This two year prospective study was performed to determine the clinical signs and haemato-biochemical alterations in eleven buffaloes suffering from caecal dilatation, in hospital admitted population of 357 buffaloes which were confirmed to have gastrointestinal dysfunction. Ten clinically healthy buffaloes were considered as control. The diagnosis of caecal dilatation was made on the basis of physical examination, after ruling out other gastrointestinal disorders. Complete anorexia, colic, constipated faeces, reduced to nil rumen motility, mild to moderate dehydration, distension of right flank and ping sounds on simultaneous auscultation and percussion of right paralumbar fossa were the most pronounced clinical symptoms. Affected buffaloes had significantly higher neutrophil count and lower lymphocytic count than control group. Biochemical analysis showed significant increase of total bilirubin, AST, globulin, lactate and blood urea nitrogen levels and significant reduction in calcium, potassium and chloride. In conclusion, caecal dilatation produces alterations in the clinical, haematological and biochemical picture compared to control healthy buffaloes.
Caecal dilatation occurs most frequently during stall-feeding period, just before or after calving, but it may also be seen during summer (Esperson 1964). The etiology is vague, except in few cases where there has been malformation of the intestines. There is, however, hardly any doubt that the cause is dietetic in most cases (Esperson 1964). The clinical signs in cattle include anorexia, cessation of defecation, distended right flank, abdominal pain in early course, hypomotility or atony of rumen and tympanic sounds on percussion of right upper flank [Braun et al1989a, Fubini et al 1986 and Umakanthan 2003). Most of the previous studies on biochemical changes in caecal dilatation of cattle have been carried out on few parameters and there is no study regarding haemato-biochemical alterations of this condition in buffaloes. The present study was thus undertaken to investigate haemato-biochemical profile in buffaloes showing caecal dilatation.
Materials and Methods
Selection of Animals and Criteria for Diagnosis of Caecal Dilatation
The present study was conducted on eleven buffaloes, out of 357 clinical cases of gastrointestinal disorders, presented at Large Animal Clinics of Veterinary Teaching Hospital, Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana during the study period from May 2009 to April 2011. The diagnosis of caecal dilatation as made on the basis of long cylindrical dilated organ lying just cranial and a little to the right of pelvic brim on per rectal examination along with ping sounds on auscultation of right paralumbar fossa. Before predicting the diagnosis other causes of gastrointestinal dysfunction were ruled out by physical examination and other ancillary tests.
Signalment and Anamnesis
Detailed signalment viz age, sex, duration of illness, pregnancy and lactation status was recorded in all the animals. A detailed history of feed intake, water intake, rumination status, defecation, type of tympany, fever and pain were noted in every case.
Each animal was thoroughly evaluated for its general condition and hydration status. The physical parameters (rectal temperature, heart rate, respiration rate, colour of mucous membranes, muzzle status and rumen motility) were recorded at the time of presentation in resting animal. Quantity and consistency of faeces in rectum, rumen consistency and any other abnormality were recorded on rectal examination.
Blood samples (2ml) were collected aseptically from jugular vein in EDTA coated vials (Accuvete-PLUS, Quantum Biologicals Pvt. Ltd). Haemoglobin, packed cell volume, total leukocyte count and differential leukocyte count were estimated by standard methods Benjamin1985). Further a thorough examination of stained blood smears was done to determine blood cell changes such as left shift and toxic changes in neutrophils, if any.
Blood Biochemical Analysis
Blood samples were collected in acid free vials without any anticoagulant, serum was separated and transferred to a dry clean vial for storage at -20°C till further evaluation. For glucose estimation blood samples were collected in vials containing sodium fluoride. VITROS DT-II Chemistry system (Ortho-Clinical Diagnostics, Johnson and Johnson Company) was used for estimation of total bilirubin, aspartate aminotrasferase (AST), alkaline phosphatase (ALP), gamma glutamyltrasferase (GGT), glucose, lactate, total protein, albumin, blood urea nitrogen (BUN), creatinine, sodium, potassium, chloride, calcium, phosphorus and magnesium. Globulin was calculated by subtracting albumin from total protein concentration. Cholesterol and triglyceride were estimated by Microlab Autoanlyser (Merk) using Bayer’s diagnostic kits. Blood samples (2 ml) were collected in sodium citrate coated vials (Accuvete Disposables) for fibrinogen estimation. Plasma was separated and fibrinogen was estimated by heat precipitation method using hand held refractometer (Feldman et al 2000).
Rumen Liquor Analysis
Rumen liquor samples were collected using 16G, 4 inch long needle inserted perpendicularly into the left paralumbar fossa. Rumen liquor was filtered through a double layer muslin cloth, centrifuged, and supernatant was analysed for chloride concentration by Microlab autoanalyser (Merck) using Bayer’s diagnostic kit.
The means and standard errors were calculated for comparison between control group and animals with caecal dilatation and data were subjected to Students t-test. Significance was set at p ≤ 0.05 and p ≤ 0.01 levels.
History of Animals with Caecal Dilatation
All the eleven buffaloes were presented with a primary complaint of colic and/or constipation. The duration of illness ranged from 4 to 20 days (mean 9.4±2.99 days). Seven buffaloes were eight year old, two were 5 year old and one buffalo each was three and four year old. All animals were completely anorectic while water intake was reduced in nine and normal in two cases. The animals had been fed with green fodder and concentrate ration and none of them had a history of recent change in diet. Nine animals had no history of tympany while it was recurrent and persistent in one animal each. Seven animals were passing constipated faeces and faecal output was absent in four cases. Nine buffaloes were non-pregnant (eight in first to fourth lactation and one heifer) and two buffaloes were 6 and 7.5 month pregnant, respectively. There was history of mild colic in six animals and severe colic in three animals. Only two animals had history of fever (>39.4°C).
On clinical examination, six animals were alert and five were depressed but rumination was suspended in all cases. The muzzle was semi-dry in six cases, dry in two and wet in three animals. Eight animals were moderately (6–8%) dehydrated, one severely (>8%) and two animals had 4–6 percent dehydration. Mucous membranes were congested in nine and anaemic in two animals. All animals were having mild distension of right flank and in addition four animals had moderate left flank distension. Trocarization of right paralumbar fossa in all the animals revealed only gas indicating gas filled caecum. The mean rectal temperature (38.14±0.26°C), heart rate (69.6±5.42 per min) and respiration rate (26.4±3.66 per min) were within normal limits. Rumen motility was absent in nine animals and reduced in two animals (<3/2 min). Auscultation of heart and lungs revealed no abnormality while simultaneous auscultation and percussion (succession) of right paralumbar fossa revealed ping sounds in all the cases. In all cases abdominocentesis yielded no peritoneal fluid. On rectal exploration, rumen was doughy in six and mushy in five cases. The faeces in rectum were scanty (pasty or pelleted) in eight animals and rectum was devoid of faeces in three animals. A large cylindrical blind pouch (dilated caecum) lying just cranial and a little to the right of pelvic brim was palpable in all the cases.
Haematology and Biochemical Analysis
The mean values of Hb, PCV and TLC did not differ significantly from their respective control values (Table 1). The mean relative neutrophil count was significantly (p ≤ 0.01) higher than control value whereas the mean relative lymphocyte count was significantly (p ≤ 0.01) lower than control value. The absolute neutrophil count was significantly (p ≤ 0.05) higher and the absolute lymphocyte count was significantly (p ≤ 0.01) lower than respective control values. Neutrophil to lymphocyte ratio was significantly (p ≤ 0.01) higher than respective control value. The mean relative and absolute counts of eosinophils and monocytes did not differ significantly from their respective control values. Neutrophelia was relative in eight animals and absolute in one animal. Moderate to marked left shift was observed in four animals while as toxic changes in neutrophils were observed in two animals only.
Blood biochemical analysis (Table 2) revealed significantly (p ≤ 0.05) higher concentrations of total bilirubin, AST, globulin and BUN than respective control values. The lactate level was also significantly (p ≤ 0.01) higher than respective control value. The mean calcium, potassium and chloride levels were significantly (p ≤ 0.05) lower than the respective control levels. The other biochemical parameters did not differ significantly from their corresponding control values.
Rumen Liquor Analysis
The colour of rumen fluid was greenish and yellowish-brown colour in six and five animals, respectively. The consistency was watery and the odour was slightly pungent in all cases. The protozoal motility was poor (+) to nil in all cases. The ruminal pH was 8 in six, 7 in three and 6 in two animals. The mean chloride concentration of rumen fluid was 35.59±4.65 mEql/L.
|TABLE1: Haematological parameters (mean ± SE) of control group and buffaloes with caecal dilatation|
|Measurement||Control (n=10)||Caecal dilatation (n=11)|
|Total leucocyte count (/µL)||9121.00±658.32||8250.0±808.39|
|*Difference significant at p ≤ 0.05
**Difference significant at p ≤ 0.01
|TABLE 2: Biochemical parameters (mean ± SE) of control group buffaloes with caecal dilatation|
|Measurement||Control (n=10)||Caecal dilatation (n=11)|
|Total Bilirubin (mg/dL)||0.09±0.01||2.68±1.02*|
|Total protein (g/dL)||7.36±0.12||7.98±0.28|
|*Difference significant at p ≤ 0.05
**Difference significant at p ≤ 0.01
To the best of our knowledge, this is the first study to describe clinical signs and haemato-biochemical changes of caecal dilatation in buffaloes. The prevalence of caecal dilatation was 3.08 percent (11/357). The etiology has been reported to be dietetic in most of the cases of caecal dilatation in cattle (Esperson 1964). However, from the results of this study, it was not possible to establish the etiology. The diagnosis was made on the basis of ping sounds on succession of right paralumbar fossa, gas on trocarization of right paralumbar fossa indicating gas filled caecum and palpable large blind pouch (dilated caecum) on rectal examination. This rectal finding concurred with that of Fubini et al (1986) and Kumar et al (1991). In differential diagnosis, abomasal displacement, intestinal obstruction and other gastrointestinal disorders were ruled out by physical examination and ancillary diagnostics. The principal clinical findings were complete anorexia, colic, constipation, abdominal distension, congested mucous membranes, mild to moderate dehydration and reduced to nil rumen motility. These clinical findings were almost similar to those already reported in caecal dilation of cattle (Braun et al 2002, Fubini et al 1986 and Umakanthan 2003).
The haematological alterations were reversal of neutrophil to lymphocyte ratio along with some degree of left shift. Similar to present findings Braun et al (1989b) also reported normal range of TLC (4000-10000/μl) in majority of cases of caecal dilatation and torsion in cattle. The increased neutrophil count may be attributed to toxaemia as a result of chronic irritation of gastrointestinal wall due to accumulated ingesta. Decreased lymphocytes could be due to release of corticosteroid as a result of stress (Jain 1986).
The significantly higher levels of total bilirubin and AST could be due to starvation and constipation leading to cellular disturbances of liver parenchyma. The increased synthesis of alpha, beta or gamma globulin as a result of inflammation and tissue damage may be the cause for increased globulin concentration. Fibrinogen is said to be a sensitive indicator of inflammation in bovines (Prathaban and Gnanaprakashan 1990). The normal fibrinogen ratio in bovines is >15 (Jain 1986) and this ratio gives more realistic picture of increased fibrinogen in inflammatory conditions and rules out any alterations due to dehydration. So fibrinogen ratio (23.99±7.0) in present study indicated that there was no realistic increase in fibrinogen concentration. The abomasal reflux, indicated by increased rumen fluid chloride concentration, could be attributed to gastrointestinal stasis owing to inhibitory effect of toxemia on gastric centre in medulla. Abomasal reflux could be the cause for dehydration, hypochloremia, hypokalemia and azotemia (Avery et al 1986, Behl et al 1997, Braun et al 1990 and Kuiper and Breukink 1986). As the ruminant diet is rich in potassium, anorexia for a number of days would have also caused a fall in potassium concentration (Sielman et al 1997 and Tagra et al 2001). Hypocalcaemia may be due to less assimilation of feed materials (Sethuraman and Rathor 1979). The lactate level was higher than reference value in all the animals (0.6-2.2 mmol/L, Radostits et al 2010). The lactate level of blood is elevated when the rate of lactate production exceeds its use. Local or systemic hypoperfusion is the common cause for increased lactate concentration. According to Allen and Holm (2008) tissue hypoxia, responsible for increased lactate levels, may have several causes such as hypoperfusion (decreased cardiac output or hypovolemia), anaemia (decreased arterial blood oxygen content) or oedema decreased tissue ability to mobilise oxygen). Hyperlactatemia in the present study may be attributed to dehydration and decreased lactate uptake due to hepatic malfunction (Vary et al 1988).
Caecal dilatation in buffaloes was characterized by anorexia, scanty faces, right flank distension, abdominal pain, reduced to nil rumen motility, varying degrees of dehydration, audible ping sounds on succession of right paralumbar fossa and dilated caecum at pelvic brim on rectal examination. Differential leukocyte count was better indicative of inflammation than TLC. Significant biochemical alterations were deranged liver and kidney function tests, hypocalcaemia, hypokalaemia, hypochloremia, increased globulin and lactate level of blood and increased chloride concentration of rumen fluid.
The authors would like to thank Dr Sushil Prabhakar, Professor cum Head, Department of Teaching Veterinary Clinical Complex, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, India, for providing the research facilities.
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