Preoperative cow-side lactatemia measurement predicts negative outcome in Holstein dairy cattle with right abomasal disorders

Long-Term Survival in 241 Cases of Intussusception in Cattle and Factors Associated with Mortality

Intussusception is a frequent cause of mechanical ileus in cattle. Long-term survival has never been described and risk factors for mortality are scarcely documented. A retrospective cohort study on 241 cattle was conducted to determine survival of intussusception and identify risk factors for mortality. Clinical records were matched with the national cattle identification database. Information on possible predictors including clinical examination, ultrasonography, blood-gas analysis and surgery were collected. Survival analysis and decision tree analysis were used. Overall survival was 44.8% until discharge. Of all animals, 39.0% could complete their life cycle and were eligible for slaughter. Male animals and cattle < 226 days old experienced a significantly higher mortality risk (hazard ratio [HR] = 2.1; 95% confidence interval [CI] = 1.4-3.0 and HR = 2.4; 95% CI = 1.7-3.4, respectively). The final model consisted of heart rate (>95 beats per minute) and packed cell volume (<36.5%) with sensitivity and specificity of 60.4% and 49.4%, respectively. A second model consisted of sex (male) and time to referral (>4.5 days) with sensitivity and specificity of 88.0% and 65.6%, respectively. The long-term prognosis for intussusception in cattle appears to be fair. Factors identified in this study may aid in the decision-making process in cases with presumed intussusception to perform the surgery or opt for euthanasia.

Evaluation of Blood Lactate, Heart Rate, Blood Pressure, and Shock Index, and Their Association with Prognosis in Calves

Diseases in young calves received as emergencies are often associated with hypovolemic and/or septic shocks. The objectives of our study were to (1) assess the correlation between clinical hemodynamic parameters and blood L-lactates (LAC), systolic blood pressure (SBP), and the shock index (SI) recorded upon arrival; and (2) to evaluate how these parameters were related to short-term outcomes in calves under 4 months of age presented as emergencies. We conducted a single-observer prospective observational study on calves aged from 1 day to 4 months, presented to the Veterinary Clinic for Ruminants of Liège from December 2020 to May 2022. Forty-five calves were included in the study. The statistical analysis revealed a significant correlation between LAC and heart rate (r = 0.570; p < 0.05) and LAC and SI (r = 0.373; p < 0.05). A high LAC value at admission was significantly associated with a negative outcome (death) (p < 0.05). In calves suffering from obstructive digestive diseases, the SI was related to the outcome and the analysis indicated a cut-off value of 1.13 (Se = 0.77, Spe = 1). In conclusion, in our study, the initial blood L-lactate value was correlated with heart rate, the shock index, and the clinical shock score, and admission hyperlactatemia was associated with a poor prognosis in calves under 4 months of age. In this cohort, the shock index in calves suffering from digestive diseases was linked with mortality.

Preoperative and Surgical Predictors of the Treatment Outcome of Dairy Cows with Right Abomasal Displacement-A Retrospective Study of 234 Cases

The displacement of the abomasum to the right (RDA) is a common condition regularly encountered in dairy cows, which requires urgent surgical correction. The survival of the patient primarily depends on early diagnosis and timely treatment, but other factors contributing to the outcome have been discussed in the literature. The objective of this study was to identify preoperative clinical, hematological, as well as intraoperative parameters that are associated with the prognosis of cows with RDA or abomasal volvulus (AV). This retrospective study included patients admitted to a veterinary teaching hospital over a period of 6 years with a diagnosis of RDA or AV. A total of 234 cows were included, of which 193 were discharged after treatment and thus classified as survivors. In contrast, 41 cases died or were euthanized during or after surgery and were categorized as non-survivors. Non-survivors showed more severe dehydration, higher heart rate, lower sodium, as well as higher L-lactate and phosphorus concentration in their blood prior to surgery compared with the survivors. During surgery, the abomasum of non-survivors was markedly dilated and twisted more frequently than in survivors. The results presented here can facilitate the early identification of animals with poor prognosis requiring more intensive peri- and postoperative care.

Oak Acorn Poisoning in Cattle during Autumn 2022: A Case Series and Review of the Current Knowledge

Oak poisoning is a known intoxication in grazing animals, but is slightly described in the literature. This case report describes 7 cattle from 3 different farms admitted to the clinic for ruminants of the University of Liège for suspected acorn poisoning in the autumn of 2022. The clinical signs were, anorexia, apathy with polyuria with low density. Further investigations led to the diagnosis of renal failure (blood urea 162 ± 88 mg/dL; blood creatinine 12 ± 4 mg/L). Supportive treatment, based on infusions (NaCl 0.9%) and electrolyte rebalancing, was administered and renal values were assessed every 24-48 h. Of these animals, 5/7 were euthanized. At necropsy, digestive erosions and ulcerations, oedema and renal hemorrhages, between the pyloric/caliceal cavity and the medulla were observed. Histopathological examination revealed necrosis of the renal tubules. The renal values of the two remaining animals were reduced, their general condition improved, and they were discharged. Acorn poisoning is a serious disease with no specific antidote or characteristic symptoms. Animals are identified as sick too late, when renal failure is already established. Farmers should be made more aware in order to prevent exposure, especially in years when acorns are abundant. Furthermore, there is no antidote for this intoxication.

Interpretation and Analysis of Individual Diagnostic Tests and Performance

Diagnostic tests are performed daily by bovine practitioners at the individual and population level. At the individual level, they help not only for making a diagnosis, but can also serve to rule in or rule out a specific condition, monitor treatment response, establish a prognosis, or to determine infection status. Performing an individual diagnostic test is technical; however, its interpretation and contextualization requires medical and epidemiologic skills that veterinary practitioners are able to master. This article shows the added value of the context of test prescription and correct interpretation highlighting the central role of the veterinary practitioner.

Left and right displaced abomasum and abomasal volvulus: comparison of clinical, laboratory and ultrasonographic findings in 1982 dairy cows

BACKGROUND

Although left and right displacement of the abomasum and abomasal volvulus are well-known disorders of cattle, a comparative evaluation of the clinical, laboratory and ultrasonographic findings of these types of abomasal displacements has not been undertaken. Therefore, the objective of this study was to compare these conditions in a large population of cows. The medical records of 1982 dairy cows with left displaced abomasum (LDA, n = 1341), right displaced absomasum (RDA, n = 338) and abomasal volvulus (AV, n = 303) were searched for the results of clinical, laboratory and ultrasonographic evaluations.

RESULTS

The main clinical findings were an abnormal demeanour in 48.2% of the cows, reduced rumen motility in 89.7% and decreased intestinal motility in 61.1%. Ballottement and simultaneous auscultation and percussion and simultaneous auscultation were positive on the left side in 96.9% of the cows with LDA and on the right in 98.5% of the cows with RDA and in 99.3% of the cows with AV. Ultrasonography was useful for diagnosing LDA in 97.9% of the cows and RDA/AV in 90.2% of the cows. The laboratory findings characteristic of abomasal reflux syndrome varied in severity; 83% of the cows had hypokalaemia, 67% had increased rumen chloride concentration, 67% had an increased base excess and 50% had haemoconcentration. Based on the clinical signs, a definitive diagnosis was made in 75.0% of the cows with LDA and in 22.5% of the cows with RDA/AV. Ultrasonography was required for a definitive diagnosis in another 22.0% of the cows with LDA and in 53.0% of the cows with RDA/AV. Laparotomy or postmortem examination was required for reliable differentiation of RDA and AV.

CONCLUSIONS

LDA, RDA and AV differ with respect to the severity and the frequency of several abnormal clinical, laboratory and ultrasonographic findings as well as the methods required for a diagnosis.

Milk Yield, Hematological and Electrolyte Parameters in Primiparous Dairy Cows After Laparotomic Omentopexy and One-Step Laparoscopic Abomasopexy Treatments of Left Displaced Abomasum

This study aimed to evaluate the effects of two different treatment options for the correction of left displaced abomasum (LDA) on milk yield, hematological, electrolyte parameters, lactate and cortisol concentrations in primiparous cows. Twenty four Holstein cows were randomly assigned into three groups: cows treated with one-step laparoscopic abomasopexy (LPS, n=8), cows treated by left paralumbar omentopexy (LPT, n=8) and healthy cows (CON, n=8), matched by parity and days in milk. Blood samples were collected before (D0) and after (D0’) surgery, and 1 (D1), 3 (D3), 10 (D3) and 30 (D30) days following surgery. LPS and LPT cows at D0 as well as LPT cows at 30 d following surgery had lower milk yield than CON cows (P<0.05), while the service period was higher in LPT than in CON (P<0.05). WBC was lower at D0 as well as Hb and Ht at D0 and D0’ in CON group than those of LPS and LPT (P<0.05). Hyponatremia, hypochloremia and hypokalemia at D0 and D0’ were observed in LPS and LPT. In addition, LPT cows had lower Na and Cl at D1 and D3 and lower K at D1 than CON (P<0.05). Impaired hydration in LPS and LPT cows was accompanied by higher concentrations of lactate at D0, D0’, D1 and D3 (P<0.01) and cortisol at D0 and D0’ (P<0.01) compared with CON group, while LPT had higher cortisol at D0’ than LPS (P<0.05). These results indicated that LPS has the potential to improve the convalescence period of LDA in primiparous cows.

Admission lactate concentration has predictive value for death or severe complications within 30 days after admission in cattle with long-bone fractures

OBJECTIVE

To determine the prognostic value of lactate concentration measurements at admission in cattle with long-bone fractures.

ANIMALS

43 cattle with long-bone fractures between July 2016 and Dec 2018.

PROCEDURES

In this prospective cohort study, lactate concentration was measured in systemic venous blood and locally in capillary blood sampled from the fractured and contralateral limbs of cattle and assessed for outcome prediction. The cutoff value was determined by maximizing the Youden index from receiver-operating characteristic curves. Multivariable logistic regression was employed to verify whether higher lactate concentrations compared with the cutoff value were an independent risk factor for poor outcomes at 30 days or 3 years after admission.

RESULTS

Poor outcome was associated with higher capillary lactate concentration in the fractured limb (P < .001) and greater difference with systemic blood (P = .005). A cutoff value of lactate difference ≥ 2.4 mmol/L (sensitivity = 0.80; specificity = 0.965) between capillary lactate in the fractured limb and systemic blood was the best predictor of death ≤ 30 days after admission (P < .001). Multivariable analysis revealed that this cutoff value was an independent risk factor for 30-day and 3-year outcomes (P < .001).

CLINICAL RELEVANCE

Admission blood lactate concentration difference ≥ 2.4 mmol/L between the fractured limb and systemic blood was a robust and independent predictor of outcome for cattle of the present report. Lactate metabolism is locally impaired in fractured limbs of nonsurviving or at higher complication risk cattle, which may help identify patients at high risk for poor outcomes.

Retrospective study on the outcomes and risk factors of right paramedian abomasopexy for right abomasal disorders in 47 dairy cows

Very few epidemiologic studies have verified the utility of the right paramedian abomasopexy (RPA) technique in cows with right abomasal disorders. This study aimed to investigate the outcomes and risk factors for non-survival in the herd within 30 days of surgery in cows with right abomasal disorders who underwent the RPA technique. Forty-seven Holstein cows with right abomasal disorders (25 with right abomasal displacement [RDA] and 22 with right abomasal volvulus [RAV]) were included. Twenty-two cows with RDA (22/25, 88.0%) and 10 cows with RAV (10/22, 45.5%) survived at 30 days post-surgery. Multivariate logistic regression analysis indicated that hyponatremia, hypokalemia, and the presence of abomasal volvulus were the major risk factors associated with non-survival.

Acid-base disorders in sick goats and their association with mortality: A simplified strong ion difference approach

Objectives

To investigate the acid‐base status of sick goats using the simplified strong ion difference (sSID) approach, to establish the quantitative contribution of sSID variables to changes in blood pH and HCO₃⁻ and to determine whether clinical, acid‐base, and biochemical variables on admission are associated with the mortality of sick goats.

Animals

One hundred forty‐three sick goats.

Methods

Retrospective study. Calculated sSID variables included SID using 6 electrolytes unmeasured strong ions (USI) and the total nonvolatile buffer ion concentration in plasma (A_tot). The relationship between measured blood pH and HCO₃⁻, and the sSID variables was examined using forward stepwise linear regression. Cox proportional hazard models were constructed to assess associations between potential predictor variables and mortality of goats during hospitalization.

Results

Hypocapnia, hypokalemia, hyperchloremia, hyperlactatemia, and hyperproteinemia were common abnormalities identified in sick goats. Respiratory alkalosis, strong ion acidosis, and A_tot acidosis were acid‐base disorders frequently encountered in sick goats. In sick goats, the sSID variables explained 97% and 100% of the changes in blood pH and HCO₃⁻, respectively. The results indicated that changes in the respiratory rate (<16 respirations per minute), USI, and pH at admission were associated with increased hazard of hospital mortality in sick goats.

Conclusions and Clinical Importance

The sSID approach is a useful methodology to quantify acid‐base disorders in goats and to determine the mechanisms of their development. Clinicians should consider calculation of USI in sick goats as part of the battery of information required to establish prognosis.

Prognostic utility of pre- and postoperative plasma l-lactate measurements in hospitalized cows with acute abdominal emergencies

The aim of the present analyses was to compare the prognostic value of pre- and postoperative l-lactate measurements in hospitalized cows requiring surgical intervention for an acute abdominal emergency, such as gastrointestinal ileus or peritonitis. For this purpose, we analyzed data from retro- and prospective case series, consisting of 754 and 98 cows, respectively. Plasma l-lactate concentrations (L-LAC) were determined upon admission to the hospital (both study populations), immediately before initiation of surgical intervention (prospective study population), and 6, 12, 24, 48, and 72 h later (prospective study population). The outcome of cows was evaluated until hospital discharge (both study populations) and 3 mo after discharge by a phone call to the farmer (prospective study population). A negative outcome was defined as death or euthanasia during hospitalization, or if discharged animals had an unsatisfied owner or were culled for medical reasons that were directly related to the initial abdominal emergency. For the retrospective study population, the overall survival rate until hospital discharge was 66%. Cows with a negative outcome (median: 6.81 mmol/L) had significantly higher L-LAC than cows with a positive outcome (3.66 mmol/L) of therapy. At the individual diagnosis level, L-LAC was associated with mortality in cows with a diagnosis of abomasal volvulus, local peritonitis, hemorrhagic bowel syndrome, and jejunal volvulus. Considering the whole study population, the area under the receiver operating characteristic curve was 0.66. For the prospective study population, the proportion of cows with a positive outcome was 65% until hospital discharge and 61% after the 3-mo observation period. At all sampling times, before and during the first 12 h after surgical intervention, cows with a negative outcome had significantly higher L-LAC than cows with a positive outcome. The largest area under the receiver operating characteristic curve for L-LAC was observed at 6 h (0.89). A cut-point of 1.77 mmol/L was identified, which had a sensitivity and specificity for predicting a negative outcome until hospital discharge of 88.9 and 73.4%, respectively. The present analyses confirmed previous findings in calves and show that persistent hyper-l-lactatemia during the early postoperative period is a more reliable indicator for a negative outcome than hyper-l-lactatemia before initiation of surgical intervention.

Preliminary Experiment Using Sensors for Cow Health Monitoring after Surgical Treatment for the Left Displacement of the Abomasum

The aim of the current study was to determine the effectiveness of two surgical techniques regarding cow respiratory rates, heart rates, and rumination time using two sensors: an experimental device created by the Institute of Biomedical Engineering of Kaunas University of Technology (Lithuania) and the Hi-Tag rumination monitoring system (SCR) produced by SCR Engineers Ltd., Netanya, Israel. The cows were divided into two groups: the PA1 group, containing cows treated by percutaneous abomasopexy (n = 10), and the RSO2 group, containing cows treated by right side omentopexy (n = 8). For the control group (KH), according to the principle of analogs (number of lactations, breed, and days in milk), we selected clinically healthy cows (n = 9). After the surgical treatment for the abomasal displacement, the experimental device was applied for the recording of the heart and breathing rates, 12 h tracking of the rumination time was implemented using the SCR, and the body temperature was measured. After 12 h, the blood was taken for biochemical and morphological tests. With the help of experimental sensors, we found that the more efficient abomasal displacement surgical method was the right side omentopexy: During the first 12 h after right side omentopexy, we found a 5.19 beats/min lower (1.10 times lower) average value of the respiratory rate, a 1.13 times higher level of the heart rate, a 0.15 °C higher temperature, and a 3.29 times lower rumination time compared to the clinically healthy cows. During the first 12 h after percutaneous abomasopexy, we found a 5.19 beats/min higher (1.07 times) average value of heart rate, a 0.02 °C higher temperature, a 6.21 times lower rumination time, and a 0.12 beats/min lower (1.01 times lower) average value of respiratory rate compared to the clinically healthy cows.

Prognostic relevance of pre- and postoperative plasma l-lactate measurements in calves with acute abdominal emergencies

In both human and veterinary medicine, l-lactate is a well-established prognostic biomarker of disease severity and mortality and has also attracted increasing attention in bovine medicine due to the availability and validation of cheap and portable l-lactate analyzers. The aim of the present study was to evaluate the prognostic accuracy of plasma L-lactate measurements in calves with acute abdominal emergencies before and during the initial therapeutic period after surgical intervention. A prospective observational study was carried out involving 83 hospitalized calves up to an age of 7 mo, which required surgical intervention for reasons of an acute abdominal emergency such as gastrointestinal ileus or peritonitis. Plasma l-lactate (L-LAC) concentrations were determined immediately before initiation of surgery and 6, 12, 24, 48, and 72 h later. The outcome of calves was evaluated 3 mo after discharge by a phone call to the farmer, and a positive outcome was defined if the calf was still alive and the owner was satisfied with the animal's postsurgical progress. A total of 29% of calves were discharged from the hospital and the proportion of calves with a positive outcome after the 3-mo period was 24%. At all sampling times during the first 48 h after initiation of surgical intervention, calves with a negative outcome had significantly higher L-LAC than calves with a positive outcome. A binary logistic regression analysis indicated that the odds for a negative outcome during the 3-mo observation period increased by a factor of 1.23 [95% confidence interval (CI): 1.04-1.44] for every mmol/L increase of L-LAC before initiation of surgical intervention, but by a factor of 5.29 (95% CI: 1.69-16.6) and 5.92 (95% CI: 1.29-27.3) at 12 and 24 h, respectively. The largest area under the receiver operating characteristic curve for L-LAC was observed at 12 h (0.91; 95% CI: 0.83-0.99), and a cut-point of 2.75 mmol/L was identified that had a sensitivity and specificity for predicting a negative outcome of 68 and 100%, respectively. In conclusion, persistent hyper-l-lactatemia during the early postoperative period is a more reliable indicator for a negative outcome in calves with acute surgical abdominal emergencies than hyper-l-lactatemia before initiation of surgical intervention. Postoperative measurements of L-LAC are therefore a clinically useful tool to identify patients with an increased risk for a negative outcome at an early stage after surgical intervention was carried out.

Prognostic value of preoperative plasma l-lactate concentrations in calves with acute abdominal emergencies

Acute abdominal emergencies in calves due to abomasal disorders, gastrointestinal ileus, or peritonitis are characterized by a rapid disease progression and usually require immediate surgical intervention. Those conditions are associated with a guarded prognosis, and the aim of the present study was to assess the prognostic relevance of preoperatively measured plasma l-lactate concentrations (l-LAC) in a large study population of calves with a broad spectrum of acute abdominal emergencies. For the purpose of this study, the medical records of 587 calves admitted to a veterinary teaching hospital over a 10-yr period were analyzed retrospectively. Plasma l-LAC was measured as part of a routinely performed biochemistry panel before initiation of surgical intervention. Hyper-l-lactatemia (plasma l-LAC >2.2 mmol/L) was evident in 75% of calves, and the overall survival rate until hospital discharge was 31%. Calves with a negative outcome were younger (median: 3.4 vs. 6 wk) and had higher plasma l-LAC (median: 4.96 vs. 3.09 mmol/L) than calves with a positive outcome. At the individual diagnosis level, l-LAC was associated with mortality in calves with a diagnosis of mesenteric torsion, right-sided dilated abomasum, small intestinal volvulus, or paralytic ileus, but not in calves suffering from peritonitis, malformations, abomasal volvulus, bloat, or small intestinal intussusceptions. Considering the whole study population, the area under the receiver operating characteristic (ROC) curve for plasma l-LAC was 0.66 [95% confidence interval (CI): 0.61-0.70]. A classification tree analysis indicated that l-LAC >8.84 mmol/L and age categories of <3 wk and <1 wk were independent predictors of mortality. The area under the ROC curve of this model was 0.75 (95% CI: 0.71-0.79) and the resulting sensitivity and specificity for the prediction of nonsurvival at the optimal probability cut-point of 0.62 were 67.7 and 76.6%, respectively. In conclusion, hyper-l-lactatemia is common in calves suffering from acute abdominal emergencies. Markedly increased plasma l-LAC is associated with an increased mortality risk, but it is not possible to reliably predict the outcome of affected calves based on a single, preoperative measurement. However, a clinically important finding of this study was that the ability to predict a negative outcome is improved when the age of the calf is considered in addition to plasma l-LAC.

Evaluating Potential Biomarkers of Health and Performance in Veal Calves

Veal calves undergo many challenges in the early stages of their life. Such challenges, including mixing procedures and transportation of calves to the veal farm, may have a negative influence on growth rate, feed intake, metabolism, immunity and disease susceptibility of calves. As a consequence, many hematological, physiological, metabolic and immunological parameters of stressed calves might be altered on arrival at the veal farm. Some of these response variables might be useful as biomarkers of performance of calves at the veal farm as they might provide information about an ongoing disease process, or may predict future diseases. Biomarkers might be helpful to group and manage calves in different risk categories after arrival. By adopting treatment decisions and protocols on a risk-group or individual basis, it would be possible to improve animal health and reduce both disease incidence and antibiotic use. Moreover, the use of biomarkers might be an economically feasible approach as some of them do not need invasive techniques and others can be measured in blood already taken during routine checks. Previous literature mainly assessed the physiological responses of calves to transportation. However, information on the link between on-farm arrival data and future health and performance of veal calves is limited. This review, therefore, examined a wide range of papers and aimed to identify potential biomarkers of future health and performance.

Prognostic Value of Cardiac Troponin I and L-Lactate in Blood of Dairy Cows Affected by Downer Cow Syndrome

Background

The downer cow syndrome (DCS) is a challenging health issue in the dairy industry. No cow‐side test is available to provide an accurate prognosis for DCS cases in farm settings.

Hypothesis/Objectives

Local or systemic hypoperfusion and myocardial lesions lead to an increase in blood concentration of biomarkers cardiac troponin I (cTnI) and L‐lactate. The objective was to determine the prognostic values of these biomarkers assessed cow‐sides in addition to clinical examinations in prognostication of a negative outcome (NO: death or euthanasia within 7 days).

Animals

218 client‐owned dairy cows affected by DCS.

Methods

In a prospective study, animals were monitored for 60 days after inclusion of each cow. Blood cTnI and L‐lactate concentrations were measured on the day of inclusion. The prognostic accuracy of both biomarkers and physical examination variables was estimated to predict NO. A mixed multivariable logistic regression model was used for data analysis.

Results

Prevalence of NO in this study was 63% on day 7. Troponin concentrations greater than 0.7 ng/mL had sensitivity and specificity of 54.1% (95% CI: 45.3–62.7%) and 78.4% (95% CI: 67.3–87.1%), respectively, for predicting NO. Blood L‐lactate was not associated with the outcome. The multivariable model revealed that heart rate >100 bpm (OR; 95% CI: 3.7; 1.3–10.2) and cTnI > 0.7 ng/mL (OR; 95% CI: 5.5; 2.1–14.6) were associated with the risk of NO.

Conclusions and Clinical Importance

Hypertroponinemia and tachycardia were associated with reduced survival in DCS cases. The use of cow‐side blood cTnI concentrations and heart rate could help to rapidly identify cows in farm setting that have poor chances of recovery and would benefit from a more aggressive treatment or euthanasia.

Blood lactate concentration as diagnostic predictors of uterine necrosis and its outcome in dairy cows with uterine torsion

In order to determine blood lactate concentrations (bLac) and their validity as a diagnostic marker in bovine uterine torsion, blood samples were taken from 54 Holstein cows with uterine torsion before the correction of torsion. bLac in a group of cows with and without uterine necrosis were 15.0 and 3.0 mmol/l, respectively (P<0.01). Moreover, bLac in a group of dead or culled dams and in that of survived dams were 10.2 and 3.1 mmol/l, respectively (P<0.01). Furthermore, the proposed diagnostic cutoffs for bLac based on ROC analysis for detection of uterine necrosis and poor prognosis in dams were set at >5.0 and >6.5 mmol/l, respectively. These findings suggest that in dairy cows with uterine torsion, an increase in bLac is a diagnostic predictor of uterine necrosis as well as poor prognosis in dams.

Factors associated with survival in the herd for dairy cows following surgery to correct left displaced abomasum

Left displaced abomasum (LDA) is a common problem in dairy cows. There have been numerous studies focused on predicting prognosis for right displaced abomasal corrective surgery, but a paucity of studies exist focused on more common LDA surgeries. Our objective was to determine if survival to 60 d or 1 yr after surgery could be predicted from the physical exam findings, periparturient disease status, and a biochemical profile from a blood sample obtained at the time of LDA diagnosis. Blood β-hydroxybutyrate (BHBA) concentrations were measured immediately using a hand-held meter. Data obtained from CanWest DHI (Guelph, ON, Canada) for all of the study subjects (n=179 cases, by 24 veterinarians from 4 clinics), including cull date, cull reason, and test-day milk production. Cows were classified based on whether or not they were culled within 60 d or 1 yr of surgery. Based on logistic regression, cows that had dystocia [odds ratio (OR)=13, 95% confidence interval (CI)=7-26] or were not ketotic (blood BHBA<1.2 mmol/L; OR=3, 95% CI=1.03-9) at the time of corrective surgery were more likely to be culled within 60 d. Higher serum concentrations of BHBA (OR=0.95, 95% CI=0.92-0.98), nonesterified fatty acids (OR=0.81, 95% CI=0.75-0.88), and Mg (OR=0.49, 95% CI=0.35-0.68) all had a protective effect against culling within 1 yr of LDA surgery. Based on survival analysis, longevity in the herd for 365 d following corrective surgery was associated with higher BHBA and Mg at the time of LDA diagnosis before surgery, as well as milk production following surgery.

Assessment of L-lactatemia as a predictor of respiratory disease recognition and severity in feedlot steers

The bovine respiratory disease complex (BRD) is a major health issue in feedlot cattle and one of the primary reasons for antimicrobial use in the North American feedlot industry. The purpose of the present study was to assess blood L-lactate levels of feedlot steers at high risk of developing BRD during the early feeding period. Blood samples were obtained at initial processing and again after BRD confirmation (using bronchial lavage or thoracic ultrasound exam). The study involved 232 recently weaned steers received at a single research feedlot that were processed without metaphylactic antimicrobial treatment. Blood samples were obtained for determination of L-lactatemia and temperament scores (very quiet or stoic [score 1], average [score 2] and very excited [score 3]) were systematically assigned at initial processing. A subsample of calves that were later confirmed as cases of BRD were sampled at first pull (day 0), and at subsequent observation points on days 3, 6, 9 and 15 following initial BRD diagnosis for blood lactate determination as a potential indicator of subsequent death. The clinical BRD cumulative incidence in the cohort was 38% (87/232). Temperament was associated with the probability of becoming a BRD case during the early feeding period. Stoic or very excited calves showed 2.2 times higher odds (95%CI: 1.3, 3.8) of becoming BRD cases compared to calves with average temperament. The impact of L-lactatemia differed by temperament strata. In calves with a temperament score of 2 (average temperament) every 1-log unit increase of lactatemia at processing resulted in 1.9 times higher odds (95% CI: 1.2, 3.1) of becoming a BRD case; this relationship was not significant in calves with a score of either 1 or 3. Twenty-nine confirmed BRD cases were studied for the dynamic lactate assessment analysis. L-lactate at first pull was not significantly different between survivors (median 3.3mmol/L; range 0.8-7.8mmol/L) and non-survivors (median 2.7mmol/L; range: 1.6-5.4mmol/L) steers. However, the dynamic assessment of L-lactatemia was associated with the hazard of death using Cox proportional hazard survival analysis. A 1-log increase of lactatemia increased the hazard of dying prior to the next observation by a factor of 36.5 (95% CI: 3.5-381.6). For calves showing a normal temperament score (i.e. temperament score of 2), a misclassification cost term analysis was conducted to identify potential L-lactate test thresholds for identifying future BRD steers. When planned test usage was for informing decision of administering or not a metaphylactic treatment at processing, experts agreed that false-negative (not treating a calf that would have benefit from treatment) to false-positive (wrongfully treating a calf that would have remained healthy) health costs ratio ranged from 8:1 to 20:1. In this situation, a threshold of 5mmol/L would have best informed treatment decision. When using L-lactate for informing the type of antimicrobial used at processing, false-negative to false-positive health costs ratio ranging from 1:1 to 3:1 could be expected and, again, a L-lactate threshold of 5.0mmol/L would have minimized the costs associated with calves' misclassification and could be used to identify calves that would benefit from a more efficient metaphylactic treatment. This study provides an interesting perspective on the potential application of chute-side markers or diagnostic tests to stratify the risk of future pull for BRD in cattle during processing in order to adapt antimicrobial treatments accordingly.

Preoperative and postoperative L-lactatemia assessment for the prognosis of right abomasal disorders in dairy cattle

BACKGROUND

Preoperative L-lactatemia and heart rate have been suggested as prognostic indicators of outcome for cows with right dilatation of the abomasum or volvulus (RDA/AV). However, postoperative L-lactatemia has not been assessed as a potential prognostic tool.

OBJECTIVES

To determine the prognostic value of postoperative L-lactatemia (LAC2 ), duration of treatment (Dt), relative L-lactatemia difference (compared with preoperative L-lactatemia [LAC1 ]) ([LAC2 - LAC1 ]/LAC2 ) and change in L-lactate over time ([LAC2 - LAC1 ]/Dt) as compared to preoperative findings (LAC1 and heart rate [HR]) as prognostic factors in dairy cows with RDA/AV.

ANIMALS

A total of 41 dairy cows were included: 19 with AV and 22 with RDA; 11 cows had a negative outcome (NO) and 30 cows had a positive outcome (PO) based on telephone follow-up with owners 30 days after surgery.

METHODS

Prospective cohort study. Analysis was performed using logistic regression and comparison of area under the receiver operating characteristics curve (AUC) using nonparametric tests.

RESULTS

LAC1 > 1.4 mmol/L or LAC2 > 2.2 mmol/L had the same accuracy with sensitivity of 100% (95% CI, 75.1-100%) and specificity of 80% (95% CI, 61.4-92.3%) for predicting NO. The relative L-lactatemia difference ([LAC2 - LAC1 ]/LAC1 ) or lactate kinetics ([LAC2 - LAC1 ]/Dt) were not associated with prognosis. The AUC of the preoperative model (which included HR and lnLAC1 ) was 0.92 (95% CI, 0.83-1.0) and that of the postoperative model (including only lnLAC2 ) was 0.95 (95% CI, 0.88-1.0); these were not significantly different.

CONCLUSIONS AND CLINICAL IMPORTANCE

Postoperative L-lactatemia is helpful to predict outcome in cows with RDA/AV. The short-term change in blood L-lactate is not a useful prognostic indicator, at least during the period of time spent on the farm for surgery and treatment.