Two-stage rumenostomy in buffaloes

Background: Rumenostomy may be performed for therapeutic and digestibility research purposes in bovines, small ruminants and camelids. Several studies requires romenostomy in buffaloes in order to sample ruminal content for laboratorial assays. However, complications and outcome of rumenostomy was poorly studied in buffaloes. Therefore, the aim of the current study was to describe a two-stage rumenostomy technique in buffaloes, focused on intra and post-operative period.Materials, Methods & Results: Nine Murrah buffaloes were submitted to a 36-h and 12-h of food and water fastening. The animals were given acepromazine and maintained in standing position. Flank local anesthesia was carried out. A circular skin incision was carried out in the center of the left flank, followed by divulsion of the external and internal obliques and transversus abdominus muscles, and incision of the peritoneum. Subsequently, a segment of the dorsal aspect of the rumen was grasped and pulled through the flank incision. The rumen was attached to the peritoneum and skin incision margins in four points (dorsal, ventral, cranial and caudal). Additional simple interrupted sutures attaching the rumen serosa to the skin were applied subsequently. Four additional interrupted horizontal mattress sutures were applied equidistantly, taking bites only in the skin and rumen serosa. Following 12 h, the second stage was carried out. The buffaloes were prepared and restrained as performed for the first stage. A circular flap was excised from the exteriorized rumen and the silicone romenostomy cannula was placed. Clinical parameters, postoperative recovery, weight and behavioral pain scale were assessed. Positioning and anesthesia regimen were adequate for the achievement of the procedure. However, two animals fell in the restraint chute during the first surgical stage. Mild ischemia of the exteriorized rumen segment was observed on the second surgical stage, which resulted in less hemorrhage and enhanced cannula positioning. Complete cicatrization and permanent adhesion of the rumen to the skin were achieved. No ruminal leakage to the abdominal cavity occurred. No signs of pain were reported. There were few cases of laxity of the romenostomy opening leading to drop of cannula, myiasis on the margin of the stoma site and few cases of mild ruminal content leakage on the long-term assessment.Discussion: Restraint in standing position was considered adequate, although lateral recumbence constitutes another option. However, higher risk of contamination and technical difficulties in placing the cannulas are expected if lateral recumbence is considered. In other trials using acepromazine, no accidental recumbence occurred. Xylazine was also indicated for chemical restraint of buffaloes. It is known that flexible cannulas provide better anatomic adjustment and adaptation as well as being effective for sampling ruminal content, as seen in the current study. Ruminal leakage is one of the most frequent complications of romenostomy, which may affect animal's welfare. The animals in the current study presented no variations on the body score, even though on those presenting cannula loosening or ruminal content leakage. Moreover, no significant changes of the ruminal content parameters were noticed. Myiasis was also reported following ruminal surgical interventions, which were mainly attributed to extensive breeding. Loss of the cannula, subcutaneous emphysema and suture dehiscence are common complications of romenostomy. Nonetheless, none of those complications were found on the current study. Thus, romenostomy was feasible and efficient for sampling and performing assays of the ruminal content in buffaloes.

Efeitos de dietas com níveis crescentes de milho no metabolismo ruminal de energia e proteína em bubalinos

Avaliaram-se os efeitos de dietas com níveis crescentes de milho em grão moído (0, 22, 37 e 49% na MS) em substituição ao feno de coast-cross mantendo-se diferentes relações proteína:carboidratos não-fibrosos (PB:CNF = 1,01; 0,39; 0,33 e 0,27) sobre o metabolismo ruminal de búfalos. Utilizaram-se quatro búfalos fistulados no rúmen, mantidos em delineamento quadrado latino 4 × 4, para a coleta de amostras do líquido ruminal, colhidas em cada período experimental (de 28 dias) nos tempos 0, 2, 4 e 8 horas após a alimentação. Em geral, os bubalinos apresentaram boa capacidade tamponante no rúmen, com pH médio alto (6,70) e aumento da ingestão de milho em grão moído. O acréscimo nos níveis de milho na dieta promoveu aumento da produção de ácido butírico. Somente a dieta com 49% de milho promoveu melhor fermentação ruminal, com menor propoção de ácidos acético:propiônico. A relação PB:CNF de 1,01 indica deficiência de energia da dieta disponível para microrganismos no rúmen ao longo do dia, enquanto dietas com PB:CNF entre 0,39 e 0,27 promovem fermentações ruminais semelhantes, o que indica sincronismo na utilização de nitrogênio e energia pelos microrganismos no rúmen nessas condições.

Efeitos de dietas contendo Leucaena leucocephala e Saccharomyces cerevisiae sobre a fermentação ruminal e a emissão de gás metano em bovinos

Este trabalho foi realizado com o objetivo de avaliar os efeitos do uso de leucena e levedura em dietas para bovinos sobre o metabolismo ruminal, incluindo o pH e as produções de ácido graxos voláteis (AGV), amônia e gás metano. Quatro bovinos machos com 800 kg e fistulados no rúmen foram mantidos em quadrado latino 4 × 4, em arranjo fatorial 2 × 2, composto de dois níveis de leucena (20 e 50% MS) e feno de capim coast-cross na presença ou ausência de levedura. Não houve influência das dietas nos valores médios de pH (média 6,82) e nas concentrações de amônia no rúmen, que variaram de 18 a 21 mg/100 mL. Houve interação entre níveis de leucena e levedura na concentração total de AGV. As dietas não diferiram quanto à concentração de ácido acético, mas os animais alimentados com a dieta com 50% de leucena e contendo levedura apresentaram maiores concentrações médias de ácido propiônico (média 19,14 mM). A emissão de metano reduziu em12,3% em relação à mesma dieta sem levedura e em 17,2% quando os animais foram alimentados com 20% de leucena com levedura. Verificou-se efeito associativo de leucena, quando fornecida em alto nível na dieta (50% MS), e levedura na redução da emissão de metano e na melhoria no padrão de fermentação no rúmen, o que pode reduzir as perdas de energia e melhorar eficiência energética do animal.

Changes in ruminal fermentation and mineral serum level in animals kept in high temperature environments

In order to evaluate the effect of environmental temperature on ruminal fermentation and on mineral levels of growing ruminants, it was used 12 male calves (initial average weight 82.9 ± 7.7 kg, 100 days of age), were employed in a randomized block design (by weight) experiment, with repeated weight measurement and two environmental temperatures: thermoneutral (24ºC) and heat-stressed (33ºC), during 38 days. The animals exposed to 33ºC presented lower dry matter ingestion, lower T3 (triiodothyronine) serum level, higher ammoniacal nitrogen (NH3-N) level in the rumen liquid, and higher rectal and body temperatures during all the experimental period when compared to the animals kept in thermoneutral environment (24ºC). The animals kept under heat stress environment (33ºC) presented higher calcium serum level, which was the highest on 31st day and the lowest on the 38th day of the experiment; phosphorus level was the lowest during all the experimental period; sodium level was lower on the 17th, 31st and 38th experimental days. Potassium and zinc levels were lower after 24 days; copper level was lower until the 24th day; magnesium level was higher until the 17th day, if compared to the ones from the animals kept in thermoneutral environment (24ºC). The heat-stressed animals presented higher levels of ammoniacal nitrogen in the ruminal liquid and a decrease in the phosphorus, sodium, potassium and zinc serum levels. These results show the necessity of changes on feed management to ruminants in temperatures over the thermal comfort limits so that performance loss is decreased.

Late obstruction of an endoscopic third ventriculostomy stoma by metastatic seeding of a recurrent medulloblastoma Case report

Endoscopic third ventriculostomy (ETV) has been established as an effective method in the treatment of tumoral obstructive hydrocephalus. Delayed closure of the ETV stoma has been attributed to scarring involving the third ventricular floor. Secondary obstruction of the stoma due to intraventricular tumor seeding is an extremely rare condition, with only one case described to date. The authors report on a unique case of late closure of the ETV stoma caused by metastatic seeding of a recurrent medulloblastoma 9 years after the initial treatment. The patient was submitted to a second endoscopic procedure in which a reddish mass located just at the third ventricular floor was resected, leading to reopening of the previous ETV stoma. To the best of the authors` knowledge, this case is the first report of an ETV obstruction due to metastatic CSF seeding of a medulloblastoma. In such cases of late failure of the ETV stoma because of tumor obstruction, a second ETV can be safely performed and lead to adequate function of the stoma, even if limited by the aggressive nature of the disease. (DOI: 10.3171/2010.1.PEDS09320)

Effects of adding polyclonal antibody preparations on ruminal fermentation patterns and digestibility of cows fed different energy sources

Nine ruminally cannulated cows fed different energy sources were used to evaluate an avian-derived polyclonal antibody preparation (PAP-MV) against the specific ruminal bacteria Streptococcus bovis, Fusobacterium necrophorum, Clostridium aminophilum, Peptostreptococcus anaerobius, and Clostridium stick-landii and monensin (MON) on ruminal fermentation patterns and in vivo digestibility. The experimental design was three 3 x 3 Latin squares distinguished by the main energy source in the diet [dry-ground corn grain (CG), high-moisture corn silage (HMCS), or citrus pulp (CiPu)]. Inside each Latin square, animals received one of the feed additives per period [none (CON), MON, or PAP-MV]. Dry matter intake and ruminal fermentation variables such as pH, total short-chain fatty acids (tSCFA), which included acetate, propionate, and butyrate, as well as lactic acid and NH(3)-N concentration were analyzed in this trial. Total tract DM apparent digestibility and its fractions were estimated using chromic oxide as an external marker. Each experimental period lasted 21 d. Ruminal fluid sampling was carried out on the last day of the period at 0, 2, 4, 6, 8, 10, and 12 h after the morning meal. Ruminal pH was higher (P = 0.006) 4 h postfeeding in MON and PAP-MV groups when compared with CON. Acetate: propionate ratio was greater in PAP-MV compared with MON across sampling times. Polyclonal antibodies did not alter (P > 0.05) tSCFA, molar proportion of acetate and butyrate, or lactic acid and NH(3)-N concentration. Ruminal pH was higher (P = 0.01), 4 h postfeeding in CiPu diets compared with CG and HMCS. There was no interaction between feed additive and energy source (P > 0.05) for any of the digestibility coefficients analyzed. Starch digestibility was less (P = 0.008) in PAP-MV when compared with CON and MON. In relation to energy sources, NDF digestibility was greater (P = 0.007) in CG and CiPu vs. the HMCS diet. The digestibility of ADF was greater (P = 0.002) in CiPu diets followed by CG and HMCS. Feeding PAP-MV or monensin altered ruminal fermentation patterns and digestive function in cows; however, those changes were independent of the main energy source of the diet.

Post-ruminal protein supply and N retention of weaner sheep fed on a basal diet of lucerne hay (Medicago sativa) with increasing levels of quebracho tannins

The ability of low to moderate levels (

Fatal monensin toxicity in a dog after chewing a bovine intra-ruminal slow-release device

A 20kg, 10-month-old male Kelpie developed a rapid onset of profound paresis progressing to flaccid paralysis and dyspnoea, followed by death about 36 hours after chewing on a partly discharged anti-bloat capsule from a dead cow. Intoxication by monensin in the capsule was considered the cause of death. No Lodes holocyclus were found on the dog. Evidence of muscle damage was seen in clinical biochemistry assays of plasma, but consent for necropsy was not obtained. The median lethal dose for Beagle dogs of the material contained in anti-bloat capsules is 0.5-1.0g. As this represents a serious toxicity risk if dogs chew these devises, the manufacturer includes a warning on potential dog toxicity in product literature.

Evaluation of Community Nursing Project : Moving Professional Boundries From A Stoma Care Nursing Service To A Colorectal Nursing Service (PDF 3607 KB)

Foyle HSS Trust's Evaluation of community nursing project. Part of the Department's redesign of community nursing project.

Pursestring closure of the stoma site leads to fewer wound infections: results from a multicenter randomized controlled trial.

BACKGROUND: Surgical site infection after stoma reversal is common. The optimal skin closure technique after stoma reversal has been widely debated in the literature. OBJECTIVE: We hypothesized that pursestring near-complete closure of the stoma site would lead to fewer surgical site infections compared with conventional primary closure. DESIGN: This study was a parallel prospective multicenter randomized controlled trial. SETTINGS: This study was conducted at 2 university medical centers. PATIENTS: Patients (N = 122) presenting for elective colostomy or ileostomy reversal were selected. INTERVENTIONS: Pursestring versus conventional primary closure of stoma sites were compared. MAIN OUTCOME MEASURES: Stoma site surgical site infection within 30 days of surgery, overall surgical site infection, delayed healing (open wound for >30 days), time to wound epithelialization, and patient satisfaction were the primary outcomes measured. RESULTS: The pursestring group had a significantly lower stoma site infection rate (2% vs 15%, p = 0.01). There was no difference in delayed healing or patient satisfaction between groups. Time to epithelialization was measured in only 51 patients but was significantly longer in the pursestring group (34.6 ± 20 days vs 24.1 ± 17 days, p = 0.02). LIMITATIONS: This study was limited by the variability in procedures and surgeons, the limited follow-up after 30 days, and the inability to perform blinding. CONCLUSION: Pursestring closure after stoma reversal has a lower risk of stoma site surgical site infection than conventional primary closure, although wounds may take longer to heal with the use of this approach. REGISTRATION NUMBER: NCT01713452 (www.clinicaltrials.gov).

Facilitators of the transition process for the self-care of the person with stoma: subsidies for Nursing

OBJECTIVE To know the facilitating factors of the transition process from dependency to the self-care of people with a stoma. METHOD This is a descriptive study of qualitative approach, including 27 people with permanent stomas due to cancer. The data were collected through semi-structured interviews and submitted to content analysis based on the Transition Theory as theoretical reference. RESULTS The self-care facilitators related to the person were the positive significance of ostomy; the preparation for this experience already in the preoperative period; emotional stability; faith; religiousness; and a sense of normalcy acquired from a next image similar to the previous one. The facilitators related to the community were the following: receiving equipment for free from the government; support from family and the multidisciplinary team, especially the nurses; and having contact with other people with stomata. CONCLUSION The results allow that nurses develop strategies to help people with stomata to resume their self-care.

Efeito de métodos de coleta de fluido ruminal em bovinos sobre alguns parâmetros ruminais e microbiológicos

Estudou-se o efeito de três métodos de coleta (manual, bomba a vácuo e sonda nasoesofageana) sobre os teores de ácidos graxos voláteis totais (AGVt), nitrogênio amoniacal e número de protozoários no fluido ruminal de bovino. Utilizou-se o delineamento inteiramente casualizado, com três tratamentos e cinco repetições. Os resultados revelaram que o método da sonda nasoesofageana proporcionou valores menores dos ácidos propiônico, butírico, AGVt e de nitrogênio amoniacal no fluido ruminal. O número total de protozoários não foi afetado pelos métodos de coleta de conteúdo ruminal. O método de coleta manual e por meio de bomba a vácuo mostraram-se eficientes para os parâmetros estudados.

Degradabilidad ruminal del forraje disponible en la pradera y del aparentemente consumido por vacas lecheras

Se evaluó la dinámica degradativa de forrajes, en muestras de una pradera permanente (Lolium perenne L.), manejadas a dos alturas de pradera, alta y baja. Las muestras consistieron en forraje disponible a ras de suelo (FD) y en forraje aparentemente consumido por vacas lecheras en pastoreo continuo (FS). La degradabilidad ruminal se estudió usando la técnica de las bolsas de dacrón y los datos fueron ajustados a una ecuación exponencial. La fracción soluble (g/kg MS), de la materia seca (MS) (299 v/s 351, s.e.d.= 5,4), de la materia organica (MO) (304 v/s 376, s.e.d.= 3,3) y del nitrógeno (250 v/s 301, s.e.d.= 6,4), fueron significativamente mayores (P<0,05) en muestras de FS que en muestras de FD. La degradabilidad potencial (g/kg MS) de MS, MO y nitrógeno, fue significativamente mayor (P<0,05) en las muestras de FS, que en las muestras de FD. La degradabilidad efectiva fue mayor en las muestras de FS, que en las muestras de FD, tanto para la MS (474 v/s 508, s.e.d.= 13,0), MO (490 v/s 529, s.e.d.= 11,6) y nitrógeno (351 v/s 419, s.e.d.= 10,0). Respecto del factor altura, sólo se encontró un efecto significativo en la degradabilidad efectiva en el nitrógeno, en favor de la altura baja (365 v/s 406, s.e.d.= 10,0).

Wound infection following stoma takedown: primary skin closure versus subcuticular purse-string suture.

Abstract: Background Stoma closure has been associated with a high rate of surgical site infection (SSI) and the ideal stoma-site skin closure technique is still debated. The aim of this study was to compare the rate of SSI following primary skin closure (PC) versus a skin-approximating, subcuticular purse-string closure (APS). Methods All consecutive patients undergoing stoma closure between 2002 and 2007 by two surgeons at a single tertiary-care institution were retrospectively assessed. Patients who had a new stoma created at the same site or those without wound closure were excluded. The end point was SSI, determined according to current CDC guidelines, at the stoma closure site and/or the midline laparotomy incision. Results There were 61 patients in the PC group (surgeon A: 58 of 61) and 17 in the APS group (surgeon B: 16 of 17). The two groups were similar in baseline and intraoperative characteristics, except that patients in the PC group were more often diagnosed with benign disease (p = 0.0156) and more often had a stapled anastomosis (p = 0.002). The overall SSI rate was 14 of 78 (18%). All SSIs occurred in the PC group (14 of 61 vs. 0 of 17, p = 0.03). Conclusions Our study suggests that a skin-approximating closure with a subcuticular purse-string of the stoma site leads to less SSI than a primary closure. Randomized studies are needed to confirm our findings and assess additional end points such as healing time, cost, and patient satisfaction.

Fontes de lipídio e monensina sódica na fermentação, cinética e degradabilidade ruminal de bovinos

O objetivo deste trabalho foi avaliar a degradabilidade, a fermentação e a cinética ruminal de dietas com caroço de algodão ou sal de cálcio de ácidos graxos, como fontes de gordura, acrescidos de monensina sódica, e verificar o efeito da última em dietas com caroço de algodão. Quatro novilhos Nelore, canulados no rúmen, foram submetidos a um experimento em delineamento quadrado latino 4x4. Os tratamentos consistiram de três dietas com monensina (sal de cálcio graxo, caroço de algodão e controle) e uma dieta com caroço de algodão sem monensina. Os períodos de incubação foram de 0, 3, 6, 12, 24, 48, 72 e 96 horas, e o líquido ruminal foi colhido nos horários 0, 1,5, 2, 3, 4, 6, 8, 12 e 24 horas depois da alimentação. As dietas com caroço de algodão apresentaram maior degradabilidade da fibra em detergente neutro e maior teor de proteína bruta. A dieta com caroço de algodão e monensina apresentou maior taxa de passagem líquida e turnover ruminal. Não houve diferença entre as dietas quanto ao pH, amônia ruminal e ácidos graxos voláteis. As fontes de gordura, sal de cálcio de ácidos graxos e caroço de algodão não apresentaram efeito deletério no rúmen. A utilização de monensina afeta a degradabilidade, a cinética e a fermentação ruminal, quando se utiliza caroço de algodão na dieta.