📘 ❞ Enteral Feeding of 3 Mature Cows by Rumenostomy (p 779-781) ❝ كتاب اصدار 2005

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J Vet Intern Med
2005;19:779–781
Enteral Feeding of 3 Mature Cows by Rumenostomy
Munashe Chigerwe, Jeff W. Tyler, Maisie E. Dawes, Dusty W. Nagy, Loren G. Schultz,
Christopher D. Luby, John R. Middleton, and David Gourley
R
umenostomy is the creation of a permanent or semi-
permanent rumen fistula. Permanent rumen fistulation
is performed to facilitate nutritional research or provide ru-
men fluid donors.
1,2
Transfaunation is an effective adjunc-
tive therapy in cattle recovering from surgery.
2
Texts have
recommended the use of rumenostomy to provide symp-
tomatic relief in cattle with recurrent bloat.
1
This report
describes the use of rumenostomy and enteral feeding as
adjunctive therapy in cows unable to eat or drink. Repeated
oroesophageal intubation may not be tolerated by many cat-
tle and the diameter of stomach tubes typically precludes
provision of large volumes of feedstuffs.
A 4-year-old, 510 kg, female Holstein dairy cow was
examined because of profuse drooling of 2 days’ duration.
The cow’s milk production was greatly decreased. The
owner reported that the cow made frequent unsuccessful
attempts to eat and drink. The cow calved 1 week before
presentation. The cow’s diet consisted of undetermined
amounts of corn silage, grass hay, and ground feed. The
owner treated the cow with procaine penicillin G
a
(20,000
IU/kg SQ q24h) the day before presentation.
The cow was depressed. Rectal temperature was 37.4
8
C,
heart rate was 80 beats/min, and respiratory rate was 52
breaths/min. The cow was estimated to be 8% dehydrated
as assessed by skin turgor. A right head tilt was noted.
Marked drooling was noted and the cow’s tongue was de-
viated to the left side of the oral cavity. The cow had facial
analgesia of the right side and was nonresponsive to tactile
stimuli of the right ear. Palpebral, corneal, and menace re-
sponses were absent in the right eye. A corneal ulcer was
noted on the right eye. The cow had proprioceptive deficits
in both hindlimbs. Rumen contents were firm on rectal pal-
pation, but rumen contractions were normal (2 contractions/
min).
On urinalysis, acidiuria (pH, 6.5; normal, 7–9) and pro-
teinuria (300 mg/dL; normal,
,
30 mg/dL) were present.
Leukocytosis (14,700 cells/
m
L; normal, 4,000–12,000 cells/
m
L) characterized by a neutrophilia (10,440 segmented
cells/
m
L; normal, 600–4,000 cells/
m
L) was identified on
CBC. Venous blood gas analysis indicated a metabolic ac-
From the Departments of Veterinary Medicine and Surgery (Chig-
erwe, Tyler, Dawes, Nagy, Schultz, Middleton, Luby) and Pathobiol-
ogy (Tyler, Dawes, Middleton), College of Veterinary Medicine, Uni-
versity of Missouri, Columbia, MO, and the Whetstone Veterinary Ser-
vice, Mountain Grove (Gourley), MO.
Reprint requests: Dr. Munashe Chigerwe, BVSc, Department of Vet-
erinary Medicine and Surgery, College of Veterinary Medicine, Uni-
versity of Missouri, Columbia, MO 65211; e-mail: chiger-
wem@missouri.edu.
Submitted March 22, 2005; Revised April 21, 2005; Accepted May
5, 2005.
Copyright
q
2005 by the American College of Veterinary Internal
Medicine
0891-6640/05/1905-0023/$3.00/0
idosis (pH, 7.19; normal, 7.35–7.5), bicarbonate concentra-
tion (9.7 mmol/L; normal, 17–29 mmol/L), TCO
2
(10.5
mmol/L; normal, 19–29 mmol/L), and a base deficit of 18.7
mmol/L. Results of serum biochemical evaluation included
increased concentrations of urea nitrogen (44 mg/dL; nor-
mal, 6–22 mg/dL), creatinine (1.4 mg/dL; normal, 0.5–1.1
mg/dL), glucose (218 mg/L; normal, 44–78 mg/dL), protein
(9.2 g/dL; normal, 5.8–7.5 g/gL), albumin (3.8 g/dL; nor-
mal, 2.4–3.5 g/dL), and globulins (5.4 g/dL; normal, 2.3–
3.9 g/L). Serum activity of AST (202 U/L; normal, 58–100
U/L), GGT (75 U/L; normal, 22–64 U/L), and creatine ki-
nase were increased (1,365 U/L; normal, 56–1,236 U/L).
Cerebrospinal fluid (CSF) analysis identified increased total
protein concentration (113 mg/dL; normal, 20–40 mg/dL);
increased lymphocytes, monocytoid cells, and activated
macrophages (83 cells/
m
L; normal,
,
6 cells/
m
L). A quan-
titative differential cell count was not provided. Based on
the clinical signs and CSF analysis results, a presumptive
diagnosis of listeriosis was made.
Listeria monocytogenes
was not recovered from CSF culture, but negative micro-
biologic cultures are common in cattle with listeriosis.
3–5
A rumenostomy was performed. Base deficit for the cow
was calculated as follows: base deficit (mmol/L)
5
0.5
3
510 kg
3
18.7 mmol/L
5
4769 mmol.
6
The fluid deficit
was calculated as 510 kg
3
0.08
5
40.8 L. The mainte-
nance fluid requirement was estimated as an additional 40.8
L/d (80 ml/kg/d).
7
Given that 1 g NaHCO
3
provides ap-
proximately 12 mmol of bicarbonate, the cow required ap-
proximately 400 g of sodium bicarbonate to replace the
base deficit. Initially, 30 L of water, 3 times per day, was
administered via rumenostomy. At each administration of
water, 50 g of potassium chloride, 40 g of calcium chloride,
and 130 g of sodium bicarbonate were dissolved in the
water. The cow was fed 1.5 kg of a balanced commercial
dairy cow grain mix
b
and 2.5 kg of pelleted alfalfa
c
3 times
per day through the rumenostomy, providing approximately
17.5 Mcal net energy (NE)/day.
8
Grain and pelleted alfalfa
were added dry through a funnel and electrolyte solutions
were administered through the rumenostomy using a large-
bore stomach tube at each feeding. Oxytetracycline
d
at 10
mg/kg was administered IV once daily. A topical ophthal-
mic antibiotic ointment
e
was administered OD, q12h.
Serum chemistry determinations repeated 24 hours after
admission demonstrated that the cow had mild metabolic
acidosis (pH, 7.31; base deficit, 4.6 mmol/L; bicarbonate
concentration, 21.8 mmol/L; TCO
2
, 23.2 mmol/L). Intra-
ruminal fluid and electrolyte administration was continued.
Based on the measured deficit, the amount of sodium bi-
carbonate administered through the rumenostomy was ad-
justed to 30 g q8h. Intraruminal calcium chloride and po-
tassium chloride were continued. Three days after presen-
tation, the cow was able to eat and drink slowly, but with
great difficulty. Serum chemistry determinations on day 3
after presentation were consistent with a normal acid–base