True gastric ulcer is a common disease in dairy cows and calves. True gastric ulcer refers to erosive inflammation of the true gastric mucosa and its deep tissues. Perforation can occur if a full-thickness lesion of the gastric wall occurs, often leading to localized or generalized peritonitis. If the contents of the true stomach exudate more, most of the diseased cattle can cause sepsis or autopoisoning and death. The diagnosis of the genuine gastric ulcer is mainly based on physical examination, exclusion and abdominal puncture.
1. Causes
The occurrence of true stomach ulcers in most dairy cattle is related to intensive feeding and a high-concentrate diet. When the diet contains a large amount of wet corn or corn silage, cattle suffer from different degrees of rumen acidosis, which often causes the disease. Calving stress can induce a genuine gastric ulcer, which is determined by the metabolic characteristics of perinatal dairy cattle. Transport stress is also one of the inducing factors. Many imported cattle suffer from large-scale outbreaks to isolate dairy farms. Besides, high-yielding dairy cows are prone to genuine gastric ulcer, because the increase of cardiac output to the breast may cause relatively low perfusion flow of abdominal viscera, which is prone to genuine gastric ulcer.
The high incidence and pathogenesis of the genuine gastric ulcer in adult cows are similar to that of genuine gastric metastasis, and the two kinds of diseases may occur at the same time or be secondary to each other. Most female cows with clinical manifestations of genuine gastric ulcer concentrate on the onset of 4-6 weeks postpartum, which is closely related to calving stress and gastrointestinal retardation.
Another high incidence of disease in adult cows is before calving, which may be related to higher cardiac output to the fetus resulting in increased plasma cortisol and reduced true gastric perfusion. Real gastritis, abdominal distension, and ulcer syndrome often occur in calves, and the exact cause is still unknown. The use of NSAIDs in calves and adult dairy cows may also lead to a genuine gastric ulcer, which is one of the side effects of NSAIDs. Lymphosarcoma in the true stomach region of adult cattle can also cause bleeding ulcers of the true stomach.
2. Clinical symptoms
According to the bleeding and perforation of diseased cattle and the severity of the disease, the genuine gastric ulcer can generally be divided into three types. Ulcer and mild bleeding. Several erosions or superficial ulcers occurred in the true stomach of diseased cattle, with or without slight bleeding. The symptoms of genuine gastric ulcer with a small amount of bleeding are not obvious, and it is difficult to diagnose in the clinic. The collection of fecal samples should avoid rectal examination to prevent false-positive occult blood.
Hemorrhagic ulcer. According to the obvious black feces of dairy cows, the first diagnosis can be made. Diseased cattle with normal feces can be diagnosed by reference to hematocrit, serum total protein, fecal occult blood and dehydration status.
Perforating ulcer. In cattle farms, the perforated gastric ulcer can be seen in calves, young adults and adult cows at any stage, and it is most common in dairy cows 1-6 weeks after delivery. According to the size and degree of perforation, the clinical manifestations vary greatly. Calves with perforated true gastric ulcers are more likely to develop diffuse peritonitis than adult cows. The pain location in acute cases is easy to diagnose, but it is difficult to locate the pain in subacute or chronic cases, and it is difficult to distinguish it from traumatic gastroenteritis. If the dairy cow is in the mid-late lactation stage, the possibility of a genuine gastric ulcer is less.
When diffuse peritonitis occurs in adult cattle and calves, the symptoms begin to be a severe and present septic shock. Fecal occult blood test, hematocrit, and total ascites protein are important diagnostic indicators for suspected hemorrhagic gastric ulcers. Serum albumin and total protein decreased as a result of large amounts of protein entering the abdominal cavity. When diffuse peritonitis secondary to true gastric perforation occurs in dairy cows, the peritoneal puncture can confirm the diagnosis: total solids and total protein in ascites increase, but white blood cells in some acute cases are quite low.
3. Diagnostic Essentials
Dairy cows' genuine gastric ulcer (erosion) is usually caused by genuine gastric obstruction, genuine gastritis, and genuine gastric ulcer. The diagnosis of a genuine gastric ulcer is mainly based on physical examination, exclusion and abdominal puncture. It is usually difficult to diagnose a sick cow before it dies. The diagnosis of hemorrhagic genuine gastric ulcers is based on pale mucosa, high heart rate, black feces, low PCV and hypoproteinemia. B-mode ultrasonography is very helpful in the diagnosis of diffuse peritonitis in calves and adult cattle.
4. Treatment
Unless dairy cows suffer from genuine gastric metastasis, it is generally believed that drug therapy is the best treatment for perforating ulcers, cattle ranchers don't need to consider surgical suture. The treatment and nursing of perforating genuine gastric ulcer with secondary focal peritonitis include dietary adjustment and drug treatment. Silage and high humidity maize should be stopped in the dairy cow diet for 1-2 weeks, and fiber components such as high-quality hay should be increased in the dairy cow diet.
If ketosis occurs due to low dietary energy, high starch diets such as cereals can be given appropriately. Drug therapy included the administration of broad-spectrum antibiotics for 7 to 14 days to control peritonitis. Coping with other complications, such as hypocalcemia or ketosis, occurs during cow illness. Corticosteroid hormones and non-steroidal anti-inflammatory drugs are prohibited to prevent the aggravation of ulcer formation.
Most cases need 5 to 14 days to recover, and dietary adjustment should continue until the complete recovery of sick animals. A small amount of bleeding ulcer of the true stomach, according to the above treatment of perforating ulcer method to adjust the diet, and give acid-fast protectant or astringent, can generally be cured. Patients with concurrent inflammatory or metabolic diseases should be treated accordingly.
Real gastric ulcer causing massive hemorrhage in dairy cows can lead to death. Drug treatment and timely dietary adjustments are needed. The method of dietary adjustment and oral antacid protectant is the same as the above. The key to treatment is to determine whether a blood transfusion is needed. If the visible mucosa is pale, the heart rate exceeds 100 beats per minute and the breathing rate is accelerated, blood transfusion is usually needed to start the compensatory function and heal the ulcer.
Healthy bovine blood of 4-6L should be transfused in general cases. There are 11 blood group systems in cattle, which usually do not cause transfusion reaction, and cross-matching tests can be omitted. The ideal blood donors should be cows with negative bovine leukemia virus (BLV) and bovine viral diarrhea virus (BVDV). Usually, a single blood transfusion is enough to stabilize the condition, while also gaining time for adjusting diet, medication and ulcer healing. Individual diseased animals may need two or more transfusions.