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Ultrasonography in gastrointestinal disease in cattle.

Ultrasonography is an ideal diagnostic tool for investigating gastrointestinal disorders in cattle. It is performed on standing non-sedated cattle using a 3.5 MHz linear transducer. In animals with traumatic reticuloperitonitis, inflammatory fibrinous changes, and abscesses can be imaged; however, magnets and foreign bodies are difficult to visualize because of the gas content of the reticulum. Ultrasonography can be used to assess the size, position and contents of the abomasum. Percutaneous ultrasound-guided abomasocentesis can be performed to evaluate the nature and chemical composition of its contents. In left displacement of the abomasum, the abomasum is seen between the left abdominal wall and the rumen. It contains fluid ingesta ventrally and a gas cap of varying size dorsally. Occasionally, the abomasal folds are seen in the ingesta. In cattle with right displacement of the abomasum, the liver is displaced medially from the right abdominal wall by the abomasum, which has an ultrasonographic appearance similar to that described for left displacement. Motility and diameter of the intestine are the most important criteria for ultrasonographic assessment of ileus. However, the cause of the ileus is rarely determined using ultrasonography. In cases with ileus of the small intestine, there is at least one region of dilatation of the intestine and motility is reduced or absent. In cattle with caecal dilatation, the caecum can always be imaged from the right lateral abdominal wall. The wall of the caecum closest to the transducer appears as a thick, echogenic, semi-circular line.

Animals↗

Psychologic and psychiatric aspects of gastrointestinal disease.

There has been an explosion in understanding of the psychosocial concomitants of functional gastrointestinal disorders. Detecting psychologic disturbance and eliciting a history of physical or sexual abuse are critical in suggesting comprehensive and efficacious treatment strategies for these patients. The challenge is to define further the use of psychopharmacologic agents, including the newer antidepressants, anticonvulsants, and anxiolytic agents, in the treatment of chronic functional gastrointestinal disorders. Further research to evaluate the usefulness of various forms of psychotherapeutic and behavioral interventions needs to be undertaken. Establishing a multicomponent treatment program delivered by a team of caregivers, each bringing their unique skills (internist, psychiatrist, psychologist, and others) to patients, must be based on further research on the efficacy of these modalities as opposed to empiric treatment.

Anti-Anxiety Agents↗

Corticosteroids in the treatment of gastrointestinal disease.

Corticosteroids remain the mainstay of anti-inflammatory and immunosuppressive therapy for many gastrointestinal conditions. We are now starting to understand their mechanism of action and the phenomenon of corticosteroid resistance. Because of the ubiquity of corticosteroid receptors in virtually all cells of the body, side effects of therapy are common and may affect multiple body sites. Newer corticosteroid analogues are being developed to minimize these complications, and concomitant use of other immunomodulatory drugs often facilitates corticosteroid dosage reduction or even withdrawal in chronic inflammatory states.

Adrenal Cortex Hormones↗