Surgical treatment of type-3 perforated abomasal ulcers in a cow

Objective: Description of the diagnosis and surgical treatment of two perforated type-3 abomasal ulcers in a cow. Materials and methods: A six-year-old Holstein Friesian cow was referred to our clinic because of anorexia, no feecal output and signs of acute abdomen. The main clinical findings were fever, arched back, tense abdomen and loss of intraabdominal negative pressure detected during transrectal palpation. Ultrasonography revealed reverberation artefacts in the dorsal quadrants of the abdomen. A tentative diagnosis of peritonitis with gas production was made, and a standing left flank exploratory laparotomy was carried out. Results: The abomasum was displaced to the left, and there were fibrinous adhesions between the abomasum and spleen. General anaesthesia was induced and maintained, and the cow was placed in dorsal recumbency. A ventral midline incision was made, and the abomasum was exteriorised. Following resection of two perforated type-3 abomasal ulcers and closing of the incisions an abomasopexy was carried out. The cow had an uneventful recovery and was discharged after eight days of postoperative care. A telephone follow-up three months after discharge revealed that the cow was healthy and had a high milk yield. Conclusions and clinical relevance: Perforated abomasal ulcers often occur with left displacement of the abomasum. Surgical resection of type-3 abomasal ulcers is challenging and has a successful outcome in few cases.