The Down Cow

Question 1

Define a down cow

Answer 1

Down >24hrs or after unsuccessful Tx (Ca, Mg, P)

• 1* cause may have been resolved
• superficial/deep nerve damage can occour
• ischameic necrosis of muscle esp. Hindlimb (compression -> anoxia -> cell damage -> inflammation -> swelling -> poor perfusion -> repeat (pressure induced compartment syndrome)

Question 2

Which nerves can be damaged when cow is down?

Answer 2

• sciatic

- perineal (across tibia) causing hyperflexion of the fetlock (knuckling)

Question 3

Causes of neuro caused down cow

Answer 3

• trauma at calving (make her stand after calving: check acute issues, allow muscles to recover, allow her to feed - percent negative cycle)
• damage to uterus, vagina and vulva
• damaged sciatic/obturator nerve (may be delayed ID as confused with swelling)
• peripheral perineal/radial/tibial nerve damage could occour with trapped limb

Question 4

Electrolyte causes of down cow

Answer 4

• continue loss of Ca after Tx (feed or subcut)
• P deficient (happy downer or creeper cows)
• Mg deficient (seen in hypocalceamia cows)
• K (low levels in down cows but no one knows why or relevance)

Question 5

Clinical signs of down cows

Answer 5

• sternal recumbency
• normal eating and drinking if provided
• normal GIT
• some attempt to stand (good sign r/o fx)
• able to just lift hindquarters off the ground (creeper/crawler cows)
• abnormal position of hind limbs

Question 6

What must be checked as part of full clinical exam of down cow

Answer 6

• lift hind legs to expose udder
• roll both sides
• check broken legs
• check ruptured cruciates (esp if trying to get up on slippery floors)
  > tibial compression possible !
• dislocated joints esp hip (Bulls)
• NEURO function
• uterus, pelvis and peritoneum per rectum
• check udder ALL QUARTERS
• crepitus in joints (use stethoscope)
• rectal with legs held backwards to find pelvic fx
  > cows are stoic!

Question 7

What problems are not treatable in the cow?

Answer 7

Fractures
Dislocations
Joint/ligament damage

Question 8

How should the down cow be cared for?

Answer 8

• sit cow up (prevent compartment syndromes)
• legs underneath
• turn to each side q4-6hrs
• soft bedding
• hobble
• feed and water
• milk twice daily to prevent mastitis

Question 9

Prognosis of down cow

Answer 9

• if no progress for 48-72 hrs PTS
• casualty slaughter may/may not be an option
• if raising on all 4 legs but missing force slightly optimistic
• biochem : muscle enzyme s
  > AST, LDH, CPK difficult to interpret
  AST >180u/l

Question 10

Tx

Answer 10

• underlying metabolic ailment (ca, mg, p)
• toxic cases (Tx underlying cause, will recover)
• musculoskeletal path : PTS
• all others: try to support and reduce ischaemia (fill warm bath to assist standing)
• care
• NSAIDs
• steroids?
• vit b complex (CCN ETC)
• lift cow
  > Bagshaw hoist (tuber coxae, see if attempting to stand, leave to stand with hoist on)
• often causes traumatic injuries
  > sling
• more comfortable
• more expensive and labour intensive
  > water tank
• ideal
• lift in or slide on board
• don’t drown!
• beware mastitis if left for a while in water
  > inflatable bag
• don’t fall off

Question 11

Causes of a down cow

Answer 11

> typically post parturition

• hypocalceamia
• hypomagnesaemia
• hypophosphataemia
• per acute toxic mastitis, metritis, peritonitis
• physical injury (dislocated hip, splits, broken)
• obstetric paralysis (obturator)
• fat cow syndrome
• CNS (lead poisoning, CCN, bolutism)
• fasciolosis
• hypoglyceamia