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The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery.

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Abomasal Displacement and Abomasal Volvulus in Cows

The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery. Only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called specialists in veterinary surgery.

Your ACVS board-certified veterinary surgeon completed a three-year residency program, met specific training and caseload requirements, performed research and had research published. This process was supervised by ACVS Diplomates, ensuring consistency in training and adherence to high standards. After completing the residency program, the individual passed a rigorous examination. Only then did your veterinary surgeon earn the title of ACVS Diplomate.

Overview: 

Cows have a specialized digestive system that helps them process their high fiber diet. They have four distinct compartments to their stomachs—the rumen, reticulum, and omasum are the forestomach compartments. The abomasum is the “true” stomach of the cow and carries out similar function to the stomach in humans.

The abomasum is suspended by a loose attachment, which means it can potentially move out of its normal position where it can fill up with gas and prevent normal flow of feed through the digestive track (abomasal displacement).

Abomasal displacements typically occur in high production dairy cows. No one knows exactly what causes the abomasum to move out of its normal position. The majority of abomasal disorders occur in dairy cows during the first three months of lactation (milk production).

Three types of commonly seen abnormal positions include:

  • Left Displaced Abomasum (LDA), most common
  • Right Displaced Abomasum (RDA)
  • Abomasal “volvulus” (twisting) on the right side (RVA)

The abomasum can also twist around itself (called an abomasal volvulus), which can compromise blood supply to the abomasum and the affected cows become much more ill much more quickly.

Signs and Symptoms: 

Abomasal Displacement

  • Loss of appetite
  • Decreased manure production
  • Decreased milk production

Abomasal Volvulus

  • Dull, depressed, loss of appetite
  • High heart rate
  • Large amounts of gas and fluid collection on the right side
  • Minimal manure production
  • Dehydration
Diagnostics: 

Your primary care veterinarian may recommend performing the following diagnostics:

  • Physical examination
  • Rectal examination
  • Simultaneous “auscultation and percussion” or “pinging” of the abdomen. A pinging noise is heard when there is a gas-filled organ up against the body wall, such as a displaced abomasum (Figure 1).
  • Passage of a nasogastric tube, through the nose into the stomach, to test the fluid from the rumen
  • Blood work evaluation
Treatment: 

The goal of treatment for abomasal displacement or volvulus initially includes stabilizing the cow with fluid therapy, calcium and/or dextrose (sugar) solutions and then to:

  • Move or replace the abomasum to a normal position
  • Prevent it from displacing again
  • Keep the procedure atraumatic for the cow

Closed (Nonsurgical) Techniques for Abomasal Displacement

  • Less expensive and relatively quick and simple techniques to perform include:
    • Rolling: Flipping the abomasum back in place (not an effective long-term treatment because most cows will have a recurrence).
    • Securing the abomasum to the body wall with a blind tack (a holding stitch placed in the abomasum without opening the belly) or a toggle pin (a special device to fix the abomasum in place).
      • Both blind tacking and toggle pin techniques prevent recurrence of the displacement, but they can have very high complication rates, including infection or damage to internal organs.
      • Laparoscopic placement (of a small camera inside the abdomen to see what you are doing) can avoid these complications.

Open (Surgical) Techniques for Abomasal Displacement 

Surgery for an abomasal displacement can be performed with the cow standing or lying down depending on the veterinarian’s preference, temperament of the cow, its physical condition, and the surgery facilities that are available. Your veterinarian may refer you to an ACVS board-certified veterinary surgeon.

An incision is made into the abdomen through the side or the bottom of the abdomen to suture the abomasum to the body wall internally.

Open (Surgical) Techniques for Abomasal Volvulus

The only option for cows with an abomasal volvulus is to undergo an open, surgical procedure that includes:

  • Evaluating the blood supply to the abomasum (Figure 2)
  • Returning it to its normal position
  • Securing it to the body wall
Aftercare and Outcome: 

In some cows:

  • Fixation to the body wall may fail
  • Infection may develop at its incision site
  • Complication after the surgery is more likely to occur if they have other illnesses, health problems (e.g., respiratory (lung) disease) or are severely dehydrated

After surgery, return cows to the herd with no special post-operative management unless drugs were used that require a specific withdrawal time.

It is necessary to:

  • Monitor the surgical wound
  • Treat incisional complications, if they arise
  • Treat other concurrent diseases, such as mastitis

Generally, the outcome following surgery for abomasal displacement is quite favorable, regardless of the technique chosen. Reports show short-term success rates as high as 85-95%; not known, is how the cows will do long-term.

The prognosis following abomasal volvulus is more guarded because blood vessels can be damaged when the abomasum is twisted and the cow will require more intensive therapy. Cows that are stressed and have increased heart rates (>100 beats/min.) may not do as well as those that are treated early in the disease.

Unfortunately, no one knows how to prevent the onset of abomasal displacements. Avoid rapid changes in diet. There has been some suggestion that heredity may play a role in development of abomasal displacement, so examine breeding lines closely.

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This Animal Health Topic was written by and reviewed by Diplomates of the American College of Veterinary Surgeons.  Any opinions stated in this article are not necessarily the official position of the American College of Veterinary Surgeons.

The American College of Veterinary Surgeons recommends contacting an ACVS board-certified veterinary surgeon or your general veterinarian for more information about this topic.

To find an ACVS Diplomate, visit www.acvs.org/find-a-surgeon.