Surgery of Abomasal Disorders
Considerations for surgical approach
Economic cost-benefit
Surgeon experience
Practicality in light of available handling facilities
Minimising additional risk
Effective return and stabilisation of abomasum in normal position
Management of concurrent abdominal pathology
Left displaced abomasum
Conservative management
Right displaced abomasum
+/- oral fluid therapy
+/- ruminal probiotics
+/- analgesics and spasmolytics
+/- treatment of concurrent medical conditions (e.g. metritis, ketosis)
Casting and rolling (30-40% success)
Surgical correction
Open
Closed
Toggle pin
Secure the pylorus and/ or lesser omentum
Secure fundus to abdominal wall
Blind fixation
Laparascopy (+/- rolling)
Right paralumbar laparotomy, pyloropexy and/ or omentopexy
Intra-operative complications
Failure of relocation
Peritonitis and friable intra-abdominal/ omental fat
Failure of decompression
Surgical correction
Indications for surgical intervention
Severe or increasing abdominal pain unresponsive to analgesics
Regurgitation on passing a stomach tube
Present or deteriorating hypovolaemic/ endotoxic shock
No response to conservative management in 2-4 hours
Correct fluid/ electrolyte imbalance
Right paralumbar fossa laparotomy, pyloro- and/ or omentopexy
An anticlockwise volvulus can be corrected by clockwise rotation of abomasum using left arm placed medially
Decompression (as for LDA) may be required before correction of volvulus
Traction on omentum does not expose pylorus with an RDA
Conservative treatment
Metoclopramide completely illegal in food producing animal in UK
Regular monitoring q 2-4 hours
As for LDA (no rolling!)
Some degree of stasis in abomasum - build up of gas rises and tends to drag it to the left and compress it causing ingesta to not be able to pass through it