Abomasal Ulceration and Displacement in Hospitalized Preweaned Dairy Calves: Diagnosis, Treatment and Prevention

Presentation Description / Summary: Abomasal disease is a common cause of morbidity and mortality in preweaned calves, most pertinently ulceration. At our institution, on average over 120 preweaned calves per year are evaluated and hospitalized for a variety of illnesses. In this population, abomasal disease (ulceration and/or displacement) may be the presenting complaint but is more commonly a co-morbidity or develops in hospital/over the course of hospitalization. Both abomasal displacement and ulceration present a diagnostic and therapeutic challenge as overt clinical signs often not present until the disease is advanced. Abomasal and pyloric ulceration are often subclinical until the point of rupture or hemorrhage. Thus, expedient identification utilizing ancillary diagnostics is essential to allow swift therapeutic intervention reduing morbidity and mortality and informing prognosis. Using case examples, subtle physical examination changes will be presented along with the most useful diagnostic modalities to include serial relative PCV/TS, electrolyte profiles and abdominal ultrasonography. Ultrasonographic assessment of pyloric appearance, abomasal position, fill and emptying are particularly important and will be described in the context of normal age-related variation. Treatments such as oral mucosal protectants, probiotics, pantoprazole, IV fluid therapy, lidocaine constant rate infusion in both therapeutic and prophylactic contexts will be detailed. In addition, scenarios in which plasma or whole blood transfusion and partial or total parenteral nutrition are indicated will be discussed. In conjunction with these therapies, indications for exploratory laparotomy will be outlined. Positive and negative prognostic indicators in the face of abomasal displacement and/or ulceration will be outlined and various management decision trees presented.

Learner Outcomes: 1) Be able to identify calves at risk for abomasal disease based upon history and clinical signs. 2) Know what diagnostic modalities are most useful in assessing abomasal disease in calves and how to interpret them. 3) Know what specific treatment modalities are appropriate for both abomasal ulceration and abomasal displacement in calves.