Ibrahim et al., J Vet Sci Med Diagn 2016, 5:3 http://dx.doi.org/10.4172/2325-9590.1000198
Research Article
Journal of Veterinary Science & Medical Diagnosis A SCITECHNOL JOURNAL
Traumatic Pericarditis in Cattle: Risk Factors, Clinical Features and
Ultrasonographic Findings 1 2 Ibrahim HMM ∗ and Gomaa NA
1 Department of Internal Medicine, Infectious and Fish Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt 2 Department of Animal Medicine, Faculty of Veterinary Medicine, Kafr El-sheikh University, Kafr El-sheikh, Egypt ∗Corresponding author: Hussam Mohamed Mohamed Ibrahim, Department of Internal Medicine, Infectious and Fish Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt, Tel: 002-050-2214233; E-mail:
[email protected] Rec date: Feb 29, 2016 Acc date: Apr 05, 2016 Pub date: Apr 10, 2016
Abstract Pericarditis is an inflammation of the pericardium with accumulation of serous or fibrinous inflammatory products. In cattle, it is always a common sequel to traumatic perforation of the reticular wall, diaphragm and pericardial sac by metallic and non-metallic sharp foreign body. A case series study was conducted between April, 2014 and December, 2015 in cattle herds in Mansoura, Egypt to determine the risk factors, clinical features and ultrasonographic findings of traumatic pericarditis. Forty cows expressing clinical signs of cardiac problems were selected and thorough clinically examined. Statistical analysis using multivariable logistic regression showed that magnet administration, positive pain test, history of abrupt and sudden milk drop and hearing grunt were significantly associated with traumatic pericarditis in cattle. Ultrasonography is the method of priority for diagnosis and characterization of pericardial effusion. Echogenic deposits and strands of fibrin are seen on the epicardium, and the ventricles are compressed by the effusion. Consequently, the prognosis is poor, and pericardiocentesis is inadequate method of treatment. Thus, prompt and humane euthanasia is indicated for cattle with traumatic pericarditis. The results of the present study point to cows with traumatic pericarditis, the definitive diagnosis of such clinical problem is not always possible based on clinical signs alone. Therefore, ultrasonography of the thorax is usually indicated, especially in doubtful cases. Furthermore, magnet administration is best prophylactic procedure to prevent such problem in cattle.
Keywords: Traumatic pericarditis; Risk factors; Clinical signs; Ultrasonography; Cattle
Introduction Cardiac diseases in cattle remain medically challenging for the clinician both to detect and to treat. Heart failure, a terminal event with various cardiac diseases, occurs when the initial cardiac and neuro-hormonal compensatory mechanisms are overwhelmed [1]. Thus, the prognosis is traditionally said to be guarded to poor in such clinical cases [2].
Pericarditis, an inflammation of the pericardium with accumulation of serous or fibrinous inflammatory products, is usually associated with progressive disturbances in the heart function and almost always results in sudden death [3]. It is usually caused by sharp foreign bodies (wire, needles, and nails) which penetrate the reticulum, diaphragm and pericardial sac with a resultant traumatic pericarditis. However, pericarditis attributable to hematogenous spread of infectious diseases, including colibacillosis, pasteurellosis, salmonellosis and anaerobic infection is much less common [3,4]. Cattle commonly ingest foreign objects, because they do not discriminate metal materials in their feed and do not completely masticate the feed before swallowing. Swallowed metallic objects fall directly into the reticulum or pass into the rumen and are subsequently carried over the rumino-reticular fold into the cranioventral part of the reticulum. Contractions of the reticulum and the pressure of the fetus during late pregnancy or the efforts of parturition promote penetration of the wall by the foreign object resulting in local or diffuse peritonitis. The swallowed object can also penetrate into pericardial sac, causing pericarditis, myocarditis, endocarditis and septicemia [2,5-7]. The disease is common when green chop, silage, and hay are made from fields that contain old rusting fences or baling wire, or when pastures are on areas or sites where buildings have recently been constructed, burned, or torn down. The grain ration may also be a source because of accidental presence of sharp objects [5,6]. The primary clinical sign in affected cattle is tachycardia depending primarily on the degree of compression of the heart by pericardial effusion [4,8]. The heart sounds are muffled because of pericardial effusion and fibrinous changes in the pericardial sac and asynchronous abnormal heart sounds are characteristically present [3,4]. With predominantly fibrinous changes, the sounds are of a rubbing, squeaking or scratching nature. With a predominance of fluid, there are splashing or gurgling sounds, which vary continuously in pitch, loudness, duration and point of maximal intensity. There is edema of the submandibular region, brisket and ventral abdomen and a varying degree of distension of the jugular veins depending on the degree of cardiac tamponade [8,9]. Sometimes cattle stand with their elbows abducted in an attempt to facilitate the cardiac function, indicating a condition of a chest pain [3]. The general demeanour, condition and appetite of cattle with traumatic pericarditis are always abnormal. Cattle often have signs of pain, such as bruxism and grunting, and the majorities have a fever of up to 40.2oC. Absence of fever does not rule out traumatic pericarditis because in rare cases the rectal temperature is normal or below normal. The respiratory rate is often elevated because of cardiac insufficiency or direct involvement of the lungs and ruminal motility is usually reduced or absent. Because pericarditis commonly results from traumatic reticuloperitonitis, tests for reticular foreign bodies are positive in the affected cows [9]. Furthermore, ultrasonography is the method of choice for diagnosis and characterization of pericardial effusion Based on this, this present study was designed to review the risk factors, clinical features and ultrasonographic findings of traumatic pericarditis in cattle.
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Citation: Ibrahim HMM, Gomaa NA (2016) Traumatic Pericarditis in Cattle: Risk Factors, Clinical Features and Ultrasonographic Findings. J Vet Sci Med Diagn 5:3.
doi:http://dx.doi.org/10.4172/2325-9590.1000198
Materials and Methods
Ultrasonographic examination
Study overview and animals Forty cows at 7–15 years of age with cardiac problems were examined in Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Mansoura University in the period between April, 2014 and December, 2015 at Dakahlia Governorate. A questionnaire was used to collect general information about each cow under investigation such as breed and herd size as well as management practices and clinical signs. Most questions were directed to evaluate the management practices that were thought to be associated with increased risk of traumatic pericarditis and to be important in clinical diagnosis of such cases. Completion of the questionnaires was performed by authors of this study during examination. Questions about general herd information were answered directly by herd owners or other persons of farm staff.
Clinical examination A detailed clinical examination of the cows was conducted, and the clinical findings were recorded [6]. Body temperature, heart and respiratory rate, rumen contractions rate and quality for each clinical case were examined and documented. A strong pressure on the xiphoid region using a fist, the withers firm pinching and pole / bar test were done to identify anterior abdomen pain as previously described in other references [10,11]. The lead signs of traumatic pericarditis are tachycardia, muffled heart sounds, asynchronous abnormal heart sounds, distension of the jugular veins and submandibular, brisket and ventral abdominal edema (Table 1).
Risk factors In this study, the collected data were concentrated on the impact of many important risk factors pioneering in the occurrence of traumatic pericarditis. These factors included the age, sex, season of the year, pregnancy, diet, cattle had a magnet, elicitation of a grunt following pole / bar test, sudden milk drop over a 24-hours period and hearing grunt or groan (Table 2).
Transcutaneous ultrasonographic examination was performed with a 5 MHz convex transducer. The position of the heart in each cow was identified before the beginning of ultrasonographic examination. The chest was clipped at the third to sixth intercostal spaces just caudal to the triceps muscle mass and from 3 to 5 cm below the olecranon to 5 to 10 cm above it. This area was cleaned with alcohol and then coupling gel was applied to enhance the contact with the probe. Animals were secured in standing position in a crate and their various thoracic-abdominal organs were examined with a 5 MHz convex ultrasonic transducer [4,12]. Ultrasonographic examination of the heart were carried out by the same person to avoid any individual variations and revised again by two persons to overcome the lack of randomization and blindness during examination.
Statistical analysis Analysis of data was performed using statistical software program (SPSS for Windows, version 16.0, SPSS Inc., Chicago, IL). Risk factors are scored. To evaluate the association between suggested risk factors and clinical signs, univariable and multivariable logistic regression analyses were used. For all statistical analysis, results were considered significant at p
