Paralytic ileus in 57 cows - symptoms, diagnosis and treatment

Paralytic ileus (PI) also known as functional ileus or adynamic ileus occurs when intestinal motor activity is impaired. Cessation of ingesta passage leads to the accumulation of fluid and gas causing intestinal dilatation. With this type of ileus, intestinal transit is functionally impaired in the absence of a physical obstruction. The present retrospective study describes the diagnosis, treatment and outcome of 57 cows with PI.

Colic occurred in 43.9% of the cows, and intestinal and rumen motility was reduced or absent in 92.9% (52/56) and 82.5% (47/57) of the cows, respectively. Ballottement and/or percussion and simultaneous auscultation on the right were also positive in 82.5% of the cows. Faecal output was minimal or absent in 94.7% (54/57) of the cows, and dilated small intestines and occasionally large intestines were palpated transrectally in 57.1% (32/56). The principal laboratory abnormalities were hypokalaemia (89.4%, 51/57), hypocalcaemia (87.5%, 35/40), hypermagnesaemia (77.5%, 31/40), positive base excess (57.4%, 27/47), acidosis (55.3%, 26/47) and hypercapnia (53.2%, 25/47). Ultrasonography in 50 cows revealed dilated small intestines with reduced or absent motility. Eleven cows had received medical treatment alone, 45 had undergone right flank laparotomy and one was euthanized immediately after clinical examination. Fifty-four (94.7%) cows were discharged and three (5.3%) were euthanized.

Paralytic and mechanical ileus are difficult to differentiate using non-invasive methods, which impacts treatment decisions. The prognosis of cattle with PI is good with adequate treatment.