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