[Uroperitoneum in a heifer]. / Uroperitoneum bei einem weiblichen Jungrind.

Uroperitoneum is a rarely documented finding in heifers. More frequently uroperitoneum is described in male youngstock suffering from obstructive urolithiasis, or abscesses of the urachus. This report describes a case of uroperitoneum most likely as a result of a traumatic rupture of the urinary bladder in an 8.5 months old heifer. The animal was presented with a severely dilated abdomen and an undulating wave was evident upon palpation. The heifer exhibited physiologic urination. Additionally, left displacement of the abomasum was evident. In consequence to findings of the ultrasonographic examination and abdominocentesis, diagnostic laparotomy was performed. Urine was evacuated from the abdominal cavity in fractions and the damaged cranial pole of the urinary bladder was excised followed by the suture of the urinary bladder. The abomasum was replaced in its physiologic position and an omentopexy was performed. The heifer was discharged from hospital and was still in the herd 5 years after discharge.

Acid-base imbalances and the association of blood-gas variables, electrolytes, and biochemical analytes with outcome in hospitalized calves undergoing abdominal surgery.

BACKGROUND: Surgical abdominal emergencies in calves are associated with a guarded prognosis and have the potential for complex metabolic derangements including acid-base imbalances. OBJECTIVES: To perform a comprehensive analysis of acid-base status and to assess the prognostic relevance of preoperative clinicopathologic variables in calves undergoing abdominal surgery. ANIMALS: Hospital-based study samples of 535 (dataset 1; DS1) and 83 calves (dataset 2; DS2). METHODS: Retrospective (DS1) and prospective (DS2) case series. RESULTS: In DS1, acidemia (pH <7.33) was present in 49.9%, whereas alkalemia (pH >7.37) was present in 30.7% of calves. Plasma L-lactate, chloride, and serum inorganic phosphorus concentration accounted for 51.9%, 11.6% and 9.4% of the variation of venous blood pH, respectively. Classification tree analysis indicated that a negative outcome (death or euthanasia during hospitalization) was associated with venous pO2 ≤33.6 mm Hg, anion gap >18.3 and >22.9 mEq/L, serum albumin concentration ≤36.5 and ≤29.4 g/L, serum urea concentration >4.4 mmol/L, and plasma ionized calcium concentration ≤1.26 mmol/L. The area under the receiver operating characteristic curve of this model was 0.85 (95% CI: 0.82-0.89, P < .001) and the resulting sensitivity and specificity for the prediction of nonsurvival at the optimal probability cut-point of 0.5 was 89.8% and 65.7%, respectively. In DS2 the model had a similar sensitivity and specificity of 90.5% and 70%, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Clinicopathologic imbalances and associated changes of acid-base status are common in calves with surgical abdominal emergencies and have clinical utility for the prediction of a negative postoperative outcome.

Clinical signs, profound acidemia, hypoglycemia, and hypernatremia are predictive of mortality in 1,400 critically ill neonatal calves with diarrhea.

Profound acidemia impairs cellular and organ function and consequently should be associated with an increased risk of mortality in critically ill humans and animals. Neonatal diarrhea in calves can result in potentially serious metabolic derangements including profound acidemia due to strong ion (metabolic) acidosis, hyper-D-lactatemia, hyper-L-lactatemia, azotemia, hypoglycemia, hyperkalemia and hyponatremia. The aim of this retrospective study was to assess the prognostic relevance of clinical and laboratory findings in 1,400 critically ill neonatal calves with diarrhea admitted to a veterinary teaching hospital. The mortality rate was 22%. Classification tree analysis indicated that mortality was associated with clinical signs of neurologic disease, abdominal emergencies, cachexia, orthopedic problems such as septic arthritis, and profound acidemia (jugular venous blood pH < 6.85). When exclusively considering laboratory parameters, classification tree analysis identified plasma glucose concentrations < 3.2 mmol/L, plasma sodium concentrations ≥ 151 mmol/L, serum GGT activity < 31 U/L and a thrombocyte count < 535 G/L as predictors of mortality. However, multivariable logistic regression models based on these laboratory parameters did not have a sufficiently high enough sensitivity (59%) and specificity (79%) to reliably predict treatment outcome. The sensitivity and specificity of jugular venous blood pH < 6.85 were 11% and 97%, respectively, for predicting non-survival in this study population. We conclude that laboratory values (except jugular venous blood pH < 6.85) are of limited value for predicting outcome in critically ill neonatal calves with diarrhea. In contrast, the presence of specific clinical abnormalities provides valuable prognostic information.

The prevalence and clinical relevance of hyperkalaemia in calves with neonatal diarrhoea.

One hundred and twenty-four calves with neonatal diarrhoea were investigated in order to assess the prevalence of hyperkalaemia and the associated clinical signs. Hyperkalaemia (potassium concentration >5.8mmol/L) was recognized in 42 (34%) calves and was more closely associated with dehydration than with decreases in base excess or venous blood pH. In 75 calves with normal blood concentrations of D-lactate (i.e. ⩽3.96mmol/L), K concentrations were moderately correlated with base excess values (r=-0.48, P<0.001). In contrast, no significant correlation was observed in 49 calves with elevated D-lactate. Only three hyperkalaemic calves had bradycardia and a weak positive correlation was found between heart rate and K concentrations (r=0.22, P=0.014). Ten of the 124 calves had cardiac arrhythmia and of these seven had hyperkalaemia indicating that cardiac arrhythmia had a low sensitivity (17%) but a high specificity (96%) as a predictor of hyperkalaemia. In a subset of 34 calves with base excess values ⩽-5mmol/L and D-lactate concentrations <5mmol/L (of which 22 had hyperkalaemia), changes in posture/ability to stand could be mainly explained by elevations of K concentrations (P<0.001) and to a lesser extent by increases in L-lactate concentrations (P=0.024). Skeletal muscle weakness due to hyperkalaemia alongside hypovolaemia may produce a clinical picture that is similar to that in calves with marked D-lactic acidosis. However, since reductions in the strength of the palpebral reflex are closely correlated with D-lactate concentrations, a prompt palpebral reflex can assist the clinical prediction of hyperkalaemia in calves presenting with a distinct impairment in their ability to stand (specificity 99%, sensitivity 29%).

Construction and validation of a decision tree for treating metabolic acidosis in calves with neonatal diarrhea.

BACKGROUND: The aim of the present prospective study was to investigate whether a decision tree based on basic clinical signs could be used to determine the treatment of metabolic acidosis in calves successfully without expensive laboratory equipment. A total of 121 calves with a diagnosis of neonatal diarrhea admitted to a veterinary teaching hospital were included in the study. The dosages of sodium bicarbonate administered followed simple guidelines based on the results of a previous retrospective analysis. Calves that were neither dehydrated nor assumed to be acidemic received an oral electrolyte solution. In cases in which intravenous correction of acidosis and/or dehydration was deemed necessary, the provided amount of sodium bicarbonate ranged from 250 to 750 mmol (depending on alterations in posture) and infusion volumes from 1 to 6.25 liters (depending on the degree of dehydration). Individual body weights of calves were disregarded. During the 24 hour study period the investigator was blinded to all laboratory findings. RESULTS: After being lifted, many calves were able to stand despite base excess levels below -20 mmol/l. Especially in those calves, metabolic acidosis was undercorrected with the provided amount of 500 mmol sodium bicarbonate, which was intended for calves standing insecurely. In 13 calves metabolic acidosis was not treated successfully as defined by an expected treatment failure or a measured base excess value below -5 mmol/l. By contrast, 24 hours after the initiation of therapy, a metabolic alkalosis was present in 55 calves (base excess levels above +5 mmol/l). However, the clinical status was not affected significantly by the metabolic alkalosis. CONCLUSIONS: Assuming re-evaluation of the calf after 24 hours, the tested decision tree can be recommended for the use in field practice with minor modifications. Calves that stand insecurely and are not able to correct their position if pushed require higher doses of sodium bicarbonate, if there is clinical evidence of a marked D-lactic acidosis. In those calves, determining the degree of loss of the palpebral reflex was identified as a useful decision criterion to provide an additional amount of 250 mmol sodium bicarbonate. This work demonstrates the clinical relevance of the discovery that D-lactate is responsible for most of the clinical signs expressed in neonatal diarrheic calves suffering from metabolic acidosis.

[Euthanasia of cattle: a clinical comparison of T 61 and pentobarbital (Eutha 77)]. / Euthanasie des Rindes--ein klinischer Vergleich von T 61 und Pentobarbital (Eutha 77).

The objective of this study was a comparison of pentobarbital and T 61 in the euthanasia of cattle. 397 cattle of different ages and breeds which had to be euthanised in the Clinic for Ruminants were enrolled. Following clinical examination, euthanasia was performed by intravenous injection of either 40 mg pentobarbital per kg body weight (BW) (0.1 ml Eutha 77) or 0.1 ml T 61/kg BW. The intervals between the beginning of injection and the following events were noted: collapse of the animal, cessation of respiration, cessation of cardiac action, disappearance of the palpebral and corneal reflexes, and maximum dilatation of the pupils. These post-injection events occurred significantly earlier with Eutha 77. In addition, events like excitations and vocalisations were recorded. Excitations occurred twice as often with T 61 (in 34% of cases) than with Eutha 77 (17%), and strong excitations (grade 3 of 3) were also more frequent with T 61 (9.8%) than with Eutha 77 (3%). Vocalisations were less frequent (30%) with T 61 than with pentobarbital (39%), but this difference was not significant. Severe vocalisations occurred very rarely. With both drugs, intervals between the beginning of injection until cessation of reflexes were longer in older animals. Following injection of Eutha 77, cessation of the corneal reflex and maximal dilatation of the pupils occurred earlier in cattle with severe disturbance of the general condition than in cattle with lesser disturbance; in the T 61-group this difference was only significant for the interval until cessation of the corneal reflex. In anaesthetized patients euthanized with T 61 cessation of cardiac action and respiration occurred earlier than in patients that were not under general anaesthesia when euthanized; in the Eutha 77 group, the difference was significant only for the interval until cessation of cardiac action.