A case report of multiple complex digestive system diseases in a cow in the dry period

Simultaneous digestive and metabolic disorders in pregnant dairy cows present significant diagnostic challenges, especially during the dry period when physiological adaptations obscure clinical signs. The concurrent occurrence of left displaced abomasum (LDA), liver abscessation, and traumatic reticuloperitonitis (TRP) is uncommon and highlights the diagnostic challenges associated with non-specific clinical signs during the dry period.

A six-year-old Holstein cow, in her fourth lactation and at 276 days of gestation, presented with lethargy, diarrhea, and reduced feed intake. Clinical examination confirmed LDA, while blood biochemistry indicated hepatic dysfunction with elevated gamma-glutamyl transferase (GGT) and aspartate aminotransferase (AST) activities. A right-sided omentopexy was performed; however, the cow's condition deteriorated, requiring an emergency cesarean section. Despite intervention, the animal failed to improve and was euthanized. Postmortem examination revealed a large hepatic abscess (21 cm in diameter) containing approximately 5 L of purulent material, TRP caused by a 4-cm nail embedded in the reticulum, and acute abomasitis. The coexistence of these conditions suggests a possible association between traumatic, inflammatory, and metabolic processes; however, the exact sequence of disease development could not be definitively established.

This case highlights the diagnostic complexity of concurrent metabolic and infectious disorders in late-gestation dairy cows. The findings emphasize the importance of early recognition, careful interpretation of clinical and laboratory findings, and comprehensive diagnostic evaluation in dry cows, where physiological adaptations and reduced monitoring intensity may delay detection of severe underlying disease.