Ruminant Medicine

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name: ruminant-medicine
description: Ruminant-specific medicine covering cattle, sheep, and goat clinical approaches. Four-compartment forestomach physiology, rumen pH/acidosis, displaced abomasum, metabolic diseases (ketosis, milk fever/hypocalcemia, grass tetany/hypomagnesemia), withdrawal times, Johne's disease, and herd health management.
---

# Ruminant Medicine

## Overview

Ruminant-specific medicine addressing cattle, sheep, and goat clinical approaches. Ruminants possess a four-compartment forestomach (reticulum, rumen, omasum, abomasum) fermentation system fundamentally different from monogastric species. Rumen pH, microbial populations, and feed transitions are critical to health; acidosis and bloat are emergencies. Metabolic diseases dominate in dairy cattle (ketosis, milk fever, grass tetany) and are tied to production stage. Displaced abomasum is a common surgical condition in dairy cows. Withdrawal times (FARAD database) are legally and ethically mandated for food-producing animals. Johne's disease (MAP) is endemic in many herds and requires biosecurity management. Species differences (cattle vs. sheep vs. goats) are significant for reference ranges, drug metabolism, and disease risk.

## When to Use

- User presents a case or question involving ruminant medicine
- User asks about rumen pH, acidosis, bloat, or forage management
- User discusses displaced abomasum or surgical indications in cattle
- User questions metabolic diseases (ketosis, milk fever, grass tetany) in dairy
- User asks about withdrawal times for medications or supplements (FARAD reference)
- User requires information on Johne's disease screening or biosecurity
- User asks about species-specific physiology or normal parameters
- Keywords: cattle, cow, bovine, sheep, ovine, goat, caprine, ruminant, rumen, reticulum, omasum, abomasum, ketosis, milk fever, grass tetany, hypomagnesemia, acidosis, bloat, displaced abomasum, Johne's disease, MAP, withdrawal times, FARAD

## Clinical Reference Values

| Parameter | Cattle | Sheep | Goats |
| --- | --- | --- | --- |
| Temperature | 101.0-102.5°F | 101.5-103.5°F | 101.5-104.0°F |
| Heart rate | 40-80 bpm | 60-120 bpm | 70-135 bpm |
| Respiratory rate | 10-30 bpm | 15-30 bpm | 10-30 bpm |
| Rumen pH (healthy) | 6.2-7.4 | Similar | Similar |
| Rumen motility | 0.5-1.5 contractions/min | Similar | Similar |

## Four-Compartment Forestomach Physiology

**Reticulum:** Filters large particles; initiates rumination. **Rumen:** Main fermentation vat (80-120 liters in adult cattle). pH depends on forage:concentrate ratio and fermentation rate. **Omasum:** Absorbs water and small nutrients. **Abomasum:** "True stomach" with acid and pepsin; analogous to monogastric stomach.

**Rumen pH and Acidosis:**
- **Normal pH:** 6.2-7.4. Below 6.0 = acidosis.
- **Subacute ruminal acidosis (SARA):** pH 5.0-6.0 for >3 hours daily. Causes laminitis, reduced feed intake, decreased milk fat, right displacement abomasum risk.
- **Acute ruminal acidosis:** pH <5.0. Severe pain, profuse diarrhea, rumen paresis, potential death. May require rumenotomy.
- **Cause:** Excessive grain, insufficient fiber, rapid diet changes, moldy forage.
- **Management:** Return to forage-based diet, improve hay quality, add sodium bicarbonate or magnesium oxide as buffers, avoid rapid transitions (minimum 10-14 days).

**Bloat:** Accumulation of fermentation gas in rumen. **Frothy bloat** (associated with legume pastures, frozen forage) is more common than **gaseous bloat**. Frothy bloat requires anti-foam agents (mineral oil, surfactants) or rumenotomy if severe.

## Metabolic Diseases in Dairy Cattle

**Ketosis (Acetonemia):** Negative energy balance in early lactation. Blood beta-hydroxybutyrate (BHB) >1.4 mmol/L is diagnostic; >3 mmol/L indicates severe ketosis.
- **Clinical signs:** Reduced milk production, weight loss, neurologic signs (incoordination, depression) in severe cases.
- **Management:** Propylene glycol (oral or IV dextrose), adequate energy intake post-freshening, monitoring BHB in transition herd.

**Milk Fever (Hypocalcemia):** Acute drop in serum calcium around parturition. Total serum calcium <6.5 mg/dL is clinical. Ionized calcium (preferred) <2 mg/dL.
- **Clinical signs:** Recumbency, inability to rise ("downer cow"), bloat, tachycardia, hypothermia.
- **Management:** IV calcium (slow infusion; risk of cardiac arrhythmias). Oral calcium post-recovery. Dietary management in late pregnancy (DCAD—dietary cation-anion difference—management).
- **Prevention:** Anionic salts (low DCAD) in 3 weeks pre-partum to enhance urinary calcium conservation.

**Grass Tetany (Hypomagnesemia):** Acute magnesium deficiency. Serum magnesium <1.4 mg/dL is diagnostic.
- **Risk factors:** Lush spring grass (high potassium, low magnesium). Lactating cows most susceptible.
- **Clinical signs:** Hyperirritability, muscle tremors, twitching, severe agitation, convulsions, death if untreated.
- **Management:** IV magnesium sulfate (slow infusion). Oral magnesium post-recovery. Prevention: magnesium oxide supplementation (0.04 g/kg/day) in spring grazing.

## Displaced Abomasum (DA)

**Left displacement (LDA):** More common; non-emergent surgically but requires timely correction.
- **Signs:** Reduced milk yield, anorexia, decreased rumen motility, "ping" on left flank percussion (gas-filled abomasum).
- **Diagnosis:** Succussion sounds (fluid shifting), ultrasound, exploratory laparotomy.
- **Surgical approach:** Right flank approach with roll-and-toggle procedure or omentopexy.

**Right displacement (RDA) or volvulus:** Potentially life-threatening; emergency surgery.
- **Signs:** Severe pain, shock, severely reduced or absent rumen sounds.
- **Diagnosis:** Rectal palpation (abomasum palpable on right side), ultrasound.
- **Surgical approach:** Right flank approach; abomasum decompression and repositioning or resection if necrotic.

## Johne's Disease (Paratuberculosis)

**Causative agent:** Mycobacterium avium subspecies paratuberculosis (MAP). Enzootic in many dairy and beef herds; impacts herd economics and welfare.

**Transmission:** Fecal-oral; primarily in young stock consuming contaminated colostrum/milk or environmental feces. Clinical disease manifests years post-infection (2-10 years).

**Clinical signs:** Chronic, progressive wasting despite good appetite. Diarrhea (may be subclinical). Weight loss, poor milk yield, eventual death.

**Diagnosis:** Fecal culture (gold standard but slow, 4-8 weeks), PCR (faster), ELISA (serum antibody). Fecal shedding begins before serology is positive. No cure.

**Management:** Biosecurity (test-and-removal programs), colostrum management (pasteurize or test), separate young stock, environmental cleaning. MAP persists in soil/pasture for years; rotation helps.

## Withdrawal Times and FARAD

**FARAD (Food Animal Residue Avoidance Databank):** Gold standard for drug withdrawal times and safe use intervals in food-producing animals. **Required for legally defensible practice.**

**General principles:**
- **Milk:** Most stringent (hours to days) due to antibiotic/food safety concerns.
- **Meat:** Species and tissue dependent (hours to weeks). Residues accumulate in fat; lipophilic drugs have longer withdrawals.
- **Extra-label use:** Requires veterinary oversight and AAFCO compliance. Off-label withdrawal times are client's responsibility; standard labels used if no explicit withdrawal specified.
- **Always verify with FARAD** (farad.org) before dispensing to food-producing animals.

## Breed Predispositions

- **Dairy cattle (Holstein):** Increased susceptibility to DA, ketosis, milk fever (large frame size, high production).
- **Beef cattle (Angus, Herefords):** Calving difficulty (dystocia) in females under 2 years. Bloat risk on lush legume pasture.
- **Sheep:** Pregnancy toxemia (ketosis in late pregnancy); higher magnesium needs than cattle.
- **Goats:** Urinary calculi in males (wethers); copper sensitivity in some breeds; high growth/lactation demands.

## Limitations

- Rumen microbial analysis requires specialized labs; routine practice relies on clinical signs and pH measurement.
- Metabolic disease diagnosis is clinical + lab confirmation; no single test is definitive.
- FARAD withdrawal times assume compliance with label dose/route; unauthorized use voids legal protection.
- Johne's disease screening tests have imperfect sensitivity; negative results do not rule out MAP infection.
- This skill provides clinical frameworks, not herd-level business recommendations; work with production medicine specialists for optimization.