Ultrasound and Radiographic Imaging Diagnosis of Diaphragmatic Hernia in a Transition Cow: A Case Report

Abstract

A four and half-year-old recently calved cross breed Jersey cow was presented with the clinical signs of anorexia, recurrent bloat, bruxism and not voided dung for the past one week. Clinical examination revealed congested mucous membrane, sunken eyeball, and severely distended lower abdomen; clinically, bloat was evident. On Auscultation of heart at 4th intercoastal space, low-intensity heart sounds were heard. Rectal examination revealed scanty foul-smelling dung with blood tinge. In an attempt to relieve the bloat rumen stomach was intubated, which failed to relieve the gas. The clinical suspicion pointed to the possibility of foreign body syndrome. Hence radiography was done by keeping the animal in standing position; however it revealed no clear contour of heart, reticulum, and diaphragm; another attempt was made, wherein the animal was cast on right lateral recumbency and radiography was done at 90-100 kVp, 50-60 mAs and a focus film distance of 90-100 cm using an 800 mA X-ray machine. As we would not get any diagnostic confirmation findings in radiography, an ultrasonographic assessment was planned. Ultrasonography was done with (Esoate Mylab 1) 2.5. to 5 MHz curvy linear transducer. Ultrasound examination of the heart (Venkatesan et al., 2019) and reticulum (Braun et al., 1993) was done at the left side between 4th to 5th intercostal space of thoracic cavity using the window between 6th to 8th intercoastal in the abdominal cavity. Physical examination revealed a dull and depressed animal; distended left flank, moderate dehydration, elevated rectal temperature (40°C), low-intensity heart sounds with a normal heart rate was observed. Hematology was unremarkable; smear study was negative for blood parasites.