Simple Indigestion: Causes and Clinical Signs

• Practical cases in digestive health covers simple indigestion, Pica indigestion in sheep, bloat involving free gas and frothy bloat (including feedlot bloat and legume bloat), as well as clinical examination of the digestive system.

Simple Indigestion

• It is characterized by atony of the rumen muscle due to dietary abnormalities.
• It is common in hand-fed animals like cattle and buffaloes, and uncommon in grazing animals.
• Clinical signs include inappetence, cessation of rumination, mild drop in milk yield, decreased rumen motility upon auscultation, mild abdominal distension, and depression.

Etiology/Causes of Simple Indigestion

• Moderate excess of carbohydrate (CHO) in the ration.
• Moderate excess of protein ration and non-protein nitrogen (NPN) such as urea and ammonia-treated roughage.
• Feeding of indigestible roughage like straw bedding.
• Feeding of indigestible materials as seen in pica.
• Lack of adequate water supply.
• Massive oral dosing with antibiotics and sulfonamides.
• Sudden change in the source and constituents of the ration.

Pathogenesis/Pathophysiology of Simple Indigestion

• Moderate increase of CHO results in increased VFA and lactic acid production, which lowers the rumen pH, inhibiting rumen motility.
• Moderate increase of protein and NPN increases ammonia production, raising the rumen pH and inhibiting rumen motility.
• Feeding on indigestible roughages or materials physically inhibits rumen motility.
• Lack of drinking water or destruction of rumen microorganisms leads to disturbances in digestion and absorption, increasing acids or alkaline end products, resulting in atony of the rumen.
• Atony of the rumen leads to decreased production of VFAs.
• Decrease in propionic acids leads to hypoglycemia, manifested by depression and decreased milk lactose and milk yield.
• Decrease in butyric acid leads to decreased milk fat (low milk fat syndrome).
• Atony of the rumen directly inhibits appetite and rumination.
• Atony of the reticulorumen leads to putrefaction of protein with the production of amides, amines and histamine, which results in toxemia and depression.
• Toxemia also leads to atony of the GIT, with constipation initially, followed by diarrhea as acids or alkaline substances move to the intestine.

Clinical Signs

• Inappetence to anorexia, cessation of rumination, and decreased rumen motility upon auscultation.
• Mild drop in milk yield and milk fat (low milk fat syndrome).
• Mild rumen and abdominal distension.
• Mild depression.
• Mild constipation in the early stages followed by diarrhea, indicating the beginning of recovery.
• Absence of pain and systemic reaction.
• Palpation of rumen may reveal doughy content.
• Spontaneous recovery occurs within 24-48 hours or with mild treatment.

Laboratory Diagnosis for Simple Indigestion

• Rumen fluid examination is conducted
• Ruminal pH value: normal range is 6.5 – 7. A decrease below 6.5 or increase above 7 may indicate simple indigestion.
• Sediment activity test (SAT): there will be a delay of sediment activity time, with a normal range of 3-9 minutes.
• Cellulose digestion test (CDT): there will be a delay of cellulose digestion time, with a normal range of 34-30 hours.
• Urine examination is done for detection of ketene bodies
• Simple indigestion yields a negative result.
• Digestive form of bovine ketosis yields a positive result.

Treatment for Simple Indigestion

• Spontaneous recovery can occur by decreasing the concentrate and increasing the hay and roughage within 24-48 hours.
• Parasympathomimetics stimulate the vagus nerve, increasing rumen motility. An example is neostigmine at 2.5 mg/45kg body weight via S|C injection.
• Alkalinizing agents are used in cases of acidic rumen pH. Magnesium oxide can be administered at 1 gm/kg body weight orally.
• Acidifying agents are used in cases of alkaline pH. Acetic acid 5 percent v/v (vinegar) can be administered at 5-10 liters orally.
• Antihistaminics such as Tripelennamine HCL or Chlorpheniramine can be given at 1 mg/kg bw via I|M or |V injections.
• Reconstitution of rumen microflora is also done
• Ruminal fluid transfer (ruminatoric) involves oral administration of fresh rumen fluid collected from a normal animal using a stomach tube and suction pump or from a slaughterhouse.
• 5-10 liters are given for cattle orally.

Control of Simple Indigestion

• Avoid causative dietary abnormalities

Pica Indigestion in Sheep

• It is a disease of sheep and goats grazing in semi-arid regions, caused by the ingestion of indigestible plastic materials like bags and ropes.
• It is characterized by signs of ruminal atony and loss of condition.

Etiology of Pica Indigestion

• Grazing on poor arid or semi-arid regions, or on garbage with ingestion of polythene and cellophane bags and ropes.
• Pica or abnormal appetite or allotriophagia is caused by a deficiency of minerals and electrolytes such as P, Co, Zinc, Mn, NaCl and protein, leading to the eating of abnormal materials other than food like hair, paper, and indigestible materials.

Clinical Signs and Examination Findings in Pica Indigestion

• Inappetence, decreased rumination, emaciation, dehydration and decreased production.
• Feces is reduced and scanty.
• Left abdominal distension.
• Decreased rumen movement upon auscultation.
• Palpation of rumen reveals firm or hard masses.
• Terminal stages show salivation, nervous manifestation, and recumbency.

Laboratory Findings in Pica Indigestion

• Hypoglycemia
• Hypocalcemia
• Hypochloremia
• Hypoproteinemia
• Hypoalbuminemia
• Metabolic alkalosis

Treatment and Prevention for Pica Indigestion

• Rumenotomy and evacuation of the rumen are done.
• Fluid therapy is supplemented with glucose, calcium, and NaCl.
• Avoid exposure to causes.
• Treatment and prevention of allotriophagia are also carried out.

Ruminal Tympany (Ruminal Bloat)

• It is defined as an abnormal distension of the reticulorumen by gases either in the form of persistent foam mixed with rumen content (frothy tympany) or free gases accumulated at the dorsal sac (free gas tympany).
• Tympany is classified into:
  • Frothy tympany (acute tympany and primary tympany)
  • Free gas tympany (secondary tympany, chronic tympany, and recurrent tympany)

Frothy Tympany Etiology

• Leguminous bloat which involves the feeding of immature, succulent, wet legume pasture or berseem, especially in prebloom-stage and when dew is present as well as feeding of immature leguminous crops as beans, peas, and cabbage.
• Feedlot bloat occurs with feeding of finely-ground concentrate or grains to feedlot lambs.

Predisposing Factors for Frothy Tympany

• Animal Factors
  • Inherited decrease in salivary secretion, leading to a lack of dilution effect.
  • Inherited decrease of salivary mucoprotein (mucins), leading to a lack of defoaming effect.
• Microbial Factors
  • Increase in slime-producing bacteria releasing slimy secretion, which increases the viscosity of rumen contents.
  • Increase in mucinolytic bacteria that destroys salivary mucins, especially in feedlot bloat.

Pathogenesis of Bloat

• Normally, gases coalesce and rise to the upper layer of the reticulorumen where eructation occurs under these conditions:
  • Only gases are coalesced.
  • Patency of tract.
  • Normal rumen cycles including eructation.
  • Accumulation of free gases only around the cardia.
• The leaf cytoplasmic soluble protein and very fine CHO particles increase the viscosity of reticulorumen contents, preventing the coalescing of gas bubbles and causing persistence of gases within the rumen content, leading to progressive reticulorumen distension and abdominal distension, resulting in:
  • Severe pressure on the diaphragm and lung.
  • Reducing lung capacity and death by hypoxia.
  • The progressive gradual increase in reticulorumen stimulates rumen motility at early stages (mild distension) then inhibits the motility by severe distension
  • Severe distension induces pressure and pain, leading to discomfort and kicking of belly (colicky pain)
  • The pressure on the lung leads to dyspnea

Clinical Findings in Bloat

• Sudden death in severe distension, especially in fattening lambs (lack of observation).
• Discomfort, kicking at belly, laying down and going up frequently, and frequent defecation and urination.
• Dyspnea, rapid shallow respiration with extension of head, opening the mouth, salivation, protrusion of tongue, and plugging of the eyeball.
• The respiratory, heart and pulse rate increase progressively by distension with anorexia, cessation of rumination, and drop of milk yield.
• Abdominal distension is prominent and progressively increased as mild, moderate, and then severe, which reveals tympanic sound by percussion.
• Trocarization or passage of stomach tube fails to evacuate froths.
• Death of untreated cases within 3 hours of disease.

Diagnosis of Bloat

• Case history of exposure to causes.
• Clinical signs.
• Clinical examination
  • Inspection
  • Palpation
  • Auscultation
  • Passage of stomach tube
  • Trocarization.
• Lab Diagnosis: the rumen content is frothy, thick, acidic, light colored in feedlot bloat.
• Differential diagnosis includes abdominal distension.

Treatment for Bloat

• Stop feeding the causative legume or ration.
• Emergency rumenotomy is performed in severe forms like severe distension, mouth breathing, etc.
• Passage of a large diameter stomach tube and using a suction pump or trocarization may help relieve distension in less severe cases with carefully slow evacuation of rumen to avoid vasogenic shock.
• Antifoaming drugs decrease the viscosity and surface tension, leading to the coalescing of gases and raising to upper layers to be eructated. Examples include:
  • Vegetable oils like cotton seed oil and linseed oil.
  • Mineral oils like paraffin oil are better due to more stability in the rumen.
• These oils are used at a dose rate of 25-50 ml for sheep and goats orally by stomach tube.
• Emulsified oil, such as dioctyl sodium sulfosuccinat, is given at 2.5-5 g for sheep and goats orally.
• Synthetic surfactants like poloxalane and alcohol ethoxylates as in DOSS are also used.

Control of Bloat

• Avoid grazing on succulent, wet, immature leguminous pasture or barseem, especially in prebloom stages and in dew.
• Avoid feeding of very fine ground concentrate or grains.
• Feeding of hay or straw before grazing.
• Harvesting the pasture or berseem or crop for feeding instead of grazing
• Limit/ restrict grazing (strip grazing) to feed the whole plant
• Avoid free grazing as the leaves of pasture are rich in soluble cytoplasmic protein and more palatable than stalks
• Restricting grazing area and time, grazing for 20minutes
• Supplement with antifoaming agents:
  • Oils, DOSS, poloxalane in the form of drench
  • Top dressing on pasture/salt licks
  • Controlled-release monensin capsules
• Monensin:
  • Enhances propionate pathway and lactate utilization
  • Decreases viscosity/ rumen surface tension

Free Gas Tympany

• It is distension of the reticulorumen by free gases accumulated at the dorsal layer caused by a failure of the normal eructation process.

Etiology of Free Gas Tympany

• Esophageal obstruction, especially in tetanus.
• Parasitic peritonitis.
• Prolonged Casting.
• Hypocalcemia.
• TRP in cattle.
• Vagus indigestion in cattle.
• LDA in cattle.

Clinical Signs and Clinical Examination Findings

• Mild to moderate rumen and abdominal distension.
• Inappetence, decreased rumination.
• Decreased rumen motility upon auscultation.
• Decreased milk and meat production.
• The respiratory, heart, and pulse rates increase but are mild.
• Percussion of rumen reveals tympanic sound only at the left flank.
• Passage of stomach tube or trocarization results in relief of distension and evacuation of gases.
• Signs of the primary diseases are also present.

Treatment for Free Gas Tympany

• Relief of gases using a stomach tube.
• Treatment of primary diseases.

Clinical Examination of the Digestive System

• Includes examination of the oral cavity, oropharynx, esophagus, rumen, reticulum, omasum, abomasum, and intestines.