كتاب Enteral Feeding of 3 Mature Cows by Rumenostomy (p 779-781)

Enteral Feeding of 3 Mature Cows by Rumenostomy (p 779781) من كتب طب بيطرى J Vet Intern Med 2005;19:779–781 Enteral Feeding of 3 Mature Cows by Rumenostomy Munashe Chigerwe, Jeff W. Tyler, Maisie E. Dawes, Dusty W. Nagy, Loren G. Schultz, Christopher D. Luby, John R. Middleton, and David Gourley R umenostomy is the creation of a permanent or semi- permanent rumen fistula. Permanent rumen fistulation is performed to facilitate nutritional research or provide ru- men fluid donors. 1,2 Transfaunation is an effective adjunc- tive therapy in cattle recovering from surgery. 2 Texts have recommended the use of rumenostomy to provide symp- tomatic relief in cattle with recurrent bloat. 1 This report describes the use of rumenostomy and enteral feeding as adjunctive therapy in cows unable to eat or drink. Repeated oroesophageal intubation may not be tolerated by many cat- tle and the diameter of stomach tubes typically precludes provision of large volumes of feedstuffs. A 4-year-old, 510 kg, female Holstein dairy cow was examined because of profuse drooling of 2 days’ duration. The cow’s milk production was greatly decreased. The owner reported that the cow made frequent unsuccessful attempts to eat and drink. The cow calved 1 week before presentation. The cow’s diet consisted of undetermined amounts of corn silage, grass hay, and ground feed. The owner treated the cow with procaine penicillin G a (20,000 IU/kg SQ q24h) the day before presentation. The cow was depressed. Rectal temperature was 37.4 8 C, heart rate was 80 beats/min, and respiratory rate was 52 breaths/min. The cow was estimated to be 8% dehydrated as assessed by skin turgor. A right head tilt was noted. Marked drooling was noted and the cow’s tongue was de- viated to the left side of the oral cavity. The cow had facial analgesia of the right side and was nonresponsive to tactile stimuli of the right ear. Palpebral, corneal, and menace re- sponses were absent in the right eye. A corneal ulcer was noted on the right eye. The cow had proprioceptive deficits in both hindlimbs. Rumen contents were firm on rectal pal- pation, but rumen contractions were normal (2 contractions/ min). On urinalysis, acidiuria (pH, 6.5; normal, 7–9) and pro- teinuria (300 mg/dL; normal, , 30 mg/dL) were present. Leukocytosis (14,700 cells/ m L; normal, 4,000–12,000 cells/ m L) characterized by a neutrophilia (10,440 segmented cells/ m L; normal, 600–4,000 cells/ m L) was identified on CBC. Venous blood gas analysis indicated a metabolic ac- From the Departments of Veterinary Medicine and Surgery (Chig- erwe, Tyler, Dawes, Nagy, Schultz, Middleton, Luby) and Pathobiol- ogy (Tyler, Dawes, Middleton), College of Veterinary Medicine, Uni- versity of Missouri, Columbia, MO, and the Whetstone Veterinary Ser- vice, Mountain Grove (Gourley), MO. Reprint requests: Dr. Munashe Chigerwe, BVSc, Department of Vet- erinary Medicine and Surgery, College of Veterinary Medicine, Uni- versity of Missouri, Columbia, MO 65211; e-mail: chiger- [email protected]. Submitted March 22, 2005; Revised April 21, 2005; Accepted May 5, 2005. Copyright q 2005 by the American College of Veterinary Internal Medicine 0891-6640/05/1905-0023/$3.00/0 idosis (pH, 7.19; normal, 7.35–7.5), bicarbonate concentra- tion (9.7 mmol/L; normal, 17–29 mmol/L), TCO 2 (10.5 mmol/L; normal, 19–29 mmol/L), and a base deficit of 18.7 mmol/L. Results of serum biochemical evaluation included increased concentrations of urea nitrogen (44 mg/dL; nor- mal, 6–22 mg/dL), creatinine (1.4 mg/dL; normal, 0.5–1.1 mg/dL), glucose (218 mg/L; normal, 44–78 mg/dL), protein (9.2 g/dL; normal, 5.8–7.5 g/gL), albumin (3.8 g/dL; nor- mal, 2.4–3.5 g/dL), and globulins (5.4 g/dL; normal, 2.3– 3.9 g/L). Serum activity of AST (202 U/L; normal, 58–100 U/L), GGT (75 U/L; normal, 22–64 U/L), and creatine ki- nase were increased (1,365 U/L; normal, 56–1,236 U/L). Cerebrospinal fluid (CSF) analysis identified increased total protein concentration (113 mg/dL; normal, 20–40 mg/dL); increased lymphocytes, monocytoid cells, and activated macrophages (83 cells/ m L; normal, , 6 cells/ m L). A quan- titative differential cell count was not provided. Based on the clinical signs and CSF analysis results, a presumptive diagnosis of listeriosis was made. Listeria monocytogenes was not recovered from CSF culture, but negative micro- biologic cultures are common in cattle with listeriosis. 3–5 A rumenostomy was performed. Base deficit for the cow was calculated as follows: base deficit (mmol/L) 5 0.5 3 510 kg 3 18.7 mmol/L 5 4769 mmol. 6 The fluid deficit was calculated as 510 kg 3 0.08 5 40.8 L. The mainte- nance fluid requirement was estimated as an additional 40.8 L/d (80 ml/kg/d). 7 Given that 1 g NaHCO 3 provides ap- proximately 12 mmol of bicarbonate, the cow required ap- proximately 400 g of sodium bicarbonate to replace the base deficit. Initially, 30 L of water, 3 times per day, was administered via rumenostomy. At each administration of water, 50 g of potassium chloride, 40 g of calcium chloride, and 130 g of sodium bicarbonate were dissolved in the water. The cow was fed 1.5 kg of a balanced commercial dairy cow grain mix b and 2.5 kg of pelleted alfalfa c 3 times per day through the rumenostomy, providing approximately 17.5 Mcal net energy (NE)/day. 8 Grain and pelleted alfalfa were added dry through a funnel and electrolyte solutions were administered through the rumenostomy using a large- bore stomach tube at each feeding. Oxytetracycline d at 10 mg/kg was administered IV once daily. A topical ophthal- mic antibiotic ointment e was administered OD, q12h. Serum chemistry determinations repeated 24 hours after admission demonstrated that the cow had mild metabolic acidosis (pH, 7.31; base deficit, 4.6 mmol/L; bicarbonate concentration, 21.8 mmol/L; TCO 2 , 23.2 mmol/L). Intra- ruminal fluid and electrolyte administration was continued. Based on the measured deficit, the amount of sodium bi- carbonate administered through the rumenostomy was ad- justed to 30 g q8h. Intraruminal calcium chloride and po- tassium chloride were continued. Three days after presen- tation, the cow was able to eat and drink slowly, but with great difficulty. Serum chemistry determinations on day 3 after presentation were consistent with a normal acid–base
-
من كتب طب بيطرى - مكتبة كتب الطب.