brown swiss 3048 foster by h1519w

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									Instructions for Cases
1. Do NOT print this out—it will waste a lot of paper.
2. Clicking on the blue underlined questions will take
   you to the answer. On the answer slide, click return to
   case.
3. On the diagnostics page, every test is not necessary.
   Choose only those that you feel will appropriately
   narrow your differential list or affect your treatment
   plan. Click on the test to obtain the results and my
   justification for performing (or not performing) each
   test.
4. Similarly, not all the offered treatments and
   preventions are appropriate or necessary. Pick those
   that you feel are best.
Brown Swiss #3048
                    Background

 Signalment: 3 year old Brown Swiss cow. 12 days
  postpartum
 History: Found down in the pasture this afternoon.
  Could stand and walk slowly when encouraged.
  Severely depressed. Herd is vaccinated annually
  with a killed respiratory disease/lepto vaccine and
  clostridial vaccine.
Physical Exam: T-97.8F, P-115, R-80. No rumen
contractions. Ping noted on right flank—
approximately 10 inches in diameter and centered
over 13th rib.

What is the most likely
cause of a ping in this
location and what should
we do about it?
Physical exam, cont.: Eyes are approximately 6mm
recessed. Right prefemoral and right supramammary
lymph nodes are enlarged. Right rear quarter is swollen,
red, and painful. Milk from that quarter is watery with
some clumps. Rectal exam: Uterus is appropriately
involuted for 12 days in milk. Remainder of physical
exam is unremarkable.


   What is the significance of eyeball recession?


   What is this cow’s problem list?


   Based on this problem list, what are your differentials?
                     Diagnostic Work Up

 Complete blood count
 Chemistry panel
 Sterile milk culture from affected quarter
 Abdominal ultrasound
 Gram stain of milk from affected quarter
 California mastitis test
 Abdominal exploratory
 Serial Salmonella fecal cultures


  Based on your findings, what is your diagnosis?
                       Diagnosis

 Acute Toxic Gram Negative Mastitis
 If you arrived at this diagnosis without any of the
 diagnostic tests, that is fine. The signs are pretty
 classic for this disease, though a culture of the milk is
 a good idea for any cow with clinical mastitis.




Now that we have a diagnosis, what should we do about it?
                      Treatment

 Intramammary Spectramast (ceftiofur)
 Intramammary ToDAY (cephaparin)
 Intramammary Gentocin (gentamicin)
 Subcutaneous Naxcel (ceftiofur)
 Subcutaneous Baytril (enrofloxacin)
 IV hypertonic saline
 IV lactated ringers solution
 Oral electrolyte solution
 Frequent stripping of milk from the infected quarter

                 Case Outcome
                          Case Outcome

Due to your prompt
administration of IV and oral
fluids, and IMM and SQ ceftiofur,
the cow is improving. The farmer
is sufficiently impressed to
consider listening to any
preventative recommendations
that you have. So…

What about the rest of the herd?
What recommendations do you
make?
             Preventative Measures

 Gram negative core antigen vaccine
 Switch to sand bedding
 Wash any manure off udder prior to milking
 Switch to Albadry (penicillin/novobiocin) at dry off
This is the end of case #1. Please contact me at
derek_foster@ncsu.edu if you have any questions or
comments concerning this case. I appreciate any
suggestions that you may have.

								
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