Patologi Sistemik dan Nekropsi

Sal. Digesti Ruminansia

drh. M. Arfan Lesmana, M.Sc.
Fakultas Kedokteran Hewan, Universitas Brawijaya, Malang
Email: arfan142002@yahoo.com
Rumen Contents
• The ruminant is only as healthy
as the contents of the rumen
• Normal rumen contents are
fairly fluid, maybe about the
consistency of runny oatmeal
• The smell should be slightly
sweet. Actually, ruminal
contents have quite a pleasant
odor
Rumen

What is the optimal pH, how is this maintained, and what happens
when the pH goes awry?
• Normal pH of rumen ranges from 6
to 7.5
• If the pH drops below 5, the Gram
negative bacteria begin to die and
the Gram positive bacteria start to
proliferate, especially
Streptoccocus bovis
• As S. bovis proliferates more and
more, the acid drops and the
situation goes from bad to more
bad. At about pH4.5, even the S.
bovis don't do very well and
lactobacilli start replicating like
crazy
 • Ruminal mucosa is normally
covered with papillae to help
increase the surface area
• Neonatal animals don't have any
papillae. They don't need them
because the rumen doesn't start
functioning
• As they begin to consume
roughage, these papillae
The rumen on the far left has more leaf-shaped, or tongue- develop
shaped papillae, indicating the ration may have been more
acidic than that consumed by the animal whose rumen is on
the right
• However, if it gets much worse,
these papillae can fuse or clump,
and this decreases the surface
area, which is a definite
disadvantage for the animal
Tympany
• The normal functioning of the
rumen requires that gas be
released periodically
• If this gas can't be released, the
rumen blows up like a balloon
• Besides being incredibly
uncomfortable, this is also life-
threatening
Bloat
• Bloat, also called tympany, is divided into primary and secondary
varieties
• Primary bloat is also referred to as "frothy" bloat. In this type of
bloat, there is no gas to release into the esophagus, because it is all
trapped in little bubbles within the rumen
• instead of having big gas pockets in the dorsal areas, these regions are
filled with foam
Tympany
• Some plants, especially the
legumes, just have too many
soluble proteins, which get mixed
up with the fluid and merge with
the bubbles
• The bubbles are stabilized because
of the excess protein and they
don't burst
• Another reason is the feeding of
high grain diets. This causes less
salivation, and so there isn't as
much saliva to decrease the foam
Primary bloat
There are some ways to avoid or decrease frothy bloat:
• One is to not feed the cattle bloating types of legumes.
• Another is to administer anti-bloating agents which are surfactant-
type materials that help to break down the surface tension of the
foam.
• The third is to increase salivation. Saliva has mucins in it which help to
decrease the foam. Some believe that cattle that are genetically
predisposed to produce minimal saliva are also very susceptible to
developing frothy bloat.
Secondary bloat
Secondary bloat is also called "free gas bloat.“
• it is usually because there is a blockage in the eructation mechanism
so the animal can't belch
• obstruction in the esophagus
• definite obstruction - a tumor, a big old apple that got swallowed
whole, or some adhesions restricting the movement of the rumen
• "vagal indigestion," in which rumen motility is inhibited because of
some vague vagal nerve damage
Why do animals with bloat die? Well, the pressure from the expanding
rumen compresses everything in the thorax and they die of cardiac
arrest. There is extremely poor venous return to the heart because of
the tremendous external pressure on the thorax
This is a photograph of the mucosal surface of the esophagus
from a sheep that came into the postmortem room looking like
a balloon.

The pathologist determined that the bloat was antemortem

because of the presence of a BLOAT LINE. A bloat line means
the esophagus is two-tone, ischemic in the thorax and
congested in the cervical area.
 FOREIGN BODIES

Hairballs and concretions of plant material and sometimes trichobezoars

combinations of the two are often found in the
forestomachs
 TRAUMATIC RETICULITIS AND RETICULO-
PERICARDITIS

Cattle often ingest bits of metal which cause problems Even worse, they can penetrate the reticular wall and
come out the other side, making a nice little track for the
rumen microorganisms to follow.
In decades past, farmers dropped magnets into the
reticulum which helps to keep metal objects anchored
within the reticulum lumen. We don't see many of these
anymore.

Vagal indigestion can also result from reticular

penetrations. Damage to the nerves supplying the rumen
causes decreased motility and then what - bloat
eventually....
RUMENITIS
The acid will cause degeneration of the stratified squamous
epithelium and if the acid comes on too rapidly, there will be
erosions and ulcerations of the ruminal mucosa.

The upper arrow (on the left) shows vacuolation of the

epithelial cells - they are dying

The lower arrow (on the right) demonstrates how the

epithelium is lifting off of the submucosa - this will soon be an
ulcer.
RUMENITIS

This is the mucosal surface of the rumen of an animal that has

recovered somewhat from a bout of ruminal acidosis. There are
big ulcers in the epithelial surface
 RUMENITIS

These ulcers progress to become scars, which seriously

decrease the surface area of the rumen
Sequela of lactic acidosis

disseminated liver abscesses These big red ring-like lesions are due to fungus, so this is
mycotic rumenitis

The ulcers serve as portals of entry for gut organisms to have access to the cow's circulation. Often
what happens after an episode of lactic acidosis is that ruminal flora get into the mucosa, enter the
blood vessels, and get a free ride to the next stop, which is the liver.
 Sequela of lactic acidosis

These big red patches are very typical of mycotic

This is rumenal hyperkeratosis. It is an indication of a diet
rumenitis
that is changing to higher grain proportions
 Gastric Ulceration
Increased histamine levels are
seen in dogs with MAST CELL
TUMORS – the neoplastic mast
cells release histamine which then
stimulates the parietal cells to
secrete HCl. For this reason,
gastric (or duodenal) ulcers are a
common complication of mast cell
tumors in dogs.
The photograph above is the stomach of a dog with a mast cell
tumor. Note the perforating ulcer in the duodenum
In Uremia, uremic toxins are all over the body, and where they
come together with bicarbonate, they tend to cause
mineralization of vessels. And those mineralized vessels are
really brittle, so they break, causing vascular problems that
lead to death of overlying or adjacent mucosa
The blue dots are mineralizing cells, so this part of the mucosa
is becoming very brittle, which means it will break, and there
will be blood loss
Gastric Displacements
SITUS INVERSUS Gastric dilatation and
torsion/volvulus
Gastric dilatation and torsion/volvulus
Gastric dilation is usually associated
with
• ingestion of a large meal, eaten
rapidly
• aerophagia
• deep chested dogs
Abdominal distention, salivating, and
retching are the hallmark signs of GDV
a complex chain of physiologic events
begins.
• The blood return to the heart
decreases, cardiac output decreases,
and cardiac arrhythmias may follow.
• Toxins build up in the dying stomach
lining.
• The liver, pancreas, and upper small
bowel may also be compromised.
Shock from low blood pressure
complicated by endotoxemia begins.
• Sometimes the stomach ruptures,
leading to peritonitis.
Gastric Dilation in Horses
• Gastric dilation in horses occurs
secondarily to colic with ileus
(what’s ileus - it’s when the guts
they aren’t moving)
• also often a sequel to the
consumption of excessive
fermentable carbohydrate,
access to lush pasture, or This photograph shows the mucosal surface of the stomach of
excessive intake of water a horse. The distended stomach causes rupture of the mucosa
that can extend to involve the full thickness of the stomach wall
Gastric Rupture
stomach may rupture after the
horse dies due to continued
fermentation and gas formation -
you must distinguish
ANTEMORTEM from
POSTMORTEM rupture?

If hemorrhage is present on the

wound margins, it is antemortem.
Abomasal displacement
Abomasal atony and increased gas
production are prerequisites for
displacement of the organ.
Influx of high concentrations of
volatile fatty acids from the
rumen, and hypocalcemia, may
play a part in instigating
hypomotility, while evolution of
gas in the abomasum is directly
related to the amount of
concentrate in the ration
Duodenal-gastric intussusception