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Dept. of Vet.

Medicine
Faculty of Agric. and Vet. Med.
King Saud Univ. Saudia Arabia

Omaso-abomasal impaction associating vagus indigestion in


a cow
By
Ali H. Sadiek and Ibrahim H. Ahmed

An adult cow, 6 years old was admitted to the clinic of the faculty
of Agric. and Vet. Med., King Saud Univ. with a history of anorexia,
distension of abdomen, passage of dry, scanty feces, moderate salivation
and the animal was inclined to move.
On clinical examination, marked destension of the abdomen was
noted, in the form of L- shape, where upper left hunger fossa and lower
right abdomen were clearly enlarged. Percussion of left flank revealed
tympanic sound and on palpation evidenced marked fluctuation. Atony of
the rumen was noticed with steal-band effect on auscultation-percussion
technique especially over the middle and lower aspect of the left
abdomen. Fluid splashing sound was audible on ballottement of the left
flank indicating presence of massive fluids on the upper sac of the rumen.
Pain test (binching of the weather, percussion over the reticular
area, forcing the animal to move upward and downward on a hill)
evidenced a positive response to pain in a form of grunting sound and
opening of the mouth, indicating a possible penetrating sharp object on
the recticuloperitonium, that was strongly suspected on use of mine
detector, that revealed a loud positive response on approaching the
reticular area.
Passage of stomach tube revealed no evidence of obstruction of the
upper digestive tract, however stomach tube failed to relief tympany.

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On rectal palpation, rectum was mostly empty, except from a little
hard fecal ball resemble those of camel and covered with mucous and
tinged with blood streaks. Dorsal sac of the rumen was filled with
fluctuated fluids and gases. No evidence of abomasal displacement was
seen. .
Laporatomy revealed no evidence of abomasal displacement,
however, Omasum and abomasum were markedly enlarged with a hard
contents filling the lower abdomen from the xiphoid cartilage to the
pelvic inlet. Surgical interference from both sides of the abdomen failed
to access or evacuate either abomasum or omasum, because of their
heavy weights and great destension in addition to their anatomical
locations. Rumenotomy revealed that the upper sac of the rumen was
filled with fluids, that rushed enormously as just the wall of the rumen
was opened (fig. 1). Ruminal fluid was watery and yellowish with putrid
characters.
On the other hand respiratory rate was slightly elevated and
bilateral nasal seromucous secretions was evidenced. Body temperature
was in its normal range. However, heart rate was markedly increased
(110/min). Signs of dehydration were evident involving loss of skin
elasticity and sunken eye.
Medicinal therapy including antifermentive drugs, laxatives and
replacement fluids failed to improve the animal health.
On the two next days after surgery, the general health of the animal
was mostly deteriorated, became recumbent and eventually succumbed.
On necropsy, omasum and abomasum were grossly enlarged, they have
tensed walls and filling the floor of the abdomen (fig. 2). On longitudinal
section of the abomasum, a mass of dry rumen like contents mixed with
sand was filling both omasum and abomasum (fig. 3 & 4). Impaction of
the abomaso-duodenal orfice with hard food was noted. Omasal contents

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were mostly similar to that of the abomasums and the omasual folds were
easily detached and dissiminated into the hard mass of food (fig. 4).
Evacuation of the omasal and abomasal contents revealed a huge amounts
of dry finely chopped starw, minsed grains and sands (fig. 5). Abomasal
wall showed conjestions, lacerations, erosions and variable sized ulcers
especially on its ventro-lateral sides (fig. 6). Different types of foreign
bodies involving keys, sharp nails, long wires and date kerns were found
imbedded in the reticulum (fig. 7). A long sharp wire were seen
peneterating the reticular wall leaving a mass of granular tissue
surrounding a canal reaching the peritoneum and inducing local
peritonitis (fig. 8).
Neutrophilic leucocytosis, increased packed cell volume, decreased
chloride and potassium concentrations of the obtained blood samples
were found. Analysis of ruminal fluid revealed increased pH (7.8),
decreased activity of ruminal flora (increased time of sedemintation
activity test and methylene blue reduction test) and sluggished activity of
rumenal protozoa.

Discussion
The case was diagnosed primarily as vagal indigestion especially
the form of ruminal destension with atony, on the basis of ruminal atony,
L-shaped abdomen, scanty dry feces, tachycardia and positive pain test.
However, the presence of steel band and tinkling sound on percussion and
auscultation of the middle left flank revealed suscpecious of abomasal
displacement. Rectal palpation and laporatomy revealed no evidence of
abomasal displacement, but confirmed a coincidence of omasal and
abomasal impaction in association with chronic reticuloperitonitis. A
coincidence of abomasal and omasal impaction in beef cows was
described (Simkins and Nagele, 1997).

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Vagus indigestion is a chronic disease of the forestomach and
abomasums characterized clinically by gradual distension of the left
paralumber fossa and bilateral distension of the ventral aspects of the
abdomen due to accumulation of ingesta in the rumen and abomasum,
decreased appetite, scant feces, weight loss, acid-base imbalance and
dehydration (Radostits et al., 1995). Abomasal impaction related to
forestomach obstruction was early discussed (Baker, 1979).
Fluid splashing sound was audible on ballottement of the left
flanks due to overdestension of the rumen with excessive quantities of
fluid. Most cases of abomasal impaction are related to pyloric obstruction
in association with vagus indigestion especially the form of ruminal
destension with atony (Rebhun, 1980).
The consumption of excessive quantities of poor quality rouhages
or finely chopped straw, which are low in both digestible protein and
energy may contribute as a cause in association with injury of the vagus
nerve (Mathison et al., 1981). When large quantities of sand are injested,
the omasum, abomasums, large intestine and cecum can become
impacted. The accumulated sand in the abomasums cause its dilatation
and atony, once impaction of the abomasum occurs, a state of subacute
obstruction of the upper alimentary tract develops. The potassium,
hydrogen and chloride ions are continuously secreted into abomasums
resulting in alkalosis, hypokalemia and hypochloremia (Taguchi, K.
(1995). Varying degrees of dehydration occurs because fluids are not
moving beyond the abomasums into the small intestine for absorption
(Radostits, et al., 1995). The animal became weak, recumbent and die
slowely of inanition and electrolyte and acid-base imbalance (Smith,
1995). Trial for surgical emptying of abomasal impaction surgically with
little success was previously discussed (Merritt and Boucher (1967). It
could be concluded that omasal and abomasal impaction in adult cows

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could be related directly or indirectly to traumatic reticuloperitonits and
its consequent complications. It is rationally difficult to distinguish
between impacted omasum and impacted abomasum rather to deal with it
medicinally. Either medicinal therapy or surgical interference may be of
little or no value to relieve the gross impaction or to restore the atonized
wall of the abomasums.
References.

Baker, J. S. (1979) :Abomasal impaction and related obstructions of the


forestomachs in cattle.
J Am Vet Med Assoc. Dec 15;175(12):1250-3.
Merritt A. M. and Boucher, W. B. (1967): Surgical treatment of abomasal
impaction in the cow.
J Am Vet Med Assoc. 1967 May 15;150(10):1115-20.
Mathison G. W. et al., (1981) : Can. J. Anim. Sci.; 61,375 cited by
Radostits et al., (1995).
Rebhun, W.C. (1980): J. Am. Vet. Med. Assoc., 176: 506. cited by
Radostits et al., (1995).
Radostits, O.M., Blood, D.C. and Gay, C.C. (1995). Veterinary Medicine:
A Text book of The diseases of Cattle, Sheep, Pigs, Goats and
Horses, 8th edn., Bailliere Tindall, London, UK.
Smith, G. (1995): Internal Vet. Medicine edn., 5th Ed. Bailliere Tindall,
London, UK.
Simkins K. M. and Nagele, M. J (1997) Omasal and abomasal impaction
in beef suckler cows. Vet Rec. 1997 Nov 1;141(18):466-8.
Taguchi, K. (1995): Relationship between degree of dehydration and
serum electrolytes and acid-base status in cows with various
abomasal disorders. J Vet Med Sci. Apr;57(2):257-60.

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Legend:
Fig. 1: Rushing of watery, yellowish ruminal fluid from a destended
rumen
Fig.2: Grossly impacted and severely destended abomasums filling the
lower abdomen.
Fig. 3: Longituidinal section on the destended abomasums leaving a a dry
yellowish mass of indigested food.
Fig.4: Grossly destended omasum, note the folds that disiminate within
the hard dry contents.
Fig. 5: Evacuation of abomasums leave a huge amounts of sand mixed
with minsed grains and straw.
Fig. 6 Lacerations, erosions and ulcers of the ventrolateral wall of the
abomasums
Fig. 7: Variety of foreign bodies collected from the reticulum
Fig. 8: A long sharp wire peneterating reticular wall.