Metabolic Disease: Downer Cow Syndrome Definition
Metabolic Disease: Downer Cow Syndrome Definition
Metabolic Disease: Downer Cow Syndrome Definition
Metabolic Disease
Downer cow syndrome
Definition:
*The term “downer cow” is frequently applied to a mature dairy cow that is still recumbent 3
hr. after calving despite treatment for hypocalcemia.
*Downer cows that are able to actively crawl are often referred to as creepers.
*The term downer cow first appeared in the veterinary literature in the 1950s and referred to
cattle that were too injured, weak, or sick to stand or walk without assistance.
*A further classification of downer cows into mentally alert, nonambulatory cattle that are
able to maintain themselves in sternal recumbency, so-called alert downer cows, and cows
with moderate to severe mental obtundation and abnormal vital signs that frequently are
unable to maintain sternal recumbency, the so-called non-alert downer cows, was proposed.
Etiology
*Alert downer cows are in most cases recumbent because of musculoskeletal or neurologic
injuries such as:
1- lesions of the sciatic or obturator nerve secondary to dystocia (calving paralysis).
2- fractures of long bones or the pelvis.
3- hip luxation, or muscle injury as a result of primary trauma or secondary to prolonged
recumbency.
4-systemic disease affecting mental status and general attitude, such as periparturient
hypocalcemia, septicemia, hypovolemia, diffuse peritonitis, and severe hepatic lipidosis.
5-Myopathies and neuropathies develop in nonambulatory cows secondary to prolonged
periods of recumbency.
6-Ischemic myopathy affecting the large muscles of the pelvic limbs and injuries to the tissues
around the hip joint and of the obturator muscles are common in cows that do not fully
recover and stand.
7-Injuries to the musculoskeletal system are also common as a result of cows “spreadeagling”
their hind limbs if they are unsteady during parturition or forced to stand or walk on a
slippery floor immediately before or following parturition.
Epidemiology
*The disease occurs most commonly within the first 2 or 3 days after calving in high-
producing dairy cows immediately following milk fever.
* Other debilitating conditions of periparturient cows that can be associated with persistent
recumbency include acute coliform mastitis, septic metritis, and acute rumen acidosis (grain
overload).
* Environmental a n d management risk factors A slippery ground surface is a major risk
factor. Cattle which must walk across slippery floors, especially at the time of calving, may
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slip and fall and injure the large muscles of the pelvic limbs, resulting in an inability to
stand.
Pathogenesis
*In most cases downer-cow syndrome is a complication of an unrelated primary problem
causing muscle weakness or persistent recumbency.
*Primary conditions that can lead to downer-cow syndrome have been grouped into four
major categories: metabolic disorders (e.g., hypocalcemia, hypokalemia), acute systemic
illness (e.g., coliform mastitis, toxic metritis), musculoskeletal disorders (e.g., fractures,
joint luxation), and undetermined causes.
*Prolonged recumbency will result in secondary damage from excessive pressure on limbs
squeezed between the body and the ground or from struggling to get up.
*Impaired blood supply to muscles and nerves and ensuing tissue hypoxia will add to the
direct damage from mechanical compression.
*-Proteinuria and in some severe cases myoglobinuria occur between 12 and 36 h after the
onset of prolonged recumbency
*-Acute focal myocarditis may occur in about 10% of cases resulting in tachycardia,
arrhythmia, and the unfavorable response to I.V calcium.
*-Prolonged recumbency can result in additional complications such as acute mastitis and
decubitus ulcers.
*- Ischemia due to prolonged recumbency associated with milk fever, may increase the cell
membrane permeability of muscle fibers and allow the loss of potassium from the cell; this
in turn causes the myotonia.
Clinical findings
*In the typical case, affected cows either make no effort or are unable to stand following
treatment for parturient paresis.
*Affected cows are usually bright and alert with good or only mildly depressed feed intake.
*The temperature is normal and the heart rate may be normal or elevated.
*Defecation and urination are normal, but proteinuria is common and may indicate extensive
muscle damage if marked.
*Some affected cows may make no effort to stand. Others will make frequent attempts to
stand but are unable to fully extend their pelvic limbs and lift their hindquarters more than
20 to 30 cm from the ground.
*In some cases, the hind limbs are extended on each side of the cow and reach up to the
elbows on each side.
*tendency to lie in lateral recumbency with the head drawn back. When placed and propped
up in sternal recumbency, these cows appear almost normal, but when they are left alone,
they revert to the position of lateral recumbency within a short period of time.
*Complications in downer-cow syndrome are common and often result in death or the need
for euthanasia. Coliform mastitis, decubitus ulceration, especially over the prominences of
the hock and elbow joint, and traumatic injuries around the tuber coxae caused by the hip
slings are common.
*The course of the disease is variable and about 50% of downer cows will stand within 4 days
or less if cared for properly.
*The prognosis is poor for those that are still recumbent after 7 days although some affected
cows have been down for 10 to 14 days and subsequently stood up and recovered.
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*Death may occur in 48 to 72 hours following the onset and is usually associated with
myocarditis.
Clinical pathology
* serum calcium and glucose concentrations are frequently within the normal range.
* phosphorus and potassium concentrations may be decreased in cows with depressed feed
intake.
* The serum activity of CK and AST are usually markedly elevated
* There may be moderate ketonuria and marked proteinuria is usually evident by 18-24 h after
* the urine may be brown and turbid because of severe myoglobinuria
Necropsy finding
*Hemorrhages and edema of the skin of traumatic origin are common.
* hemorrhages and degeneration of the medial thigh muscles. Hemorrhages around the hip
joint.
* Local areas of ischemic necrosis of the musculature (gracilis, pectineus, and adductor
muscles) occur at the anterior edge of the pelvic symphysis.
Differential diagnosis
*Differential diagnoses for alert downer cows:
• Hypocalcemia
• Calving paralysis
• Fractures of bone or pelvis
• Hip luxation
• Botulism
*Differential diagnoses for non-alert downer cows:
• Hypocalcemia
• Hepatic lipidosis/puerperal liver coma
• Coliform mastitis
• Toxic metritis
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quantities of water, most cows will attempt to stand with some difficulty and assistance
within 24hours.
* Cows should be milked normally and the udder kept clean by washing with germicide soap.
* If the cow makes an effort to stand on her own or by some coaxing such as a gentle nudge in
the ribs, she should be assisted to stand by ensuring a good nonslip ground surface.
* Several different kinds of cow-lifting devices have been used to assist downer cows to
stand. Hip lifters, which fit and tighten over the tuber coxae, and body slings such as
harnesses are designed to fit around the abdomen and thorax of the animal.
* If the animal bears weight on all four legs, she should be allowed to stand with the aid of the
device for 20 to 30 minutes and then lowered
down. This procedure can be repeated once or twice a day, provided the cow is able to support
her own weight while standing.
* More recently, water flotation tanks have been used for the management of nonambulatory
cows. Proposed devices consist of a watertight metal tub with inside dimensions of
approximately 234 cm long, 109 cm wide, and 130 cm high.
Control
*Close monitoring of periparturient cows for signs of milk fever Immediate and adequate
treatment of cows with milk fever
*Provide comfortable calving area with soft bedding and non-slippery flooring
*Avoid moving pregnant cows too late to calving area
*Avoid moving fresh cows too early out of calving pen
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