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This study examines the association of pre-surgical clinical parameters in cows with left displacement of the abomasum (LDA) with the probability of cure. Data from 466 cases of LDA in which omentopexy was performed were analysed. Cows were classified in three categories according to the outcome of treatment. Cows in the first category were cured, i.e. sent back to the farm for further milk production. Cows in the second category were sent for slaughter because of an unfavourable prognosis concerning productivity. Cows in the third category either died or were salvaged because of poor prognosis concerning survival. Factors were examined for their possible influence on the outcome of treatment by comparing the values of successfully treated cows to those cows that either died or had to be sent for slaughter. Factors that were associated with a favourable prognosis were a short duration of disease, an undisturbed general condition, good appetite, normal faeces, a higher body weight, lower haematocrit, haemoglobin and erythrocyte counts, lower urea, AST and bilirubin, and higher sodium, potassium and chloride concentrations compared with cows with an unfavourable prognosis. Haemoconcentration was associated with higher AST, bilirubin and urea and with low sodium, potassium and chloride. Acetonuria was associated with increased AST and bilirubin and low urea. Low sodium and potassium concentrations were associated with an impaired general condition. It is concluded that a thorough clinical examination with special emphasis on general condition, liver function and dehydration status is of great importance in determining the prognosis of abdominal surgery in cows with LDA.