Diagnostic reliability of clinical signs in cows with traumatic reticuloperitonitis and abomasal ulcers
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RESEARCH ARTICLE
Open Access
Diagnostic reliability of clinical signs in cows with traumatic reticuloperitonitis and abomasal ulcers Ueli Braun* , Karl Nuss, Sonja Warislohner, Christina Reif, Carina Oschlies and Christian Gerspach
Abstract Background: Clinical signs of traumatic reticuloperitonitis and abomasal ulcer are often similar making the disorders difficult to differentiate. The goal of our study was to compare the frequency of individual clinical signs of cows with traumatic reticuloperitonitis and cows with abomasal ulcers and determine their diagnostic significance. The frequency of the findings “rectal temperature, heart rate, respiratory rate, demeanour, signs of colic, arched back, abdominal guarding, bruxism, scleral vessels, rumen motility, foreign body tests, percussion auscultation, swinging auscultation and faecal colour” of cows with traumatic reticuloperitonitis (TRP, n = 503) and cows with type 1 (U1, n = 94), type 2 (U2, n = 145), type 3 (U3, n = 60), type 4 (U4, n = 87) and type 5 (U5, n = 14) abomasal ulcer were compared, and the reliability indices “diagnostic sensitivity and specificity, positive and negative predictive values and positive likelihood ratio” were calculated. A total of 182 healthy cows served as controls (control group). Results: None of the cows in the control group had colic, rumen atony or melena, 99% had no abnormalities in demeanor and appetite and did not have a rectal temperature of ≤38.6 or > 40.0 °C, a heart rate > 100 bpm or a respiratory rate > 55 breaths per min, and 95% did not have an arched back or bruxism. The control group was therefore ideal for comparative purposes. Many signs such as mild increase in rectal temperature, scleral congestion and positive foreign body test were non-diagnostic because they occurred in healthy as well as in ill cows. Likewise, differentiation of cows with TRP and abomasal ulcer was not possible based on single clinical variables; a detailed history and a comprehensive assessment of all clinical findings were required for this. Conclusions: The findings of the present study serve as a guide for the veterinarian in the differentiation of cows with traumatic reticuloperitonitis and abomasal ulcer. Keywords: Cattle, Traumatic reticuloperitonitis, Abomasal ulcus, Sensitivity, Specificity, Predictive values, Likelihood ratio+
Background Traumatic reticuloperitonitis (TRP) and abomasal ulcer are important diseases, and together with displaced abomasum, belong to the most common gastrointestinal disorders of dairy cows. Traumatic reticuloperitonitis may be acute or chronic [1, 2] and abomasal ulcers are classified * Correspondence: [email protected] Department of Farm Animals, Vetsuisse-Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland
as types 1 (U1), 2 (U2), 3 (U3), 4 (U4) or 5 (U5) [3–8]. U1 is a non-perforated ulcer of the abomasal mucosa associated with minimal haemorrhage, whereas U2 involves the erosion of a large blood vessel and is therefore associated with massive intraluminal
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