BAU

1. Definition
A ‘Downer Cow Syndrome’ has been
defined as a cow that has been in sternal
recumbency for more than 24 hours

2. Characteristics
 Recumbent longer than 24 hours
 Usually occurs following parturient paresis
 No detectable specific diagnostic cause
 Animal in sternal recumbency
 Remain recumbent even after two successive treatment with calcium
 Occurs at any time but associated with parturition

3. Etiology
Factors (immediately pre- and post-parturition and at calving)
(1)Metabolic disorders:
 Hypocalcaemia
 Hypomagnesaemia
 Hypokalemia
 Acetonaemia
 Fat cow syndrome
 Hypothermia
 Acidosis and bloat

4. CONTD…
(2)Severe toxaemia:
 Acute coliform mastitis
 Acute septic metritis
 Acute diffuse peritonitis
 Aspiration pneumonia
 Traumatic reticulo-peritonitis
 Rupture of uterus

5. CONTD…
(3)Traumatic injuries:
 Falls on hard surface
 Riding by other cows
 Rupture pelvis
 Fractured femur
 Rupture of the round ligament
 Dislocation of hip
 Rupture of muscle (abductor muscle, gastrocenemius)
 Nerve damage

6. Epidemiology
 Downer cows are most commonly seen in the interval from two days
before to 10 days after parturition
 Downer cows are usually between 5 to 8 years of age which are high
producers
 Many have a history of Milk fever
 An incidence of 21.4 cases per 1000 cows, of these recumbent cows,33%
recovered,23% were slaughtered and 44% died or required euthanasia

7. Pathogenesis
• Prolonged recumbency Compression/pressure damage
Muscles
Biceps femoris Semitendinosus
Semimembranosus Abductor muscle
Local muscle damage
Lead to increase pressure within osteofacial compartment
Internal filling of the compartment with blood or edematous fluid

8. Contd…
A combined effects with external compression obstruction of blood supply
Ischaemia (anoxia)= cell damage and inflammation
Leading to ‘leaky’ blood vessels and post-compressed swelling
Absorption of muscle damaged products in the circulation
Myoglobinuria + Proteinuria + Brown discolored urine +
Extremely high creatine phosphokinase
Indicate muscle damage

9. Contd…
Nerves
Sciatic nerve damage Peroneal nerve damage
Compression against the caudal Compression on the lateral side of
aspect of the femur just distal to the stifle joint where it passes the point
where the sciatic nerve over the proximal end of the
transverses the hip joints fibula
Recumbency Peronial paralysis
Knuckles over the Fetlock when
. attempting to walk
Recumbency

10. Contd…

11. Clinical findings
(1)Alert downer
(a)Normal
 Bright and alert
 Eat and drink moderately
 Rectal temperature
 Heart rate
 Respiration rate
 Defection and urination

12. Contd…
(b)Abnormal
 Sternal recumbency
 Unable to extend limbs to reach a standing position
 Some cows make frequent attempt to rise, resulting in the cow
‘creeping’ or ‘crawling’ along the ground with both hind limbs flexed
and displaced posteriorly- the ‘frog-leg attitude’

13. Contd…
(2)Non-alert downer
 Severely affected
 Do not usually eat or drink
 Lateral recumbency with head drawn back.
 Mucoid faeces with some times spots of blood
With complications-cause death

14. Course
 Variable, depending on the nature and extent of the lesions and
quality of the care
 About 50% downer cows will get up within 4 days
 Prognosis is grave if the cow is recumbent after 7 days
 Death may occur in 48 to 72 hours associated with myocarditis which
may be due to repeated administration of calcium solution

15. Diagnosis
(1)History and characteristic clinical signs
 The clinical sign of recumbency 24 its onset is the basis of diagnosis.
 Occurrence of parturient paresis
 Delayed or incomplete treatment of Milk fever
 Failed to rise within 24 hours following two successive course of
treatment
 Hard and slippery floor

16. Contd…
(2)Clinical examination
 Special examination on the caudal part the spine, including the tail,
the pelvic ring and hind legs
 Rectal examination to detect any abnormalities
 Painful reactions to manipulation, abnormal mobility, lack of motor
and sensory responses or audible crepitation may reveal the site and
nature of the physical injuries responsible for prolonged recumbency

17. Contd…
(3)Biochemical analysis
 Blood minerals and haematological values are within normal range
 Serum Aspirate Aminotranseferase (AST) and Creatininekinase (CPK)
levels are usually elevated and indicate muscle damage. The CPK
activity occurs after 48 hours and then falls rapidly, even though cows
remained recumbent
 A marked proteinuria is usually present 24 hours after the onset of
recumbency
 The urine may be brown because of severe myoglobinuria

18. Contd…
(4)Necropsy changes
 No specific lesions at necropsy
 Haemorrhage and degeneration can be found in the upper hind leg
musculature
 Some have myocarditis

19. Contd…
(5)Differential diagnosis
 Maternal obturator paralysis
 Systemic diseases-Coliform mastitis, Acute diffuse peritonitis,
Ephemeral fever
 Physical injuries-Pelvic and limb fractures, coxofemoral dislocation,
Spinal injuries, rupture of the gastro-cnemius muscle and radial
paralysis

20. Treatment
 The main advice to give is that all cases of recumbency cows should
be treated correctly, sufficiently and promptly
 The basic aim of treatment is to get the cow into her feet
 The treatment should be symptomatic and can be mad on the basis of
biochemical tests and conditions
 There is no specific preferred treatment, although many have been
described
 Cows that show relapse after treatment with calcium alone, a slow
intravenous inj. of a solution containing calcium, magnesium,
phosphorus and dextrose is given while the rate, rhythm and intensity
of heart sounds are carefully monitored

21. Contd…
 Phosphorus containing solution eg. 30g Sodium acid phosphate in 300ml
of water,5% solution 20 to 40 ml or Tonophosphan.20ml should be
administrated intravenously because downer cows have been shown to
have persistent hypophosphatemia
 Tripelennamine hydrochloride @10 to 15 ml should be administrated
intravenously, which appears to act a potent, temporary CNS stimulate
in cattle and is usually given before attempting to get the affected cow
to rise
 It is essential to move downer cows from concrete floors or slippery,
muddy yards before attempting to get them to stand

22. Contd…
 Affected cows should be kept in sternal recumbency, changed from
side to side at least every 3 hours to minimize the degree of ischemic
necrosis and para-analgesia which results from prolonged
recumbency
 Adequate bedding is necessary to protect the bony prominences

23. Prevention
 As there is no single cause of the ‘Downer cow syndrome’ preventive measure
should be aimed at eliminating the risk factors that predispose the cows to
recumbency in the parturient paresis
 The aim is to prevent prolonged recumbency and muscle damage. However it is
believed that most downer cows have been recumbent from parturient paresis
 The time interval between the onset of recumbency and treatment for Milk
fever should be as short as possible
 Treatment of Milk fever must ensure that animals receive sufficient calcium in
time

24. Contd…
 The amount of calcium required to effect a recovery seem to vary at
least 12g of calcium given intravenously may be required to effect a
cure. A solution of 25% Calcium borogluconate contains 10.4g
Ca/500ml
 Under-dosing should be observed closely after treatment for possible
relapse
 Close observation during calving and post calving