Bovis ISSN 2398-2993

Abomasal ulceration

Contributor(s): Sophie Mahendran , Paul Wood

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Introduction

  • Abomasal ulcers penetrate the basement membrane of the mucosa.
  • Cause: multifactorial - anything that affects abomasal defenses such as trauma, hyperacidity, stress, concurrent disease and NSAID usage.
  • Signs: melena, colic, anemia, sudden drop in milk production.
  • Diagnosis: PCV, fecal occult blood, ultrasound, exploratory laparotomy.
  • Treatment: treatment of concurrent disease, broad spectrum antibiotics, antacids.
  • Prognosis: dependent on type of ulcer - good for type 1, grave for type 4.

Pathogenesis

Etiology

  • Ulcers  penetrate the basement membrane of the mucosa, and may extend into the submucosa, muscularis externa and serosa
    • In contrast, erosions are only discrete mucosal defects that don't penetrate the muscularis mucosa.
  • The cause of abomasal ulceration is multifactorial.
  • Several bacteria have been isolated, although no infectious component has been confirmed
  • Ulcers are typically found around the pyloric region:
    • Possibly due to alkalinization by bile reflux from the duodenum, although less likely than in humans, due to the more distal location of the bile ducts entering the small intestine.
    • Possibly due to mechanical trauma to the pyloric mucosa by coarse feeds.
  • There has been an association in well grown calves, which are aggressive milk drinkers, resulting in milk over-flow into the reticuorumen allowing bacterial colonization:
    • This is thought to allow overgrowth of clostridium perfringens type D.
  • There has also been a link to anything that predisposes cattle to inappetance such as periods of illness or weather-induced inappetance:
    • This leads to low abomasal pH, promoting ulcer formation.
  • Stress causes increased cortisone, which reduces gastric mucus secretion, leading to reduced mucosal protection
    • There is also decreased cell renewal in the gastric mucosa.
  • Copper deficiency Nutrition: copper causes altered elastin cross-linkages which results in compromized abomasal mucosa and vasculature:
    • Also linked to reduced neutrophil function and reduced cytochrome oxidase activity of leukocytes.
  • Non-steroidal anti-inflammatory drugs Anti-inflammatory drugs: an overview which inhibit prostaglandin can predispose to ulcers due to their importance in maintaining mucosal integrity, increasing mucus secretion and microcirculation, and reducing hydrochloric acid secretion.
  • The ingestion of coarse feeds may cause traumatic damage to the abomasal mucosa, as can pica secondary to enteritis.

Pathophysiology

  • Abomasal ulcers can be classified into four categories:
    • Type 1: nonperforating with minimal to no intraluminal hemorrhage.
      • Often occur in the peripartum period, associated with concurrent disease.
    • Type 2: nonperforating but with severe blood loss due to erosion of major blood vessels in the submucosa.
      • Often occur with concurrent disease.
      • Can be associated with lymphosarcoma infiltration of the abomasum.
    • Type 3: perforating ulcer with localized peritonitis due to abomasal contents leaking into peritoneal cavity or omental bursa.
      • Causes fibrin deposition and abomasal adherence to the peritoneum, omentum or surrounding viscera.
    • Type 4: perforating ulcer with diffuse peritonitis due to rapid spread of abomasal contents throughout the peritoneal cavity.
      • Often present as a medical emergency.

Epidemiology

  • Approximate 0.2-5.7% prevalence in beef calves.
  • Approximate 32-76% prevalence in veal calves.
  • Approximate 1-2.6% prevalence in dairy cows.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Marshall T S (2009) Abomasal ulceration and tympany of calves. Veterinary clinics of North America: Food Animal Practice 25 (1), 209-220 PubMed.
  • Braun U (2003) Ultrasonography in gastrointestinal disease in cattle. The Veterinary Journal, 166 (2) 112-124.
  • Smith D F, Munson L & Erb H N (1986) Predictive values for clinical signs of abomasal ulcer disease in adult dairy cattle. Preventive Veterinary Medicine 3 (6), 573-580 PubMed.

Other sources of information

  • Fecteau M E & Whitlock R H (2009) Chapter 10 -  Abomasal Ulcers. Food Animal Practice, 29-34.


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