Case Studies

Question 1

A dairy client phones you up and has one of his heifers out in the paddock looking quite bloated and uncomfortable

What do you advice?

Answer 1

On the phone:

• Assess urgency: recumbent (sternal/lateral)? Eating?Behaviour?
• Herd or individual (1 or multiple vet?)
• Advice to stab if urgent (LEFT side) – Where the rumen is
• If it has gone then great leave at 1cm
• If it hasn’t then the chances are this is frothy bloat and will need 3-5cm
• ETA – good for when they are panicking
• Leave out the non essential questions at this point – so we don’t need to know the cause of the bloat atm.

Question 2

A dairy client phones you up and has one of his heifers out in the paddock looking quite bloated and uncomfortable

What do you do when you arrive on farm?

Answer 2

• Pass a stomach tube and or place a trochar if stomach tube does not pass
• Brief clinical exam (dyspnea, open mouth breathing, salivation, head extended)
• Unlikely but may have something going on at the same time
• Review relevant history (specifically mention feed, pasture)
• Check other animals – can ask this, but get them to ACTIVELY check them

Question 3

A dairy client phones you up and has one of his heifers out in the paddock looking quite bloated and uncomfortable

What steps do you take next to manage this case and why?

Answer 3

Clinical exam, inc. oral cavity

Attempt to pass the stomach tube again; there should be more chance of dislodging obstruction now pressure of gas is relieved

Drench with paraffin/cooking oil/mineral oil provided blockage is situated past oropharynx (i.e. thoracic inlet); lubricant to facilitate clearing the obstruction

Place red devil/permanent trocar if obstruction does not pass (likely); prevents bloat recurring while steps above are used to allow obstruction to soften overnight

NSAID; analgesic effect

If not lactating: smooth muscle relaxant (metamizole); potential relaxation of smooth muscle in oesophagus