Case report

Jejunal Hemorrhage Syndrome of dairy cattle

Abstract

In the last three years, veterinary practitioners from Iowa, Minnesota and Wisconsin, USA, have reported, with increased frequency, a peracute, segmental haemorrhagic enteritis in mature dairy cattle. Based on these reports, clinicians at Iowa State University have begun to suspect Jejunal Haemorrhage Syndrome (JHS) as a new emerging disease syndrome. The morbidity rate for this disease has been sporadic, and mortality approaches 85-100% due to the peracute nature and severity of this disease. There are frequently no prodromal signs and the mature cow is found dead, or an individual cow is found down and in systemic collapse. Clinical signs include sternal recumbency, diaphoresis, enophthalmia and signs of shock due to occlusion of the small intestine. Ballotment of the standing cow in the lower right abdominal area can elicit a pronounced fluid slosh, due to backup of ingesta and fluid behind the occlusive lesion. Signs of abdominal pain include bruxism, vocalization, treading and kicking at the abdomen. At necropsy, segmental lesions localized to the jejunum are observed. These areas consist of frank haemorrhage and immediate clotting, forming a functional occlusion of the small intestinal lumen. Necrosis of the lumen may or may not be apparent. In April 1999, the Veterinary Diagnostic and Production Animal Medicine Department at the Iowa State University College of Veterinary Medicine was asked by a northeastern Iowa veterinarian to investigate recurring sporadic peracute death losses. Examination of affected cattle, production records, rations and post-mortem results led investigators to conclude that a variant of Clostridium perfringens, specifically type A, should be considered further as a possible cause of this disease syndrome. Recommendations for investigation of a problem herd are discussed. Specific items of increased risk in this particular herd included an association between increased milk production and death loss, an increased incidence rate associated with higher soluble carbohydrate feeding rates, and disease following re-introduction of culture-positive alfalfa haylage. There appear to be gut motility aberrations, evidenced by intussusceptions in tandem with Jejunal Haemorrhage Syndrome lesions.