Transnasal Esophagorumenoscopy and Laparoscopic Assisted Rumenostomy in a Cow With Digestive Distress—Case Report

Traumatic reticuloperitonitis (TRP) is a relatively common disorder in adult cattle which could appear in various forms including local peritonitis, diffuse peritonitis, acute pericarditis, and chronic peritonitis. The objective of the present study was to compare the changes of plasma proteins including haptoglobin (Hp) and serum amyloid A (SAA) as acute phase proteins (APPs) in various types of TRP in cattle. Blood samples were collected from 73 cows: 53 cases of TRP and 20 healthy control subjects. Measurements of plasma proteins were done using validated methods. Results showed that SAA and Hp had very similar pattern and magnitude of changes in various types of TRP and revealed significant increase in acute diffuse peritonitis (312.4 μg/mL and 2.16 g/L, respectively) compared with other types of the disease (P < 0.05). Fibrinogen (660 mg/dL), alpha-globulin (24.5 g/L), and total protein (87.7 g/L) had their maximal increase in acute diffuse peritonitis too. Beta- and gamma-globulins increased significantly in traumatic pericarditis and chronic peritonitis, respectively. Albumin revealed significant decrease in acute local peritonitis (20.9 g/L), but it was increased significantly in acute diffuse peritonitis (34.5 g/L) compared with other groups (P < 0.05). The results of the present work showed that patterns of changes in plasma proteins including APPs might be different according to the type of TRP studied. This could be taken into consideration in clinical practice where it might be of potential benefit in correct diagnosis of the specific type of TRP.

Traumatic reticuloperitonitis (TRP) and traumatic pericarditis (TP) are disorders that occur because of cows swallowing metal foreign bodies due to malnutrition or different etiological reasons. Foreign bodies cause serious complications by piercing the peritoneum or sinking into the pericardium. This study analyzed the levels of neopterin, procalcitonin, and endothelin-1 and various hematological parameters in blood samples of cows with TRP and TP. This study included 2–7-year-old Simmental cows with TRP (n=35) or TP (n=35) and healthy controls (n=20). Glutaraldehyde tests were used to assess inflammation levels, and radiography confirmed the diagnoses. Total leukocyte count was found to be significantly higher in the TP and TRP groups compared to the control. In addition, while lymphocyte, monocyte and granulocyte counts were found to be higher in the TP group compared to other groups, erythrocyte and hematocrit levels were significantly lower. TP cows had higher neopterin levels than those of TRP and control cows. TRP cows had higher procalcitonin and endothelin-1 levels than those of TP and control cows. These increased levels were diagnostically important. Procalcitonin had the highest sensitivity and specificity for distinguishing between TRP and TP cases. As a result, neopterin, procalcitonin and endothelin-1 levels in cows with TRP and TP were found to be important in confirming the diagnosis and determining the severity of the disease.

This study was aimed to evaluate the effect of traumatic reticulitis and other affections on some blood variables in buffaloes. Female buffaloes (n = 62) were divided into eight groups: control, non-penetrating reticular foreign bodies (NPRF), traumatic reticulitis (TR), traumatic reticuloperitonitis (TRP), traumatic reticuloperitonitis with peri-reticular abscess (TRP + PA), traumatic reticuloperitonitis with vagus indigestion (TRP + VI), diaphragmatic hernia (DH), and traumatic pericarditis (TP). Results revealed a significant decrease in RBC count in cases of NPRF, TR, TRP, TRP + PA, and TP. Platelet count was significantly decreased in case of TRP. Serum albumin concentration was significantly decreased in cases of TRP, NPRF and TR. Serum zinc was significantly decreased in case of TP. Serum phosphorus was significantly decreased in case of DH. It could be concluded that anemia is a consistent finding in affections of the rumen and reticulum in buffaloes. The tendency of buffaloes to ingest foreign bodies may be attributed to deficiency of phosphorus and/or zinc.

Foreign body syndrome or traumatic reticuloperitonitis (TRP) remains the disease of most interest for many clinicians in developing countries. Ultrasonography is remaining the best diagnostic tool for diagnosis of such disease. Therefore, this work was planned to approve the importance of ultrasound in diagnosis and detection of different complications of this disease in buffaloes. Sixty buffaloes with TRP and 20 clinically healthy buffaloes were examined clinically and ultrasonographically. A 3.5 to 5 MHz convex probe was used to scan the area just behind xiphoid cartilage as well as abdominal and thoracic cavities. Peritonitis and abdominal abscesses were detected as abdominal lesions (n=41) while pericarditis, pleurisy and thoracic abscesses were detected as thoracic lesions (no=19) secondary to TRP. The most clinical signs of abdominal affected buffaloes were anorexia, tympany, scanty faeces and decrease of milk production. The thoracic affected buffaloes had the same previous signs in addition to signs of congestive heart failure (no= 12), respiratory signs (no=4) or both (no=3). Signs of pain reaction were observed in 6 cases with abdominal lesions while these signs were detected in all cases had thoracic lesions. The reticulum of healthy buffaloes appeared with half-moon shaped and had 3.95 0.5 biphasic contractions/ 4 minutes. In contrast, reticulum with TRP appeared corrugated with reduced or absence of reticular motility. Local and diffuse peritonitis were clarified in 26 cases, peri-reticular abscess in 9 cases, hepatic abscesses in 4 cases and splenic abscess in 2 cases. Moreover, pericarditis was detected in 12 cases, pleuropneumonia in 4 cases and thoracic abscess in 3 cases. In conclusion, ultrasonography should be considered as suitable tool for detection the different complications of foreign body syndrome in buffaloes.

Closure of tracheoesophageal fistula with two‐layer tracheal‐esophagoplasty and tracheal advancement

Eating and rumination behaviour in 22 cows with traumatic reticuloperitonitis was recorded after the start of treatment. Based on the results of clinical, ultrasonographic and radiographic examinations, the cows were divided into two groups: Group A consisted of 12 cows without an intramural or perforating foreign body and group B had 10 cows with an intramural or perforating foreign body. Cows of group A received amoxicillin, flunixin meglumine and a NaCl-glucose infusion, and cows of group B received the same treatment accompanied by foreign body removal via ruminotomy. All cows were fitted with a horse halter equipped with a pressure sensor integrated into the noseband, and eating and rumination activities were recorded continuously for 7 days. Additional 24-hour- recording periods occurred on days 14 and 30. Results obtained previously from 300 healthy cows were used for comparison. Median daily eating time in group A was 168 minutes (reference interval 211 to 319 min) on day 1 and increased to within the reference interval by day 3. Eating time on day 14 was 290 minutes and significantly longer than on day 1. Eating time was 294 minutes on day 30. Eating time in group B was comparable, and the patterns of normalisation for the number of chewing cycles related to eating, rumination time, the number of regurgitated cuds per day and the number of chewing cycles per cud were similar to that of group A: all variables were significantly reduced on day 1 and normalised within 3 to 5 days. The findings showed that eating and rumination are reduced in cows with traumatic reticuloperitonitis and that successful treatment results in rapid normalisation. Monitoring eating and rumination behaviour using a pressure sensor integrated into a halter allows objective clinical assessment of cows recovering from traumatic reticuloperitonitis.

BackgroundThe treatment of traumatic reticuloperitonitis (TRP) in cattle has a long and impressive history that goes back more than 100 years. This study describes treatment for TRP in 503 cattle. Initial treatment was based on radiographic findings; cattle with a foreign body attached to a magnet were treated conservatively using antibiotics, anti-inflammatory drugs and intravenous fluids. Cattle with a foreign body lying on the ventral aspect of the reticulum or penetrating or perforating the reticulum received a magnet in addition to medical treatment. Cattle were radiographed again the next day. When the foreign body was completely attached to the magnet, medical treatment was continued. When the foreign body was not attached or still penetrated/perforated the reticulum, a rumenotomy was carried out.ResultsOf the 503 cattle, 232 were treated conservatively, 206 underwent surgery, 61 were slaughtered or euthanased and four were treated after discharge at home with a magnet and antibiotics. Surgical treatment was significantly more successful than conservative treatment; 90% of 206 operated and 82% of 232 medically-treated cattle were discharged.ConclusionsFor practical purposes, cattle suspected of having traumatic reticuloperitonitis should initially be treated with a magnet and antibiotics and re-evaluated, ideally radiographically, when response to treatment does not occur within 3 or 4 days. Surgery is limited to cases in which the foreign body fails to completely attach to the magnet.

Cough in specific populations (paediatric patients, elderly patients and patients with underlying disease)

Ultrasonographic and radiographic findings in 503 cattle with traumatic reticuloperitonitis

Traumatic reticuloperitonitis (TRP) is a prevalent and economically significant thoraco-abdominal disorder in bovines caused by ingestion of traumatic metallic foreign bodies leading to reticular perforation and septic peritonitis. Due to overlapping clinical features with other gastrointestinal disorders, diagnosis often remains challenging. This study aimed to assess the diagnostic utility of peritoneal fluid cytology and D-dimer concentration in bovines with confirmed TRP. Peritoneal fluid was collected from six affected and six healthy bovines, and evaluated for gross appearance, total protein, red and white blood cell counts, and D-dimer levels. Cytological smears stained with Giemsa were semi-quantitatively scored for polymorphonuclear cells (PMNC), mononuclear cells (MNC), fibrin, red blood cells (RBCs), and bacteria. TRP cases exhibited significantly elevated total protein (p&lt;0.01), RBCs, total leukocyte and neutrophil counts (p&lt;0.05), and D-dimer levels (p&lt;0.05) compared to controls. Cytology revealed increased PMNC scores and decreased MNC scores (p=0.0022), with significantly higher fibrin deposition, bacterial presence, and RBC infiltration (p&lt;0.05). A strong positive correlation (&rho; = 0.926, p = 0.033) between tube clot test and D-dimer concentration indicated active fibrinolysis concurrent with peritonitis. Based on cytological scoring, cases were stratified into mild, moderate, and advanced septic TRP stages, with findings ranging from sterile exudates to marked neutrophilic infiltration, fibrin clumps, and intra-/extracellular bacteria. This study demonstrates that the integration of peritoneal fluid cytology and D-dimer estimation provides a rapid, minimally invasive, and field-applicable diagnostic approach with high clinical relevance. The semi-quantitative cytological scoring system developed herein enhances the accuracy of TRP diagnosis and staging, particularly in field conditions where advanced diagnostics may be unavailable. Overall, this multimodal approach improves the early identification and management of septic peritonitis in bovines, reducing diagnostic ambiguity and improving prognosis.

Antimicrobial therapy has been the main stay of therapy of community-acquired aspiration pneumonia (CAAP), but the duration of treatment has not been established. The objective of this study was to describe the time to reach clinical stability in patients with aspiration pneumonia compared to community-acquired pneumonia (CAP). A retrospective case control study at two university affiliated centers encompassing 329 consecutive patients admitted with CAAP and 329 consecutive patients with CAP was conducted between 2007 and 2011. While the median time to stability for patients with CAP was distributed around a median of 4 days, there was a bimodal distribution for time to clinical stability in patients with CAAP with dual peaks at days 2 and 5, respectively. CAAP patients who required more than 2 days to achieve clinical stability had a higher mortality rate compared to those with 2 days or less [odds ratio (OR) 5.95, 95% CI 2.85-12.4], and a longer hospital stay (6.6 ± 5.8 vs. 3.9 ± 1.2 days; p < 0.001). None of the CAAP patients who achieved clinical stability in 2 days or less was transferred to a higher level of care. In a multivariate analysis, time to clinical stability was found to be an independent predictor of outcome in patients with CAAP (OR 2.59, 95% CI 2.02-3.32). Normalization of vital signs in aspiration pneumonia follows a distinct pattern from that of patients with CAP. Time to achieve clinical stability may assist in identifying CAAP patients who are likely to require a shorter hospital stay and a shorter course of antimicrobial therapy.

To evaluate by use of radiography the efficacy of oral administration of magnets in the treatment of traumatic reticuloperitonitis in cows. 90 cows referred because of indigestion. Radiography of the reticulum was performed. In all cows, radiographic findings revealed a metal foreign body in the reticulum. A magnet was administered orally, and the reticulum was again radiographed to assess the position of the magnet and to determine whether the foreign body was attached to the magnet. The magnet was observed in the reticulum in 75 cows and in the cranial aspect of the dorsal sac of the rumen in 9 cows; in 6 cows, the magnet was not observed. The foreign body was fully attached to the magnet in 49 cows. In 6 cows, the foreign body was in contact with the magnet but still penetrated the reticulum. In 24 cows, the foreign body did not contact the magnet, and in 11 cows, it was not clear whether the foreign body was attached to the magnet. A foreign body at an angle to the ventral aspect of the reticulum of > 3 degrees was less likely to become attached to a magnet, compared with a foreign body situated horizontally on the ventral aspect of the reticulum. A foreign body with no contact to the ventral aspect of the reticulum or a perforating foreign body was also less likely to become attached to a magnet. Position of the foreign body within the reticulum greatly influences the efficacy of treatment with a magnet.

Magnets were administered orally in 42 cows diagnosed with traumatic reticuloperitonitis (TRP) with radiographic evidence of sharp foreign bodies in their reticulum, and without any prior administration of atropine sulphate. Upon radiologic investigation, magnets were observed within the reticulum in 40 cases and foreign bodies were attached to the magnet in 24 cases. In 8 cases, though foreign bodies were dislodged but their attachment could not be clearly discerned. Foreign bodies were not attached to the magnet in 4 cows due to the presence of nonferromagnetic foreign bodies and in 2 cows because the foreign bodies were penetrating deep through the wall of the reticulum. In 2 cases, the foreign body was unattached to magnet and located close to magnet probably in the magnetic field. The radiological findings of foreign body attachment, non-attachment or displacement were confirmed in 14 animals by rumenotomy. It was concluded that magnet therapy is effective and radiological diagnosis is a reliable tool in making decision about surgical intervention in cases of TRP following administration of magnet.

Relata-se a ocorrência de hérnia diafragmática associada a reticuloperitonite traumática em vaca da raça Jersey. O animal, aos 90 dias de gestação, apresentava histórico de timpanismo rumenal, anorexia, emaciação e debilidade física. Ao exame físico, observaram-se distensão intensa da fossa paralombar esquerda, hipomotilidade e presença de ressonância timpânica no rúmen. A passagem da sonda oro-ruminal e a rumenocentese foram ineficientes e o rúmen permaneceu distendido por grande quantidade de digesta. Durante a láparo-rumenotomia exploratória removeram-se, aproximadamente, 80 litros de conteúdo rumenal, além de um pedaço de corda; vários corpos estranhos metálicos perfurantes e pedras foram removidos do retículo. Na palpação interna do retículo verificou-se uma hérnia diafragmática, projetando parcialmente um pequeno segmento da porção cranial do retículo para o interior da cavidade torácica. No 15º dia do pós-operatório observou-se deiscência da ferida cirúrgica com drenagem de exsudato purulento amarelado fétido, optando-se pela eutanásia do animal. Os achados clínicos, cirúrgicos e anatomopatológicos sugerem que a hérnia diafragmática foi adquirida em conseqüência da perfuração do retículo pelos corpos estranhos, ruptura do diafragma, migração da porção cranial do retículo e dos corpos estranhos nele contidos em direção ao tórax.Bovino. Corpo estranho perfurante. Hérnia diafragmática. Reticuloperitonite traumática. PALAVRAS-CHAVE: Bovino. Corpo estranho perfurante. Hérnia diafragmática. Reticuloperitonite traumática.

BackgroundIn the livestock industry, Foreign Body Syndrome is a devastating disease condition. Feeding management, lacking of food discrimination, and eating chopped food increase the risk of swallowing sharp foreign bodies in bovine species. In addition to the honeycomb cells shape of the reticulum, the contractions of the reticular wall, gravid uterine pressure, and parturition efforts, foreign bodies can penetrate the reticular wall, causing cascade of problems including traumatic reticulitis, traumatic reticuloperitonitis, and traumatic pericarditis. The present study was carried out to evaluate the diagnostic significance of cardiac troponin I rapid test cassette and other cardiac biomarkers including serum cardiac troponin I (cTn I), creatine kinase-myocardial band (CK-MB), lactate dehydrogenase (LDH), and aspartate aminotransferase enzyme (AST), in confirmed cases of traumatic pericarditis (TP) and/or traumatic reticuleoperitonitis (TRP) in cattle and buffaloes.MethodsA total number of 30 animals (22 cattle and 8 buffaloes) with different signs such as anorexia, jugular distension, brisket edema, and signs of pain (reluctance to move, arching back, and abduction of the forelimbs) were included in the present study. Based on case history, clinical signs, ferroscopic, pericardiocentesis, radiographic and ultrasonographic examinations, TP were confirmed in cattle (n = 10) and buffaloes (n = 8) while TRP were confirmed only in cattle (n = 12). Additionally, 20 clinically healthy animals (n = 10 cattle and 10 buffaloes) were used as a control group. Blood samples were collected for determination of blood level of Tn-I, and activity of CK-MB, LDH, and AST.ResultsThe obtained results revealed a highly significant increase in serum cTn I in diseased cattle with TP and TRP (P = 0.00), while buffaloes with TP showed no significant changes in serum cTn I (P = 0.111). Both diseased cattle and buffaloes showed increased serum activities of CK-MB, AST, and LDH enzyme. On the other hand, cardiac troponin I rapid test cassette failed to detect cTn I in diseased animals.ConclusionThe study concluded that the cardiac troponin I rapid test cassette did not have a diagnostic significance and could not be used as a point-of-care under field condition for diagnosis of TP and TRP in large ruminants. However, the serum troponin I level is helpful in diagnosis of TP and TRP in cattle. Although cardiac biomarkers have some diagnostic values in TP and TRP, the traditional diagnostic methods (clinical, radiography and ultrasonography examinations) are crucial for thorough evaluation of TP/TRP cases in bovine.