[Buiatrics: What's your diagnosis?] / Rindermedizin ­ Was ist Ihre Diagnose?

INTRODUCTION: Therapy of a high-grade balanoposthitis with partial penile and preputial prolapse after unsuccessful initial therapy of a ten-year-old dexter bull. Two punctures, about 1 cm depth were found at the base of the prolapsed tissue, which were probably caused by partially perforating U-stitches by the local veterinarian. The highly inflamed and swollen tissue disabled the penis to retract. The prolapse was repositioned and the preputial opening was partially closed using a modified Buhner stitch. Consecutively, antibiotics and anti-inflammatory drugs were administered, and regular wound toilets were performed. After 14 days, the increase in circumference at the base of the prolapse was partially removed and histopathologically identified as pyogranulomatous inflammation. Surgery was repeated two weeks later. Potentia coeundi could thus be re-established. This case shows that regular breeding hygienic examinations are of great importance in order to identify morphological changes in early stages and to treat them adequately.

INTRODUCTION: Traitement d'une importante balanoposthite avec prolapsus pénien et préputial partiel après traitement initial infructueux d'un taureau Dexter de dix ans. Deux perforations d'environ 1 cm de profondeur ont été trouvées à la base du tissu prolabé, probablement causées par des points de suture en U posés par le vétérinaire traitant pour éviter une récidive. Le tissu très enflammé et enflé a empêché le pénis de se rétracter. Le prolapsus a été repositionné et l'ouverture préputiale a été partiellement fermée à l'aide d'un point de Buhner modifié. Consécutivement, des antibiotiques et des anti-inflammatoires ont été administrés et des toilettes des plaies régulières ont été effectuées. Après 14 jours, l'augmentation de la circonférence à la base du prolapsus a été partiellement réséquée et identifiée histopathologiquement comme une inflammation pyogranulomateuse. La chirurgie a été répétée deux semaines plus tard. La potentia coeundi a pu ainsi être rétablie. Ce cas montre que des examens d'hygiène d'élevage réguliers sont d'une grande importance afin d'identifier les changements morphologiques aux stades précoces et de les traiter de manière adéquate.

Urethral fistula after resection of a penile fibropapilloma in a Holstein Friesian bull.

INTRODUCTION: A 2-year-old Holstein Friesian bull with a penile tumour was referred to the University of Veterinary Medicine Hannover, Foundation, Germany, where the tumour was resected and diagnosed as a fibropapilloma. A urethral fistula was diagnosed eight days postoperatively and was present nine months later, although the bull had normal copulation behaviour and satisfactory fertility. Surgical removal of fibropapillomas in close proximity to the urethra is an effective treatment. A urethral fistula, which may occur as a postsurgical complication, did not have an adverse effect on copulation capacity and fertility of the bull.

INTRODUCTION: Un taureau Holstein Frisian de 2 ans atteint d'une tumeur du pénis a été référé à l'Université de médecine vétérinaire de Hanovre, Fondation, en Allemagne, où la tumeur a été réséquée et diagnostiquée comme un fibropapillome. Une fistule urétrale a été diagnostiquée huit jours après l'opération et était présente neuf mois plus tard, bien que le taureau ait eu un comportement de copulation normal et une fertilité satisfaisante. L'ablation chirurgicale des fibropapillomes à proximité immédiate de l'urètre constitue un traitement efficace. Une fistule urétrale, qui peut survenir comme complication post-chirurgicale, n'a pas eu d'effet négatif sur la capacité de copulation et la fertilité du taureau.

Evaluation of intravenous regional anaesthesia and four-point nerve block efficacy in the distal hind limb of dairy cows.

BACKGROUND: Intravenous regional anaesthesia (IVRA) and hindfoot four-point nerve block anaesthesia (NBA) are recommended for local anaesthesia (LA) in the distal limb of dairy cows. Two studies were conducted to compare the efficacy, time until onset and stress responses to IVRA and NBA in dairy cows. In the first cross-over designed study, eight healthy unsedated German Holstein cows, restrained in lateral recumbency (LR) on a surgical tipping table, were treated with IVRA and NBA using procaine 2% as a local anaesthetic. Distal limb desensitization was tested by electrical (e-), mechanical (m-) and thermal (t-) nociceptive stimulation 10 min before and 15 and 30 min after LA. Hormonal-metabolic (blood concentrations of cortisol, lactate, non-esterified fatty acids, and glucose) and cardio-respiratory (heart and respiratory rate, mean arterial blood pressure) stress responses to treatment were assessed at predetermined intervals. In the second study, six healthy, unsedated German Holstein cows in LR were treated (crossover design) with IVRA and NBA. Short-interval e-stimulation was measured by the time until complete distal limb desensitization. RESULTS: In the first study, four of eight cows responded to e-stimulation 15 min after IVRA, while none of the cows treated with NBA responded until the safety cut-off level was reached. E-stimulation revealed complete desensitization of the distal limb 30 min after LA in all cows. Half of the cows did not respond to m- and t-stimulation before LA, so no further evaluation was performed. Stress reactions to IVRA and NBA treatment were similar, but differences may have been masked by stress response to LR restraint. In the second study, complete desensitization was achieved 12.5 min after NBA, while one of the six cows still responded to e-stimulation 20 min after IVRA. CONCLUSION: Hindfoot nerve block anaesthesia and intravenous regional anaesthesia induced complete desensitization of the distal hind limb in dairy cows. However, the anaesthesia onset after NBA was significantly faster than that of IVRA, which may be clinically relevant in the field, particularly when distal limb anaesthesia is required for major claw surgeries under time constraints.

Short communication: Pilot study on hormonal, metabolic, and behavioral stress response to treatment of claw horn lesions in acutely lame dairy cows.

Short-term effects of therapeutic claw trimming in acutely lame cows (n=21) with nonadvanced claw horn lesions on the endocrine, metabolic, and behavioral stress responses were investigated in comparison to regular claw trimming in nonlame control cows (n=21). Controls were matched to lame cows by parity and stage of lactation. Lame cows suffering from typical sole ulcers or white line disease were blinded and randomly assigned to 2 treatments, receiving 15 min before interventions either ketoprofen (n=11; 3mg/kg of BW intramuscularly; Romefen, Merial, Lyon, France) or placebo (n=10; saline in equivalent amount and route of administration). All cows underwent functional claw trimming in lateral recumbency on a surgical tipping table, and claw horn lesions in lame cows were conventionally treated (removal of loose horn, block on opposing claw, bandaging of affected claw). Blood samples collected 15 min before, at the end, and 24h after claw trimming were analyzed for concentrations of cortisol, fatty acids, lactate, and glucose, and fecal samples (collected before treatment and after 24 h) for cortisol metabolites. Behavioral stress responses during functional and therapeutic claw trimming were recorded. Concentrations of blood cortisol, fatty acids, glucose, and fecal cortisol metabolites were higher in lame than in nonlame cows after treatment. During claw treatment, more leg movements were recorded for lame cows than nonlame cows. Pre-emptive administration of ketoprofen had no obvious effects on stress responses to therapeutic claw trimming. Treatments of claw horn lesions caused a significant stress and pain reaction in acutely lame cows, demonstrating the necessity of adequate pain management protocols for such interventions.

Malignant mesenchymoma in the nasal cavity of a bull.

A 4-year-old bull was presented with facial distortion and abnormal respiratory noise. Endoscopically, a proliferative mass was found obliterating the left nasal cavity and a tumour was suspected. The head was examined after slaughter and there was a well-circumscribed solid structure (15×12×6 cm) extending into the paranasal sinus, the choanal region and the bones of the orbit, with focal penetration of the nasal septum. Microscopically, the mass consisted of well-differentiated trabeculae of woven and lamellar bone, areas of chondromyxomatous, immature and mature cartilaginous tissue, and regions with irregular whorled spindle cells. Tissue differentiation of the mass was variable. Centrally, there was osseous differentiation with an outermost fibromatous area resembling a zone of endochondral ossification. There was suppurative and ulcerative inflammation where the tumour extended through the hard palate and into the pharynx. A nasal malignant mesenchymoma was diagnosed on the basis of these features.

High caudal epidural anaesthesia with local anaesthetics or alpha(2)-agonists in calves.

The objective of this study was to examine the efficacy of a caudal epidural anaesthesia using lidocaine or xylazine in a high volume for analgesia of the flank, navel and hamstring tendon. Fourteen calves weighing 57.7 +/- 5.1 kg and 37.9 +/- 9.3 (mean +/- SEM) days old were randomly divided into two groups of seven calves each. Calves belonging to the lidocaine group were given a 2% lidocaine solution in the sacrococcygeal vertebral space epidurally at a volume of 0.4 ml/kg (8 mg/kg) body weight (BW). Animals of the xylazine group were administered an epidural anaesthesia with xylazine at a dose of 0.1 mg/kg BW, diluted with a 0.9% saline solution to a corresponding final volume of 0.4 ml/kg BW. Heart rate and respiratory rate were measured and the degree and duration of analgesia was determined by the response to a skin prick with a hypodermic needle over a period of 350 min after epidural injection. After epidural anaesthesia with lidocaine the mean heart rate increased during dorsal recumbency, whereas after xylazine both heart rate and respiratory rate decreased significantly (P < 0.05). The epidural injection of xylazine compared with lidocaine caused longer (P < 0.05) analgesia at the hamstring tendon (mean +/- SEM, 120.7 +/- 29.7 min versus 93.6 +/- 3.5 min) and at the flank (100.7 +/- 24.4 min versus 78.3 +/- 11.1 min). There were no differences in the intensity of analgesia between groups. After xylazine application analgesia at the navel was achieved for 95.0 +/- 14.1 min whereas after lidocaine injection sufficient analgesia at the navel was found in just two of seven calves for 55 and 95 min respectively. Based on above experiences, a second study was performed, in which a combination of xylazine and local anaesthetics was used and the injection volume was increased to prove the efficacy of caudal epidural anaesthesia in 15 calves (26.3 +/- 26.7 days; 57.1 +/- 19.5 kg) submitted to the clinic for regular umbilical surgery. In these cases the xylazine (0.1 mg/kg BW) was diluted with 2% lidocaine (n = 7) or 2% procaine (n = 8) to a corresponding final volume of 0.5-0.6 ml/kg BW. In all cases complete anaesthesia of the surgical area was achieved and no adverse effects were observed. Overall the high volume caudal epidural anaesthesia represents an effective, safe, cheap and easy to perform alternative for anaesthesia of the navel, flank and hamstring tendon in calves without major side effects.

Arthrotomy and arthrodesis in the treatment of complicated arthritis of the fetlock joint in adult cattle.

One Galloway bull and three German Holstein-Friesian cows aged between three and five years with complicated arthritis of the fetlock joint were treated by arthrotomy (on the bull and two of the cows) or by arthrodesis (on the other cow). Arthrotomy involved four vertical dorsolateral/dorsomedial and palmolateral/palmomedial incisions 5 cm long to give access to the joint cavities and allow fibrin, debris and necrotic tissue to be removed. Arthrodesis consisted of lateral and medial (abaxial) horizontal 5 cm incisions along the joint space. After debridement, the joint surfaces (cartilage and superficial bone tissue) of the metacarpus and first phalanx were completely abraded with a high-speed surgical drill. The interdigital region, palmar and dorsal tendons, vessels and nerves were conserved during both arthrotomy and arthrodesis, and the pouches were flushed during the surgery. The incisions were sutured and a casting tape was applied. Six weeks later, the cast was removed and a supporting bandage was applied. Each animal received 10 mg/kg ampicillin subcutaneously twice a day from one day before surgery until a mean (sd) of 23 (4) days after the arthrotomies and 36 days after the arthrodesis. After a recovery period of at least one year, all the animals could be used without restrictions.

Purification of prostaglandin D synthase by ceramic- and size exclusion chromatography.

Prostaglandin D synthase (L-PGDS) is a major glycosylated polypeptide in cerebrospinal fluid (CSF). The overexpression of L-PGDS in inflamed bovine mammary glands indicates its role as biomarker. No diagnostic tool for the quantitative detection of L-PGDS in cows has been reported. Immunometric ELISA tests might help to identify inflamed bovine tissue. The isolation of pure bovine L-PGDS, which is required for the generation of monoclonal antibodies, is an important prerequisite for a diagnostic ELISA test. Our goal was to identify a suitable technique to generate pure L-PGDS from bovine substrates. In the present study a two-step method for the purification of bovine CSF using ceramic hydroxyapatite chromatography followed by size exclusion chromatography is described. Subsequently, the identification of bovine L-PGDS was demonstrated by Western blot analysis and the high grade of the pure product was shown by 2-D PAGE. The yield of purified L-PGDS was 6.8 mg/l bovine CSF. L-PGDS from bovine CSF is shown to consist of multiple isoforms identical in molecular mass and pI values to those in previously described secretions of inflamed bovine mammary glands. In addition, the method was successfully applied to the purification of L-PGDS from human CSF.

Colostrum management in calves: effects of drenching vs. bottle feeding.

The objective was to examine whether the administration of colostrum by a drencher is a safe method to achieve satisfying immunoglobulin concentrations in newborn Holstein Friesian (HF)-calves. Twenty-one calves were fed 1 h postnatum with 2 l colostrum from their dam using a nipple bottle (group I); 15 calves were drenched with 4 l colostrum from their dam 1 h postnatum (group II). Thereafter, all calves were fed milk replacer exclusively. Serum concentration of total immunoglobulin [analysed by Sandwich-enzyme-linked immunosorbent assay (ELISA)] 24 h postnatum was higher in drenched calves (25.2 g/l; 12.8/52.2; median and 10/90 percentiles) compared with bottle-fed calves (14.1 g/l; 9.2/24.7). To characterize the kinetics of immunoglobulin absorption, 17 blood samples were taken frequently within 72 h postnatum using a jugular catheter in five calves fed 2 l colostrum by nipple bottle and five calves drenched with 4 l colostrum 1 h postnatum. A slightly delayed increase of serum immunoglobulin concentration (approximately 3 h) was obvious in drenched calves compared with bottle-fed calves, but drenched calves reached significantly higher immunoglobulin concentrations compared with bottle-fed calves. It is concluded that the proper application of colostrum by a drencher is a useful method for adequate colostral supply in newborn calves. The failure of the oesophageal groove reflex in drenched calves caused no clinical consequences.

Post surgical development of inflammatory adhesions and reticular function in cows suffering from traumatic reticuloperitonitis.

Inflammatory adhesions between reticulum and ventral abdomen in patients suffering traumatic reticuloperitonitis (TRP) may induce a massive inhibition of reticular contractions and thereby an impairment of the separation process of particles in the reticulorumen. However, a substantial disturbance of digesta passage (Hoflund-syndrome) is found only in a few TRP-cows. We hypothesized that this is due to a retrieval of reticular motility due to rebuilding and degradation of adhesions within months after the removal of the foreign body as the primary inflammatory stimulus. Accordingly, it was the objective of this study (a) to assess the extent and structure of inflammatory adhesions in cows with TRP over a period of six months following surgery and (b) to persecute reticular function by characterizing the sequence of reticular contractions sonographically and by assessment of particle size distribution in the faeces of patients by means of wet-sieving. Twenty-six cows suffering from TRP were studied on the day of rumenotomy (day 1) and on day 6, day 12 and 6 months post operationem. Additionally, six healthy control cows were investigated once. All cows were on a hay and concentrate diet. On day 1, the reticular floor and the reticular wall were affected by adhesions in varying extent in all cows; the contraction distance and contraction velocity of the reticulum were markedly reduced and the portion of large particles in the faces increased compared to healthy cows. On day 12, the portion of large particles did not vary any more from that of control cows; a tendency towards an increased contraction distance compared to day 1 was found. Sonographically, only marginal differences were detected in respect to extent and consistency of adhesions. Six months after rumenotomy, in 9 of 16 re-investigated cows sonography revealed no adhesions at the reticulum at all, in other cases the extent of adhesions shrunk considerably. Contraction distance and contraction velocity and particle size distribution in the faeces were found to be nearly comparable to that of control cows. It is concluded that inflammatory adhesions disappear in the majority of the TRP-patients, as a consequence reticular function normalizes. A serious disturbance of digesta passage seems to develop exclusively in those patients with the most extensive adhesions and may be also in such cows, where the primary adhesions cause the development of extensive abscesses.

Outbreak of pneumonia and arthritis in beef calves associated with Mycoplasma bovis and Mycoplasma californicum.

During an outbreak of pneumonia and arthritis in beef calves and young cattle on a large farm in north-west Germany, Mycoplasma bovis and Mycoplasma californicum were isolated from tracheobronchial lavage fluids and synovial fluids. The microbiological findings in dead and living animals and the immunohistochemical demonstration of M californicum antigen in lung and arthritic joint tissue, indicated that under poor housing conditions and possibly other predisposing factors, this mycoplasma, like M bovis, can colonise the respiratory tract and may be able to cross the respiratory mucosal barrier to spread through an infected animal and cause systemic infections that may contribute to severe arthritis.

[Experiences with the use of xylazine for sacral epidural anesthesia in cattle]. / Erfahrungen mit der Anwendung von Xylazin zur sakralen Epiduralanästhesie beim Rind.

The effect of epidural administered xylazine was investigated in 10 mature Holstein cows (mean age: 5.4 +/- 1.2 years, mean BW: 572 +/- 23 kg): 5 cows were treated with xylazine in a low dose of 0.05 mg/kg body weight, 3 cows in a medium dose (0.07 mg/kg BW) and 2 cows in a high dose (0.1 mg/kg BW). Xylazine dosages were diluted in sterile saline to a final volume of 5 ml. As a control, lidocaine (5 ml of a 2% solution) was given to 5 cows epidurally. Duration of regional anaesthesia after low dose of xylazine (0.05 mg/kg BW) was significant longer (mean: 2.2 hours) compared to lidocaine treated cows (mean: 1.1 hour). Regional extension of anaesthesia was comparable after dosing with xylazine and lidocaine (tail, after, vulva and perineum). All cows remained standing, but in xylazine treated cows systemic effects, e.g. mild sedation, decreased heart- and respiratory rates, decreased rumen motility and mild bloat were observed. With increased dosages of xylazine a prolongation of epidural anaesthesia up to 3 hours was achieved, but regional extension of this effect remained nearly unchanged. With increased xylazine dosages, cows showed marked sedation and ataxia and sternal recumbency were induced.