I went out to a dairy farm to look at a sick cow that the dairy farmer was very concerned about. This cow calved about 15 days before. She had not been wanting to eat and had had a severe decrease in milk production that dropped overnight. She was relatively normal up until that point. All of the other cows in the herd are healthy, happy, and milking great! ⁣ ⁣ I started my physical exam and her temperature, respiration, and heart rate were all normal. She looked depressed (eyes dull, ears down, weak, etc). When I pinched her skin, it took a few seconds to return to normal. This suggests that she is dehydrated. On rectal exam, she had very minimal fecal material. ⁣ ⁣ Next, I moved on to listen to her gastrointestinal tract with my stethoscope. Her gut sounds were reduced and she had poor stomach motility. On the left side, I flicked her abdomen with my finger and listened. It made very distinct ‘ping’ sound near in rib cage and over the last few ribs. I had my diagnosis! The cow had a LEFT DISPLACED ABOMASUM (LDA). ⁣ ⁣ The abomasum is one of the ‘stomachs’ in a cow. As many of you probably already know, cows have four compartments in their stomach. Each compartment of the stomach has a name but we are going to focus on the last compartment called the abomasum. This compartment is the most like a humans stomach. It is filled with acid and enzymes that helps digest food. It normally sits on the right side of the body. When it is displaced to the left side, gastric contents and sometimes blood flow can be obstructed making the cow very sick. ⁣ ⁣ Majority of the time, if I say I'm doing a stomach surgery in a cow, this is what I am correcting. There are multiple techniques to correct a LDA in a cow. I commonly do surgery and do a right flank pyloric omentopexy. I freeze the cow, cut a 10cm incision into the right side of the abdomen, reach around to the left side, deflate the abomasum, pull it back to the right side, suture the stomach to the body wall, and then close the abdomen. ⁣

CAUSES -Multifactorial -Low gut motility associated with imbalanced minerals/electrolytes (low calcium or potassium) -Decreased stomach fill b/c of uterine infection or mastitis -Post calving emptiness of abdominal cavity -Improper diet (high concentrate, low roughage) -Ketosis

CLINICAL SIGNS -Inappetence -Depression -Decreased milk production rapidly -+/- ketosis

DIAGNOSIS -Clinical signs above

-Characteristic ‘ping’ (b/c of the gas build up in the stomach) left side between ribs 9-13

TREATMENT -Surgical: multiple surgical techniques then post surgical oral fluids/electrolytes/sugars, pain medication, and antibiotics -Closed (non surgical): rolling the cow can fix it but recurrence is very likely

PROGNOSIS -95% survival rate after correction of a simple LDA

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