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==History and Clinical Signs==
==History and Clinical Signs==
A typical history would be a recently calved cow with a sudden drop in appetite and milk production. Animals display general malaise and abdominal pain. On clinical exam a rapid loss of condition may be evident, [[Ketosis of Cattle|ketosis]] or decreased ruminal activity on ausculatation. Often the left flank bulges behind ribs and the temperature may be normal or slightly raised.
A typical history would be a recently calved cow with a sudden drop in appetite and milk production. Animals display general malaise and abdominal pain. On clinical exam a rapid loss of condition may be evident, [[Ketosis of Cattle|ketosis]] or decreased ruminal activity on ausculatation. Often the left flank bulges behind ribs and the temperature may be normal or slightly raised.
==Treatment==
==Treatment==
Any concurrent diseases should be treated e.g hypocalcaemia, metritis, mastitis or ketosis.
Any concurrent diseases should be treated e.g hypocalcaemia, metritis, [[Streptococcal mastitis - bovine|mastitis]] or ketosis.
Conservative management can be attempted in low value animals.
Conservative management can be attempted in low value animals.
Rolling can be undertakne to try and manipulate the abomasum into the correct position. This technique involves casting the cow onto her right side and rolling her over whilst percussing and balloting the pings to track the movement of the gas filled abomasum. Reoccurence is likely and success rates with this are usually 30-50%.
Rolling can be undertaken to try and manipulate the abomasum into the correct position. This technique involves casting the cow onto her right side and rolling her over whilst percussing and balloting the pings to track the movement of the gas filled abomasum. Reoccurence is likely and success rates with this are usually 30-50%.
A number of surgical techniques are documented to correct the displacement. These include:
A number of surgical techniques are documented to correct the displacement. These include:
*Blind toggle abomasopexy
*Blind toggle abomasopexy
Toggles are useful in low value animals as it is a cheap and fast technique. The animal is cast and rolled onto her back. Two toggles are inserted through the ventral abdominal wall into the abomasal lumen. Once positioned the two toggles are tied together. Following this blind suture it is possible to toggle the incorrect area (e.g. rumen, reticulum) resulting in fatal complications. To avoid this complication a PH strip can be used to confirm the correct location following cannulation before the toggles are put in place.
*Right flank omentopexy
*Right flank omentopexy
The right flank is incised one hands distance behind the last rib and the displaced abomasum is located. The organ is then deflated and repositioned in the correct location. The abomasum is sutured to the abdomainl wall and the incision is closed in aroutine manor.
The right flank is incised one hands distance behind the last rib and the displaced abomasum is located. The organ is then deflated and repositioned in the correct location. The abomasum is sutured to the abdominal wall and the incision is closed in a routine manor.
*Left flank omentopexy
*Left flank omentopexy
The left flank is incised just caudal to the last rib and the omentum adjacent to the abomasum is located. A long nylon suture is passed through the fat a few times and then through the ventral body wall. An assistant can help locate the correct position for the suture to be passed by palpated the region with a pair of artey forceps. The two pieces of suture are tied externally and hold the abomasum in the correct position whilst adhesions form.
The left flank is incised just caudal to the last rib and the omentum adjacent to the abomasum is located. A long nylon suture is passed through the fat a few times and then both ends through separate points on the ventral body wall. An assistant can help locate the correct position for the suture to be passed by palpating the region with a pair of artey forceps. The two pieces of suture are tied externally and hold the abomasum in the correct position whilst adhesions form.
*Right paramedian abomasopexy
*Right paramedian abomasopexy
For this technique the cow is sedated and cast onto her back. An incision is made to the right of midline caudal to the most posterior part of the sternum. The abomasum is located, repositioned and sutured to the body wall.
For this technique the cow is sedated and cast onto her back. An incision is made to the right of midline caudal to the most posterior part of the sternum. The abomasum is located, repositioned and sutured to the body wall.
It is important that post-operatively the cow is given a large amount of roughage and slowly given increasing amounts of concentrate.
It is important for all surgical techniques that post-operatively the cow is given a large amount of roughage and concentrates are introduced into the diet slowly.
==Prevention==
==Prevention==
On farms with a high incidence of LDAs or RDAs it is likely that there is a problem with the diet of cows in early lactation and this should be addressed. Overall cases can be reduced by maintaining adequate roughage, avoiding a rapid decrease in rumen volume following calving hence avoiding rapid dietary changes and postparturient illness( hypocalcaemia, ketosis, metritis).
On farms with a high incidence of LDAs or RDAs it is likely that there is a problem with the diet of cows in early lactation and this should be addressed. Overall cases can be reduced by maintaining adequate roughage intake, avoiding a rapid decrease in rumen volume following calving, preventing rapid dietary changes and postparturient illness( hypocalcaemia, ketosis, metritis).
==Prognosis==
==Prognosis==