In the present study, 31 animals were found to be affected with TRP which included 14 Jaffarabadi buffaloes, 06 non-descriptive buffaloes, 07 Gir cattle, 03 Kankrej cattle and 1 Holstein Friesian cattle. Out of 31 animals, 29 were females and 2 were males. The age of affected animals was ranging from 4 to 13 years with a mean age of 8.18±0.45 years. Reproductive status of the animals revealed, 09 animals were pregnant (above 6 months), 12 were recently parturiated and 7 were non-pregnant and 3 were heifers. Occurrence of TRP is more in the animals above 6 years which was mainly due to the pregnancy
(Sharma et al., 2015), parturition (
Singh, 2002) acted as predisposing factors for the development of the disease but
Hutchins and Blood (1957) reported pregnancy was not major risk factor for development of TRP. However the pregnant animals had poor prognosis.
Anamnesis
Brief history of the affected animals was noted in which, 8 animals were anorectic, feed intake was decreased in 19 animals and normal in 4 animals. Changes in the feeding can be due to reticular adhesions
(Athar et al., 2010), pain caused by foreign body, systemic illness and toxaemia
(Radostits et al., 2007).Dung output was normal in 15 animals, scanty in 9 animals, diarrhoea in 3 animals and absence of defecation was observed in 4 animals. Bloat was seen in 25 animals in which, recurrent bloat was seen in 10 animals, seen once or twice in 15 animals while no bloat was observed in remaining animals. Prolonged standing was observed in 5 animals and 2 had difficulty in walking.
Clinical examination
The clinical examination (Table 1) revealed, distended left paralumbar fossa, congested conjunctival mucous membrane, pyrexia, pale mucous membrane, cachexia, difficulty and increased respiratory rate, lachrymation, jugular pulsation, grunting, brisket edema, ventral edema of abdomen, difficulty in walking and foreign body tests like positive slope test, pole test, arched back were seen. Examination of rumen motility at left paralumbar fossa revealed, changes in motility pattern of the rumen such as increased (>3 contractions/2 min), decreased (<3 contractions/2min) or atony of rumen.
Ferroscopy
Metal detector showed positive results in 27 animals and failed to locate metallic foreign bodies in remaining animals, whichmay be due to the increased distance between ferroscope and foreign body or increase level of effusions and highly dense adhesions which masked the foreign bodies
(Hussain et al., 2018). The mean ferroscopic deflection was recorded to be 22.79±1.25 µA. In majority of the animals, deflection in the ferroscopy was noted between 6
th to 8
th ICS indicating the presence of metallic foreign body in the reticulum.
Radiography
Left lateral radiographic view of reticular region using factors revealed presence of at least one radiopaque metallic foreign body in 22 animals (Fig 1), while in remaining animals,no foreign body was detected during radiography. Failure to detect the metallic foreign bodiescan be due to lack of sufficient metallic density of the foreign bodies to be visualized by radiography and it may be combined with larger body size of the animal
(Sasikala et al., 2018). Most of the sharp metallic foreign bodies were present at ventral floor of reticulum, either lying or penetrating. Radiographically detected foreign bodies included potential foreign bodies such as nails, wires, metal pieces, small rods, keys and non-potential foreign bodies like bolts, coins, small stones, washer. Similar findings were noted by
Athar et al., (2010) and
Braun et al., (2018).
Ultrasonography
Ultrasonographic examination of the reticular region revealed half-moon shaped reticulum exhibiting either a smooth contour or an undulating wall with or without fibrin deposits. Reticulitis was graded as mild to moderate and severe reticulitis. Presence of reticulitis was due to the repeated injury by sharp penetrating foreign bodies and decreased or atonic reticulum along with fibrin deposition were characteristic findings of TRP
(Braun et al., 2018).
Examination of reticular motility revealed different patterns such as characteristic biphasic motility, partial contractions or reduced motility and no motility. Similar motility patterns were also observed by
Imran et al., (2012). Partial or absence of motility can be due to the reticular adhesions with diaphragm or abdominal wall which hindered the movement. Echogenic fibrin deposits along with accumulation of peritoneal fluid (Fig 2) and formation of fibrin mesh with interspersed hypoechoic fluid (Fig 3) were also noticed. Reticular movements with each respiration were observed in some animals indicated diaphragmatic adhesions which was similar finding to
Imran et al., 2012). Ultrasonographic findings observed in the present study are tabulated in Table 2.
Haematology
Complete blood count revealed majority of the animals had leucocytosis andneureophilia before surgery (day 0). Post-operatively on day 12, significant decrease in levels of leucocytes and highly significant decrease in neutrophils levels was observed. Lymphocyte levels were in normal range but significantly increased on day 12.Leucocytosis and neutrophilia are were due to inflammatory reactions and exudations in the abdominal cavity (
Weiser, 2012;
Rajput et al., 2018). Haemoglobin, haematocrit and total erythrocyte count values differed non-significantly between day 0 and day 12 along with remaining parameters.The details of all haematological parameters on day 0 and day 12 are mentioned in Table 3.
Peritoneal fluid
Out of 31 animals, it was possible to collect peritoneal fluid in 26 animals. Failure of collection in remaining animals was attributed to localized peritonitis or severe dehydration
(Athar et al., 2010). Different colors of peritoneal fluid obtained were normal straw, yellowish, pinkish and brownish (Fig 4). There was increase in the value of total protein and total nucleated cell counts. Change in color, increase in total protein and total nucleated cell counts was due to the inflammatory process in the abdominal cavity leading to extravasation of proteins
(Athar et al., 2010) and increase in the nucleated cells due to peritonitis
(Wilson et al., 1985). Similar findings such as increase in total protein and nucleated cells along with change in color of peritoneal fluid were observed by
Athar et al., (2010); Hussain and Uppal (2014);
Dezfouli et al., (2012) and
Turkar et al., (2015). Details of peritoneal fluid characteristics are mentioned in Table 4.
Blood trypsin inhibitor spot test
Test yielded positive results in 23 animals and negative in remaining 8 animals (Fig 5).
Surgical management
In all 31 animals standing left paralumbar rumenotomy was carried out by regional anaesthetic techniques such as paravertebral nerve block or field block with 2% Lignocaine HCl. Rumen fixation was performed by Weingarth’s method and 30-40% of rumen content was removed to reduce the bulk. Both reticulum and rumen were explored for the presence of sharp metallic foreign bodies. A magnet was used to find the foreign bodies. In majority of the cases foreign bodies were found at the ventral floor of reticulum either penetrating or lying
(Athar et al., 2010; Mersha and Desiye, 2012), followed by cranial surface and near the reticulo-omasal orifice of the reticulum. Common metallic foreign bodies recovered were nails, wires, screws, metal pieces, keys, sewing needle and non-potential foreign bodies like nut, bolt, coins, round metallic structures, pieces of leather and plastic were also recovered in some cases. Reticular adhesions were observed with diaphragm, abdominal cavity, spleen and liver.
Complications observed during the present study included, death of 4 animals, suture line abscess in 4 animals, sub cutaneous emphysema in 2 animals and recurrence of bloat in 5 animals. Similar complications were observed by
Balasundara et al., (2012) and
Nugusu et al., (2013). Some other complications like incisional drainage of peritoneal fluid in one animal and complete stoppage of milk production was seen in 5 animals.
