True gastric torsion, also known as the right transposition of the true stomach, refers to the torsion of the true stomach around its longitudinal axis of 180-270 degrees, which is clockwise torsion of the true stomach (the right direction of the true stomach) between the liver and the right abdominal wall. With the increasing demand for milk, dairy farmers blindly pursue milk production, depending too much on concentrate feed to improve milk production of dairy cows, without paying attention to the improvement of feeding and management conditions, and raising scientifically. At the same time, due to the unreasonable feed mix, leading to a nutritional imbalance of dairy cows, which causes problems in the digestive system of dairy cows, resulting in huge economic losses. The following is a detailed understanding: the clinical symptoms of dairy cow true gastric volvulus comprehensive treatment measures.
Most of the cattle suffer from abdominal pain, loss of appetite, even complete abolition, stop rumination, significantly weaken the rumen function, resulting in ketosis and anterior gastric retardation. When the symptoms are serious, the diseased cattle will show mental malaise, physical exhaustion, refusal to walk, obvious depression of eyeballs, body temperature of 38-39.5 C, respiration of 20-50 times/min, heart rate of 60-120 times/min, pulse increase, a small amount of exercise will lead to tachycardia, arrhythmia, shortness of breath.
The crisp steel pipe sound can be heard by tapping and auscultation at the intersection of the horizontal line of the shoulder joint of the diseased cow and the right 8-13 ribs. The right abdomen of diseased cattle is dilated. Most of them are in the rear edge of the right rib because of gas accumulation and water accumulation. The true stomach will bulge in bundles. The tapping sound can be heard when the fist is impacted on the lower part of the right rib. The puncture and microscopic examination showed that there were no ciliates and the pH value ranged from 3.0 to 6.0.
Rectal examination at the posterior edge of the rib arch on the right side of the diseased cattle can often detect the posterior edge of the true stomach, which is dislocated from the anterior and inferior part of the left kidney. Like the hemisphere, pressing has elasticity. It feels that the true stomach contains a lot of liquid and gas, and has a clear boundary with the rumen so that the two can be separated and the rumen backpack is bulged. There were no abnormalities in other intestinal segments.
The disease is mainly differentiated from the left displacement of the true stomach. If the right side of the true stomach moves or twists, cows often show acute symptoms, such as obvious abdominal pain, frequent kicking of the abdomen, back depression, and the odor of excreta, etc., and the right side of the abdomen can be heard between the walls of the auscultation jingle or water sound. If the true stomach moves to the left of the cow, the sound of tapping on the 11-12 ribs of the cow's abdomen will be like tapping on a metal pipe, and the true stomach sound will also be heard through auscultation. If the intercostal tapping in the abdomen of a cow produces a sound like tapping metal, but the true stomach sound cannot be heard during auscultation, it needs to be carefully distinguished. This phenomenon may be due to the obvious sagging of the rumen caused by the prolonged cessation of feeding in the cow, resulting in excessive emptiness of the abdominal cavity.
Western medicine treatment. Mainly restore the stomach power of diseased cattle and alleviate metabolic alkalosis. Diseased dairy cows should be fasting and only provide a small amount of drinking water to prevent the aggravation of the disease. The diseased cattle can be intravenously injected with a mixed solution consisting of 1 bottle of 500 ml 10% glucose solution, 2 bottles of 500 ml 5% glucose solution, 2 bottles of 500 mL compound saline, 2 bottles of 500 mL sugar saline, 6 bottles of 200,000 IU gentamicin, 3 10 mL vitamin C and 2 pieces of 10 mL compound vitamin B, twice a day for one course of treatment for 1 to 2 days. Intravenous injection of 400 ml 10% glucose injection, 20-30 mL vitamin C, or 300 mL 5% glucose sodium chloride injection, 10-20 mL gastric motility (compound vitamin B), or 300 mL 5% glucose sodium chloride injection, 100-200 mL calcium gluconate, or 500 mL 5% glucose sodium chloride injection, 3-4 g ampicillin sodium can also be given. At the same time, with a subcutaneous injection of 10-20 mL Seikeling injection.
Physical therapy. After using medicine, there is still too much gas in the true stomach of diseased cattle, and the appearance is expanded. It is necessary to use a vertical puncture needle to deflate at the most obvious place where the exterior is bulging and steel pipe sound occurs. In the right abdomen, it is necessary to vibrate the true stomach with hand, that is, to massage the true stomach with a fist in hand, and to promote the whole body from small to large. The abdomen will vibrate without damaging the body so that it can be repositioned as soon as possible.
Surgical treatment. The sick cattle should fast for 3 hours before the operation, and then stand in a six-column fence. Choose the right gown fossa as the surgical site. After shearing and sterilizing, draw a line about 20 cm in length with a knife handle at the surgical site, and then perform local multi-layer infiltration anesthesia at multiple points on both sides of the site. The surgeon cuts the skin with a knife and immediately clamps the blood vessels with hemostatic forceps, then bluntly separates the external oblique muscle, the internal oblique muscle, the rectus abdominis, and the transverse abdominal muscle once; then opens the peritoneum, exposes the abdominal cavity, extends the left hand, pulls out a small amount of omentum, finds the true stomach along the right abdominal wall, and then along the true stomach. Find the place where the torsion occurs and determine the direction of the torsion. The true stomach is restored by holding it in the opposite direction of the torsion until it becomes a smooth curve. If the true stomach expands considerably, the needle No. 20 (with duct) can be used to puncture the stomach before the operation, and the gas or liquid in the true stomach can be discharged, then the operation can be carried out. After the position of the true stomach returns to normal, attention should be paid to avoiding the vessels passing through the fixed silk thread at the base of the greater omentum, then fixing it on the abdominal wall muscles to control the appropriate tightness, then intraperitoneally injecting appropriate amount of intraperitoneal injection, and sequentially suturing the peritoneum, rectus abdominis, oblique abdominis and oblique abdominis, finally the skin. For nodule suture, it is better to spray 2 1.6 million IU dry penicillin powder on each layer after sewing, and repair the wound, apply appropriate Iodophor for disinfection, cover the bandage to avoid infection. Afterward, sick cattle need to be fed with 1500-2000 mL vegetable oil.
Diagnosis and treatment of true gastric volvulus in dairy cows
（1）The milk yield of the cow with hair disease was significantly higher than that of other cows in the same period, belonging to high-yield cows, but not new-born cows.
（2）According to the survey, the daily feed concentrate content of pasture is slightly higher. The normal proportion of concentrate in the diet of high-yield dairy cows should be between 25% and 50%. Otherwise, the excessive concentrate can easily lead to gastric dysfunction.
（3）The disease occurs at the end of April and coincides with the high incidence month of true gastric volvulus. True gastric volvulus occurs mainly in cold weather from November to May of the second year, because cold stress can cause an acid-base imbalance in gastrointestinal motility retardation.
2. Clinical symptoms
The cow's symptoms were mild, its body temperature was lower than normal, and its heart rate was irregular, so it was not acute type. Observing the feces, it was tar-like, indicating that its feces were abnormal and the urinary system was disordered. If it is an acute type, severe abdominal pain will be found in dairy cows, and systemic symptoms will be aggravated. The characteristics of circulatory system failure and shock crisis often appear quickly. The right ventral mid-abdomen was significantly expanded. There was a large range of bang sound area from the back of the right rib arch to the middle of the abdomen. The shock water sound was detected again by impact palpation. Through the determination of urine PH, it shows that there is metabolic alkalosis. If not treated in time, it will reduce the number of breaths and cool the superficial endings. Then it may be accompanied by severe internal bleeding, pale nipple skin and pudendal mucosa. If the condition continues to deteriorate, it will be large, small omentum will tear, pylorus. The stomach wall is highly dilated, showing hemorrhagic infiltration, dark red, some of the contents of the stomach are bloody, the ascites are mostly yellow and cellulose. First-born cattle are more prone to this disease after delivery, because the body cavity and body function of the first-born cattle develop rapidly in the late pregnancy, so it will not adapt to the growth rate of the fetus, and it is easy to squeeze, so that the change of the true stomach position and dysfunction aggravate the true stomach retardation; but the cow is not the first-born cow, the cause of the disease may be. It is related to improper feeding and management.
True gastric volvulus is a progressive disease, which can be treated by surgery combined with drug therapy, and surgery is the only effective way to treat the disease. Because of the warming weather, at first, medication was used, mainly conservative treatment, observation of its therapeutic effect. At first, medication was found to have a better effect. Surface symptoms were alleviated and the disease was alleviated. However, in the following days, it was found that the disease had relapsed and developed towards serious development and wasting. Therefore, conservative drug therapy has been unable to control the disease, surgery is the only effective treatment at this stage. It should be noted here that there are two important complications of true gastric volvulus: direct injury of the vagal branch and thrombosis along the torsion site of the gastric lesser curvature, which may lead to the failure of surgery and medication.
After the operation, the cow's condition was getting better and better, and it gradually resumed feeding, and its posture was gradually normal.
According to the diagnosis of clinical symptoms, we should pay attention to the difference between true gastric volvulus and true gastric displacement.
1. True gastric volvulus is characterized by acute onset, a marked increase of abdominal circumference, loss of appetite, a decrease of milk production, obvious abdominal pain and severe dehydration. It is easy to feel the enlarged true stomach during the rectal examination. The percussion on the right abdominal wall combined with a wide range of steel pipe sounds has a high sound quality. The symptoms of the sick cow appear. The incidence of true gastric displacement is relatively slow, the symptoms of abdominal pain are mild, the abdominal circumference changes are not obvious, there are a certain appetite and milk.
2. When listening to the right ventral percussion combined with true gastric volvulus, the sound range of steel tube is small and the sound quality is low. Sometimes it is not easy to get it. It needs repeated auscultation, otherwise, it is easy to miss and misdiagnose. The cow was diagnosed with true gastric volvulus only after repeated auscultations.
3. Valve gastric puncture can also be used to differentiate true gastric volvulus from true gastric displacement. When true gastric volvulus occurs, light yellow or brown liquid can be observed. PH is about 4.0, that is, the liquid is true gastric juice. In cases of true gastric displacement, it is not easy to puncture the true gastric juice.
Experience in treatment
Surgical treatment is the most effective treatment for this disease, but it must be based on clinical practice with the use of drugs. According to clinical practice, conservative treatment was first adopted to control the condition and relieve the symptoms, followed by surgical treatment. The effect was remarkable.
True gastric volvulus can be secondary to true gastric displacement, but not all true gastric displacement can be secondary to true gastric volvulus. True gastric volvulus has nothing to do with age and sex of cattle. Like true gastric metastasis, true gastric volvulus occurs when the body position changes or abdominal pressure increases sharply due to labor, lying up, jumping, etc. on the basis of true gastric relaxation or expansion, resulting in rupture of the omentum that fixes the true gastric position, and the true gastric volvulus occurs in different degrees along the counterclockwise direction. Turn, cause acute obstruction of the true stomach, aggravate effusion, pneumatosis, and expansion, severe gastric wall bleeding, necrosis and rupture, and finally death due to circulatory failure.