When you work in general practice, and do not have ready access to advanced imaging,…
Percussion and auscultation of the abdomen is a standard examination technique utilised by livestock veterinarians to help diagnose abdominal lesions in ruminants. As a vet student, the most memorable and oft talked about ‘pings’ are those that are produced on the left by a Left Displaced Abomasum (LDA) and on the right by a Right Displaced Abomasum (RDA). But the trap for the novice veterinarian is to forget that the ruminant viscera may contain gas (and therefore produce the characteristic ‘ping’ sound on examination) at a number of locations due to a variety of physiologic and pathologic causes.
In this video Associate Professor John House outlines the specific locations in which common abdominal lesions produce pings in the cow. As John reinforces to his students, part of a complete physical examination of the ruminant involves thoroughly examining the abdomen and attempting to clearly delineate the area in which a ping (if present) can be produced through percussion, ballottement and succussion with simultaneous auscultation. Interpreting this finding alongside the rest of the physical examination results will help differentiate between the possible diagnoses. In this way it is possible for a clinician to avoid making a hasty diagnosis and undertaking unnecessary surgery, or alternatively, obtain some guidance about the possible differential diagnoses they may be confronted with if undertaking an exploratory laparotomy. Given there are few scenarios more alarming to a new veterinarian than finding that their presumed diagnosis is incorrect while the surgery is underway, this is time well spent.
About the Presenter
Associate Professor John House BSc, BVMS (Hons), PhD, Dip ACVIM is the Director of Bovine Clinical Services at the Livestock Veterinary Teaching and Research Unit, The University of Sydney. He is extensively published, is a highly regarded teacher and mentor to veterinary students, and is a sought after specialist bovine clinician. I had the privilege of being both a student of John’s and in completing some training on a couple of the large dairy farms for whom he consults. “The difference to our herd since John has been consulting has been amazing”, one farm owner confided in me at the time, with obvious delight, “The cows are so much healthier and more productive and the farm is far more profitable as a result”. Inspiring words for an aspiring veterinarian.
Need to know more?
Associate Professor John House has contributed to the latest edition of Diseases of Cattle in Australasia: A Comprehensive Textbook, edited by Parkinson, T.J et al., and which is due out in early 2019.
The Livestock Veterinary Teaching and Research Unit is a commercial veterinary service which offers both ambulatory and herd health consultancy. Associate Professor John House and the veterinary team at The Livestock Veterinary Teaching and Research Unit welcome referrals for herd health program design and implementation, and disease investigation.
References Radostits , O.M., Mayhew, I.G and Houston, D.M (eds). Veterinary Clinical Examination and Diagnosis, Philadelphia, WB Saunders, 2000, pp 422-434