Caecal dilation

1. Caecal dilatation and torsion
• Dilatation and/or torsion of the caecum
involves distension, displacement and torsion
of the caecum including the spiral colon.
– Free end of caecum in cattle is devoid of
mesentery and thus prone to rotation. Dilatation
may preceed or follow the torsion.
– Condition is more common in dairy cows following
parturition
– In buffaloes caecum is not predisposed to torsion
because blind end is not devoid of mesentery

2. Etiology
• Excessive feeding of grains
• Results in production of increased
concentration volatile fatty acids (VFA )
• Gas due to fermentation of undigested grains
• Volatile Fatty acids cause hypomotility or
atony of the caecum resulting in accumulation
of gas and ingesta with subsequent dilatation
and possible torsion of the organ.

3. Clinical signs
• Simple dilatation takes gradual course
• Onset may be acute if torsion occurs
• Clinical signs – similar to bowel obstruction
• Abdominal pain – early course of disease
• Rapid loss of appetite
• Cessation of defecation
• Dehydration

4. • Temperature, pulse and respiration rate – normal
• Subnormal temperature, tachycardia – in advanced cases of
caecal torsion
• Hypo motility or atony of rumen
• Distended right paralumbar fossa
• Tympanic resonance of right paralumbar fossa on
auscultation and percussion
• On rectal palpation – a long cylindrical movable gas filled
structure in pelvic inlet or just close to pelvic bone
• Rupture of distended caecum during transportation of
animal is a possibility and if it occurs death is sudden

5. Diagnosis
• Based on
– History
– Clinical signs
– Auscultation and percussion
– Rectal palpation
– Right flank laparotomy
– biochemistry
– Hypochloremic, hypokalemic, metabolic alkolosis –
– Haemo concentration and azotaemia – similar in bowel obstruction
– Auscultation and percussion of right flank
– Smaller resonant area and more caudal in case of caecal dilatation (in
case of right side displacement of the abomasum - more cranial)

8. • Conservative treatment – when animal is in
good condition
• Administration of parasynpathomimetic drugs
– (Neostigmine)
• Total dose of 12.5 – 2.5 mg s/c for every 3-4
hours for a period of 2-3 days
• A continuous drip of neostigmine (200 mg/10l
normal saline)
• Saline purgatives alone or with liquid paraffin

9. Surgical treatment
• Caecotomy
– Right flank laporotomy in standing position
– Exteriorise the free end of caecum
– Milk out the caecal contents following caecotomy
– Clean the caecal edges with normal saline
– Suture with absorbable suture with Cushing pattern
followed by Lembert’s
– If torsion is there, correction should be made
– Reposition of the caecum into abdominal cavity
– Laparotomy wound is closed in a routine manner

10. Typhelectomy
– In cases where the caecum is devitalized and necrotic,
resection is indicated
– After exteriorization of caecum through right flank
– Intestinal clamps on the distal end of the ileum and
proximal end of the colon should be placed.
– Blood vessels supplying the caecum should be dorsally
ligated and severed
– The necrosed caecum in resected out and cut edges of
ileum and colon are anastomosed by using synthetic
absorbable suture material
– Close the laporotomy incision in a routine manner
– Partial resection is sufficient if only a part of caecum is
necrosed

11. Post operative care
• Administration of broad spectrum antibiotics
• Adequate fluid therapy
• Prognosis is good following surgery