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Vagal indigestion
Synonym(s): bloat, vagus
Podcast: Vagal indigestion
Introduction
- Cause:
- Vagal indigestion is characterized by dysfunction of reticulorumen, which hinders the passage of ingesta from the reticulorumen, abomasum or both, resulting in the distension of the abdomen.
- Vagal indigestion is a syndrome which is seen in cattle and also less commonly sheep.
- Signs: generally non-specific and depend on the location of the obstruction/problem; decreased milk yield and appetite, abnormal feces including quantity, abdominal distension with potentially recurrent bloating.
- Diagnosis:
- Diagnosis is often based on clinical presentation and examination in the field; however this could potentially lead to an incorrect diagnosis.
- The best diagnostic method(s) to implement will depend on the potential primary cause and findings of the clinical examination and are discussed in much further detail below.
- The most reliable method of obtaining a definitive diagnosis is usually an exploratory laparotomy.
- Treatment: depends upon primary cause.
- Prognosis: usually poor.
Pathogenesis
Etiology
- A group of motor disturbances that hinder passage of ingesta from reticulorumen, abomasum or both.
- Anterior functional stenosis:
- Most common cause is Traumatic reticular peritonitis Traumatic reticular peritonitis.
- Other causes include abscesses, adhesions and peritonitis in the region of the reticulum, hepatic abscess Ruminal acidosis, diffuse peritonitis, ruminoreticular fold neoplasia, diaphragmatic hernia and rumenitis/Reticulitis Reticulitis.
- Esophageal lacerations Esophageal lacerations (resulting in vagal nerve damage).
- Severe bronchopneumonia Aspiration pneumonia.
- Posterior functional failure: abomasal displacement and volvulus Left displaced abomasum: surgical correction Right displaced abomasum: surgical correction.
Pathophysiology
- The classification of vagal indigestion syndrome was categorized into four different types; however this is system is no longer used and appears to not be clinically significant.
- The current classification method divides the types of vagal indigestion into anterior functional stenosis and posterior functional failure (see below).
- Anterior functional stenosis
- May occur with insufficient vagal excitatory stimuli, resulting in a decreased motor drive of the primary reticular cycle.
- This results in the paralysis of the omasum and reticuloomasal orifice.
- Substantial reticular adhesions prevent normal delivery of small particle ingesta and fluid to reticulorumen orifice resulting in decreased or absent flow into the omasum.
- This will result in the normal stratification of the rumen being disrupted.
- Pyloric outflow failure (posterior functional failure)
- Results in the accumulation of ingesta in the abomasum and omasum, which initially has no impact of the reticulorumen motility and maintains normal ingesta stratification.
- As the stenosis progresses, the abomasal content will overflow into the rumen, which can result in severe distension and decreases forestomach motility and increased fluid retention.
- There is a marked dehydration and hypochloremic metabolic alkalosis.
- It can also be seen at the end of gestation if there is a large fetus as compression leads to decreased ingesta flow from the abomasum.
Timecourse
- Usually over several days, unless it is posterior functional failure.
Epidemiology
- This is usually a sporadic individual animal problem.
- There are potential implications at a herd level for Displaced abomasums Displaced abomasums, in terms of transition cow management.
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.
- Miesner M D & Reppert E J (2017) Diagnosis and treatment of hardware disease. Vet Clin North Am Food Anim Pract PubMed.
- Sattler et al (2000) Etiology, forms, and prognosis of gastrointestinal dysfunction resembling vagal indigestion occurring after surgical correction of right abomasal displacement. Can Vet J 41, 777-785 PubMed.
- Yoshimura et al (2000) Antimicrobial susceptibility of Arcanbacterium pyogenes isolated from cattle and pigs. Zoonoses and Public Health. 47 (2), 139-43 PubMed.
Other sources of information
- Jones S & Smith B (2015) Chapter 32: Diseases of the Alimentary Tract. In: Large animal internal medicine. 5th edn. pp 638-842.
- Fubini S & Divers T (2008) Chapter 5: Noninfectious Diseases of the Gastrointestinal Tract. In: Rebhun’s Diseases of Dairy Cattle. 2nd edn. pp 130-199.