Sick doe..vet and I stumped

[Tapsmom]

Thank you Rammy. I have been second guessing myself again since yesterday morning.

 

[Rammy]

Dont do that. You went above and beyond doing everything you could. I know how you feel. Trust me. Ive BTDT many times. You gave her more time than anyone else would have and as good of quality of life as possible. She was one lucky girl.

 

[greybeard]

The preliminary results already came over. But they are "greek": to me. I am waiting to hear back from my vet for clarification. I think it is telling me she had an impaction in her Abomasum..but I am not sure it clarifies what it was.. It is written in very medical terminology.
This was their leading line:
Can anyone translate?

I will give it a shot, with my words underlined just to make it easy to read, but will preface it with this. I very much doubt you did anything wrong, and I very much believe the vet did all he/she could do as well. They, like us, are just human, and when you get up into the ruminants and above mammals, we are all very very complex biological life forms.

"
MORPHOLOGIC DIAGNOSIS:
ABOMASUM: severe impaction...

It was overly full of partially digested foodstuff...this usually means it was full of pelleted feed but not always, it can be impacted with undigested forage. (more on that later)

RUMEN: severe tympany with frothy ruminal contents

that means a gas filled rumen..bloat. The word tympany is used to describe the drum like sound a Dr or vet would listen for when trying to determine whether an organ or cavity is filled with air, liquid or solids.

SMALL INTESTINE: segmental transmural thinning and abnormal liquid contents

The walls of the small intestine were thinner than they should be. Transmural in this context usually means the thinning is across the entire small intestine, but she apparently means it was found only in segments of the organ.

BODY AS WHOLE: 1) thin body condition; 2) moderate anemia; 3) serous atrophy of fat

Absence or degraded fat..the fat has broken down into a semi liquid (serum) state. she didn't give a location so I would assume 'everywhere'. Not a surprising find at all considering the condition of the digestive system. Fat atrophy in humans, other mammals, and livestock is almost always nutritionally caused but that doesn't mean under-fed. Plenty to eat but other problems caused the nutrition not to be able to be utilized.

ABDOMINAL CAVITY: moderate sanguinous peritoneal effusion

Sanguinous means bloody/full of blood/or allowing blood to pass, tho in some instances, it can also mean allowing any other fluid to pass. In this case, I suspect the vet meant there was blood present in the abdominal cavity...not a huge amount, not trace amounts, but in between..moderate amounts. Peritoneal effusion means a presence of fluid in the peritoneum (membrane surrounding the abdominal cavity) where there shouldn't be but a trace amount. A trace amount, because there is always some fluid there, a very thin but viscous fluid that lubricates to keep organs from chafing as they are moving around. IOW, I believe the vet means there was moderate volumes of blood that had found it's way into the abdominal cavity

COMMENTS:
The most significant findings on gross examination of this goat were ruminal tympany

gas in the rumen..bloat

and abomasal impaction.

covered that but I'll post a picture of what is commonly found in the impacted organ

No physical cause for pyloric stenosis was observed. "

This is a little puzzling but may be illuminating as well. One word at a time. "Stenosis' usually means narrowing or even closed. Pyloric refers to a sphincter type muscle that is between the abomasum and the small intestine. Most mammals have one and in humans that little muscle can cause absolute misery if it doesn't open correctly or if it stays open and doesn't seal off. If it doesn't close off, it can allow intestinal gases and very strong digestive fluids back up into the stomach, or in this case, the abomasum. Kid goats (and calves) don't have a fully developed pyloric sphincter at birth, or even the part that is between the abomasum and the small intestine...the duodenum. Those begin to fully develop within a few weeks of birth as the younguns don't need them while only on milk.
In older calves and grown bovines, a leaking pyloric sphincter can cause gas pressure from the large and small intestines to back up thru the doudenum and into the pyloric sphincter. This in itself, can prevent material in the abomasum from traveling on out into the small intestine and a blockage can begin in the abomasum. Inversely, IF the pyloric sphincter opening is congenitally too small or doesn't open, again, the abomasum is blocked.

Now, the vet didn't actually say the pyloric opening was too small. She/he just stated there was no observed CAUSE for it. From that, I infer (so shoot me) that there WAS stenosis, but the cause of the stenosis wasn't apparent.


I relabeled the aforementioned parts because this image isn't very clear:

 

[B&B Happy goats]

Nice explanation @greybeard , well done

 

[Tapsmom]

Thank you everyone. Grey beard that was VERY helpful. I just spoke to my vet a little while ago and she translated for me as well. Her take was that it was a neurological cause. I.e for some reason the "pyhyloric spincter" was not allowing food to move to and from her abomasum. This resulted in the blockage and everything else snowballed. Thus there was absolutely nothing any of us could have done to prevent ..or heal her. She said she has never seen it in a goat but it can occur in cows. Even with an ultrasound it would probably not have been discovered. The blockage may have been found, but since the blockage was a result and not the cause of her problems, it would probably not have helped.
Now that we have some results, she is going to further research it for me.
I do apologize if I am not explaining this clearly.

 

[greybeard]

Her take was that it was a neurological cause. I.e for some reason the "pyhyloric spincter" was not allowing food to move to and from her abomasum. This resulted in the blockage and everything else snowballed. Thus there was absolutely nothing any of us could have done to prevent ..or heal her. She said she has never seen it in a goat but it can occur in cows. Even with an ultrasound it would probably not have been discovered. The blockage may have been found, but since the blockage was a result and not the cause of her problems, it would probably not have helped.

Neurological anomaly could certainly be the cause, as relaxing of the pyloric sphincter is controlled via pathways of the abdominal ganglia. There is also a hormone called Cholecystokinin (CCK) that is responsible for keeping the sphincter muscle contracted. The bottom line is, there could be dozens of reasons why the muscle doesn't relax.

It can sometimes be corrected and usually is in humans, by surgery. They go in, and cut a small incision in part of the lining around that muscle, which allows the muscle to relax as it bulges out the incision. (similar to what happens when a hernia occurs)

[an aside that we might want to keep in mind]
It's sometimes called HPS which stands for Hypertrophic Pyloric Stenisis.
Its happens just by chance most of the time but there is also a lot of evidence in most mammals, that problems with thickening of this muscle can also be genetic..an inherited trait.
In humans, enough research has been done to know what the risk factors are.

Epidemiology & Demographics

•
Incidence 2 to 4 cases per 1000 live births.

•
4:1 male‐to‐female predominance.

•
More than 90% of cases are sporadic.

•
Between 7% and 10% of cases are familial.

○
A mother who had HPS as an infant transmits the risk of developing HPS to her offspring (19% for boys and 7% for girls).

○
A father who had HPS as an infant transmits a lower risk of developing HPS to his offspring (5% for boys and 2.5% for girls).

○
Siblings of patients with HPS are 15 times more likely to have HPS than children without any affected siblings. First‐born males are not necessarily more frequently afflicted than other siblings.

And I think that's all I care to speak...already gone way beyond my paygrade...

 

[Tapsmom]

Thank you so much Greybeard! I was as concerned about the possibility of it being genetic. We have 2 of her daughters, her son and her twin brother. This situation has really stunk, but as long as we can learn from it, all is not lost.
You have all been wonderful and your support means more than you know.
I actually did ask my vet about a possible genetic link so I am glad you brought that up. Your knowledge is amazing!

 

[greybeard]

Thank you so much Greybeard! I was as concerned about the possibility of it being genetic. We have 2 of her daughters, her son and her twin brother. This situation has really stunk, but as long as we can learn from it, all is not lost.
You have all been wonderful and your support means more than you know.
I actually did ask my vet about a possible genetic link so I am glad you brought that up. Your knowledge is amazing!

Perhaps it's knowledge now........yesterday, it was mostly just research. I do a LOT of reading, but I don't consider anything knowledge until it is used.
And, on one board or another, I had read previously, of a member that had problems with the pyloric sphincter so I knew how it worked in humans. I've been blessed/cursed with a very good memory and an insatiable curiosity.

 

[HomesteaderWife]

I am so sorry to hear your sweet goat lost her battle. Prayers for you and your family losing her, but I give you so SO much credit for doing all you could to improve her condition and learn what was wrong.

 

[Tapsmom]

Thank you very much. There is a big hole in our herd at the moment. She was quite the presence! But we do have her brother and a few of her offspring.