5 Vagus Indigestion and Omasal Impaction

Transcript

Dear vets,

Greetings to all!

In lesson four, we have discussed the Ruminal tympany, in that we have discussed Etiopathogenesis, Clinical signs, Diagnosis, Differential diagnosis, Treatment, and Management of the frothy and free gas bloat. In lesson five, we are going to discuss two diseases one is Vagus indigestion and Omasal impaction.

Let us first discuss Vagus indigestion; what do you mean by Vagus indigestion, I think you know that the vagal nerve is the 10th cranial nerve, supplying the stomach and all other internal organs in the abdomen. Suppose if it is affected due to some other reason, some of the conditions, automatically it will lead to some vagal nerve problem associated with the digestive disturbance. So, it is otherwise called Hoflund syndrome, the person who has identified the syndrome in his name is called Hoflund syndrome. Here are two areas to be covered:

1. Proximal functional stenosis and
2. Distal functional stenosis

Or

1. Anterior functional stenosis and
2. Posterior functional stenosis

Etiology: mainly the Dorsal vagal nerve or Ventral vagal nerve damage, that is due to some inflammation or scar. so what will happen Dorsal nerve damage, there is an achalasia reticulo omasal orifice, that is achalasia means, there is an opening but the content is not moving. In the case of Ventral vagal nerve affection, there is stenosis or achalasia of the pyloric part of the abomasum it is going to be there. Apart from that, there will be reticular adhesions, that will compress the vagal nerve or any other conditions associated with the nerve root or nerve track, compression-like Actinobacillosis, in sheep-Cysticercus tenuicollis, Fibropapilloma and Abomasal impaction, Omasal impaction, then Indigestion in the late pregnancy. Suppose the rumen reticulum omasum is fully distended during the late pregnancy and the pregnancy also has a gravid uterus, that is compressing the vagal nerve will lead to this type of Vagal indigestion.

Pathogenesis:

here Anterior functional stenosis- there is an achalasia reticulo omasal orifice, that will lead to failure of Omasal transport because the omasum is not allowing the content to move to the abomasum. So here the Paralysis of the forestomach and abomasal walls will be there and the accumulation of content in the rumen is making the left side fully distended, so when you are doing the rectal examination you feel the L-shaped rumen because of the Dorsal sac and the Ventral sac both are distended with the content, and it will lead to hyper-motility of the rumen. Here another one more thing is decreased reticular motility because of the distended rumen and vagal nerve damage, there is a decreased reticular motility. The decreased reticular motility is having significance in the development of Anterior functional stenosis. Here what will happen Achalasia and Atony of the rumen and here the Particulate matter, will be the fibrous material and the liquid portion of the rumen liquor, separation is very difficult he is going to be impaired, so that will be affecting the outflow of the content to the Omasum. Sometimes there may be a coarser fiber present in the feces like 0.5 centimeters and more length diameter is going to be present in the dung material, which is an indication of the reticular adhesions. And the animal may develop vagal tone mediated Bradycardia and in the case of Anterior functional stenosis, there won’t be any metabolic alkalosis and dehydration.

In the case of Posterior functional stenosis- there is a Pyloric obstruction; the abomasal pyloric end is having Achalasia, so the failure of the outflow of the content to the pylorus region. Here the abomasal fluid keeps on accumulating and sometimes it may be regurgitated which is called internal vomiting, regurgitated into the rumen, so the rumen chloride content will be elevated because available hydrochloric acid that will be regurgitated into the rumen, is going to be elevated. so that is one of the significant findings when you are going for a rumen fluid examination. So, in the case of posterior functional stenosis due to pyloric obstruction or pyloric stenosis, it is leading to severe dehydration, metabolic alkalosis, hypochloremia, hypokalemia. So, the animal may develop a flask Paralysis.

What are all the Clinical signs you can expect in vagal indigestion,

• the animal may develop a papple shaped abdomen-papple shaped abdomen means apple on the left side, pear on the right side,
• it will have inappetence to anorexia, the vagal indigestion animal will be having slow progression, it will have development slowly, over a period of one week it will be developing so it may be due to either it is initially the indigestion problem or bloat or it will look like a foreign body syndrome but slowly it’s not going to respond to your treatment,
• it will be progressing to the adverse level, so it is going to pass the scanty pasty feces and the animal will be emaciated and that abdominal distension will be more progressive,
• and initially, there will be a hypermotility followed by hypomotility of the rumen, so the rumen distention with hypermotility is going to lead to L-shaped rumen and Bradycardia and the rumen contents will be macerated and frothy in nature,
• then rumen discharge with atony, the content will be very soft porridge-like, atony of the rumen, persistent foams will be there, scanty feces is also there, and
• Pyloric obstruction is seen in late pregnancy.

Diagnosis: mainly based on the History, Clinical signs, and Exploratory, Laparotomy, and Rumenotomy. Another one more test is very useful in the field condition Atropine test, so to identify whether the Bradycardia is going to be modified or not, so you have to administer the Atropine 40 mg at 1% level subcutaneously to the animal, we have to examine the heart rate for every 5 minutes once the 15 minutes after the administration of the atropine sulfate the minimum of 15.8% increase in the heart rate is indicating that positive for vagal indigestion.

Differential diagnosis: it should be

• Traumatic reticular paternities-TRP
• Abomasal impaction
• Phytobezoar
• Foreign body syndrome
• Abomasal ulcerations
• Omasal impaction and
• the distension of the abdomen due to late pregnancy also be addressed.

Treatment :

• The prognosis of this vagal indigestion case is unfavorable, so slaughter for salvage is one of the ultimate aims. But some of the cases can be tried with Rumenotomy, Rumen lavage you can do,
• Fluid and electrolyte therapy is to be given for 3-5 days,
• Mineral oils– we can have 5-10 liters of mineral oils can administer every day for 3 days,
• then if the late pregnant animals, you have to go for induction or parturition that will help to elevate the problem.

The next disease is Impaction of Omasum :

• It is very rare in cattle and most of the time, it is not diagnosed that is undiagnosed because the omasum is not accessed by your palpation, percussion, auscultation.
• It will be there in the right midline in the central third of the abdomen,
• It is spherical in shape, and it is having a leaf-like structure inside that, it is filtering the content which is coming from the rumen,
• It is also having so many other functions like volatile fatty acid (VFA) absorption, electrolyte absorption, water absorption so that is the main function,
• then is Impaction of the omasum is secondarily involved with other diseases like any other advanced stage of pregnancy or any obstruction in the pyloric.

The Clinical signs are:

Because it is very difficult to palpate percussion auscultate, that’s why based on the clinical signs we can conclude that it may be due to because of Omasal impaction, only an autopsy will confirm the disease. The clinical signs are:

• Anorexia,
• Decreased ruminal movements,
• Cessation with defecation
• Empty rectum- the animal will be having empty rectum and not void dung
• Subacute abdominal pain will be there,
• The sudden drop in milk yield and
• Pain can elicit on the 7th – 9th intercostal space on the right side right thorax.

Diagnosis: it is only done at Autopsy, the Omasal impaction is difficult to diagnose on the anti[1]bottom clinical examination. It will be having an enlarged, excessively hard, dry powdery appearance in the postmark so which indicates Omasal impaction.

Treatment: there is no specific treatment you have to go for

• Rumenotomy- through the Rumenotomy that event, you can introduce a tube you can infuse some oils, mineral oils to the omasum and you can also knead just massage the omasum through the medial wall of the rumen and we’ll able to just to make the omasal impaction to be resolved.

So far we have discussed this in five lessons. It has covered

1. Rumen dysfunction and Omasal impaction in cattle, Simple Indigestion, Ruminal impaction,
2. Ruminal lactic acidosis,
3. Subacute Ruminal acidosis, Ruminal drinkers, and Ruminal alkalosis
4. Ruminal tympany and
5. Vagus Indigestion and Omasal Impaction.

I hope that these 5 lessons would have created some diagnostic capabilities and treatment modalities in your liberal practice.

Thank you!