutrophils appeared necrotic or apoptotic after AV. PF of cows with abomasal displacement showed distinctive features of ischaemia and inflammation. Characteristics of haemostatic dysfunction and cell damage were mainly evident in PF of cows with AV. The results suggest that anti-inflammatory therapy is indicated in each cow with abomasal displacement. Additionally, medical treatment should be directed to prevent complications of ischaemia and reperfusion in cows with AV.  相似文献   

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