The Prevention, Surgery and Post-Operative Care of

a Left Displaced Abomasum

By: Christine Rowehl and Jessica Bradford

3/17/2010
 2

Introduction
If you own and operate or work on a dairy farm, you have probably come across a
number of left displaced abomasums. This document is written with the understanding
that you have basic background knowledge in dairy anatomy, ruminant digestion, and
standard dairy operating practices. By reading this, you will be more informed about the
prevention, surgery, and post-operative care involved with a left displaced abomasum.

A left displaced abomasum (LDA) is a common occurrence in dairy cows. The

abomasum is the final of four stomach compartments in ruminant animals. It is the site
of gastric digestion and is similar to a human’s stomach. Generally, an abomasum is able
to twist and shift within the abdominal cavity when extra space is present. This extra
space could be caused by low gut fill or by recent freshening (calving). An LDA is
defined as the movement of the abomasum from the midline up to the left side of the
abdominal cavity as a result of loss of muscle tone and accumulation of excess gas (See
Figure 1.) An LDA will ultimately result in shutdown of the entire digestive system.

Figure 1 – The Movement of the Abomasum in an LDA

Diagnosis
Diagnosing an LDA requires a stethoscope and sensitive ears. The stethoscope is placed
on the cow’s left side in the region around the last two ribs. If flicking the skin in this
area produces a sound similar to a chain hitting a metal pole, then there is a buildup of
gas present, indicating an LDA. If a noise that sounds like rolling thunder is heard while
simply listening for 30 seconds to 1 minute, then the rumen (fermentation chamber, see
Figure 1) is moving well. Rumen activity is an excellent indicator of overall digestive
health.
 3

Production Implications
A high incidence of LDAs suggests that a herd is not reaching its maximum potential. If
a cow has had an LDA, her production will be severely limited during that lactation.
The stress on the cow from an LDA not
only decreases her milk production, but
also puts strain on her immune system
and general health. An unhappy cow
will not produce to her full potential,
either. Figure 2 shows an example of a
cow’s milk production before and after
an LDA that occurred around 48 days
in milk. The economic loss from
decreased production can be
devastating to a producer. Figure 2 – Production loss due to an LDA

Prevention
There are a variety of factors that play a role in whether or not a cow will develop a left
displaced abomasum. Nutritional factors such as fiber content of the ration, particle size
of feed, dry matter intake and feed availability all may affect a cow’s susceptibility to
problems. Metabolic disease status may also contribute because often one disease will
encourage the onset of another. Poor management and excessive stress around the time
of calving may also increase the risk of an LDA occurring.

Short-term Management Changes

A producer can make immediate changes to protocols to help lower the incidence of
LDAs in the herd. Due to the fact that recently freshened cows are much more
susceptible to developing LDAs, regular close observation can help identify at-risk cows
before this becomes an issue. Two important observations are noting the cow’s
interaction with her feed and whether or not she is sorting her feed. She should be very
interested in eating immediately after the feed is put down in the morning. Feed should
be available to the cow at least 20 hours of the day because a full rumen decreases LDA
risk. Additionally, a cow that sorts her feed may be at a greater risk due to poor rumen
fiber mat formation. Other observations include general appearance and cud chewing.

A cow should be attentive to her surroundings

QuickTime™ and a
TIFF (Uncompressed) decompressor
are needed to see this picture.
Figure 3 – Cud Chewing
with alert ears and eyes; if she is lying down in a
stall, she should be chewing her cud, similar to the
cow in Figure 3. Generally, sunken eyes and
droopy ears indicate that the cow is depressed or
not feeling well. Cows that display any of these
warning signs or are already diagnosed with
another metabolic disease need to be regularly
checked with a stethoscope for rumen motility.
 4

Long-term Management Changes

Long-term management changes include regular body condition scoring and forage
analysis. Regular body condition scoring (BCS) is a classification system that allows a
producer to monitor weight changes and obese cows. Over-conditioned cows have a
reduced dry matter intake peri-parturition, leading to decreased gut fill and increased risk
of developing an LDA. It is recommended that a cow have a BCS of 3.00-3.25 on a 5.00
scale at the time she calves to minimize these risks.

When analyzing forage, particle size and

neutral detergent fiber (NDF) measurements
should be considered. Incorrect particle size
contributes to sorting of feed, and small
particles deter the formation of the essential
fiber mat in the rumen (See Figure 4.) NDF is
a critical measurement to indicate that a cow is
receiving adequate fiber, which is a major
component in dry matter. Producers should
work with nutritionists to ensure correct
particle size and nutrient composition.
Figure 4 – Rumen Fiber Mat Formation

Statistically, if the LDA incidence is greater than five percent in the herd, then a producer
should consult with his/her nutritionist and veterinarian about minimizing risk through
management changes.

Surgery – Your Only Option

In the event that an LDA does occur, a veterinarian should be called in order to
surgically correct the displacement. Only a licensed veterinarian should perform the
surgery described in this section.

The area where the surgery will be performed should be well-lit and clean with plenty of
dry bedding.

After the cow has been restrained, an

anesthetic such as Xylazine is injected
into the tail vein. Once the cow is lying
down, she is rolled onto her back and
her legs are elevated and restrained
(See Figure 5.) The surgical area is
then shaved and scrubbed with soap
and an iodine solution. Finally, the site
is sprayed with alcohol.
Figure 5 – Rolling of a Cow
 5

The veterinarian will then make an incision a hand-width above the cow’s navel and a
hand-width to the right of the midline. Any veins that are nicked are tied off. Once the
abdominal cavity has been reached, the veterinarian locates the abomasum and uses a
needle to release excess gas. Next, the abomasum is pulled into the proper position on
the cow’s right side and is stitched to the abdominal wall. The stitches are permanent
and serve to prevent the LDA from occurring again. The incision is then closed and
cleaned thoroughly. The restraints are then removed from the cow’s legs. Finally, an
anesthetic reversal such as Tolazoline is administered intravenously along with a
dextrose solution.

Post-operative Care
Post-operative care procedures are typical of any large animal surgery. First and
foremost, the incision should be kept clean and dry. In hot summer months, fly spray
may be especially useful. Also to reduce exposure to pathogens, the cow should be kept
in a pen with clean dry bedding and should not be moved to radically new environments.
If the cow is unusually stressed due to other metabolic diseases or LDA-causing factors,
the producer should consider giving probiotics or prebiotics along with B vitamins and
dextrose. These will help stimulate rumen activity and promote a faster recovery.
Antibiotics may be given as a prophylactic treatment. Extra hay should be given in all
cases to keep the rumen full. Finally, if other drugs are given, withdrawal times for meat
and milk need to be considered.

Conclusion
Minimizing the incidence of LDAs on a farm means more profit for the farmer and
happier cows. This can be achieved through some simple management changes such as
observation, body condition scoring and forage analysis. Surgery is the best treatment for
this condition, and so post-operative care will be required. High quality care is the key to
successfully preventing complications. Always consult with a veterinarian for questions
regarding animal health.
 6

Works Cited

Title Page: http://www.ces.ncsu.edu/chatham/ag/SustAg/agquiz.html

Figure 1: From AnSci 310: Introduction to Dairy Management Notes – From Dry-Cow
Sense Lecture

Figure 2: From AnSci 310: Introduction to Dairy Management Notes – From Dry-Cow
Sense Lecture

Figure 3: http://www.123rf.com/photo_4056958.html

Figure 4: From AnSci 310: Introduction to Dairy Management Notes – From Feeding
High Quality Forage Lecture

Figure 5: From AnSci 310: Introduction to Dairy Management Notes – From Dry-Cow
Sense Lecture