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Vagal indigestion

ISSN 2398-2993

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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

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
  1. May occur with insufficient vagal excitatory stimuli, resulting in a decreased motor drive of the primary reticular cycle.
  2. This results in the paralysis of the omasum and reticuloomasal orifice.
  3. Substantial reticular adhesions prevent normal delivery of small particle ingesta and fluid to reticulorumen orifice resulting in decreased or absent flow into the omasum.
  4. This will result in the normal stratification of the rumen being disrupted.
  • Pyloric outflow failure (posterior functional failure)
  1. 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.
  2. 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.
  3. There is a marked dehydration and hypochloremic metabolic alkalosis.
  4. 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.