What is Downer Cow Syndrome

What is Downer Cow Syndrome         

• Cox (1982) proposed that downer cow was any cow which was down in sternal recumbency for more than 24 hours without evidence of a systemic involvement.
• Blood et al. (1983) defined the downer cow syndrome is a condition occurring following parturient paresis, characterised clinically by prolonged recumbency even after 2 successive infusions with calcium.
• Allen and Davies (1981) suggested that downer syndrome occurred as a result of one of the combination of the factors like milk fever, hypophosphataemia, fat cow syndrome, excessive protein intake, Vitamin E & Selenium deficiency, recumbency due to trauma and malnutrition.
• Jonsson (1983) suggested that downer syndrome occurred as a result of one of combination of the factors like muscular injuries, nerve injuries, persistent hypocalcaemia, persistent hypophosphataemia, myocardosis, hepatosis, septic mastitis and other factors.
• Jonsson (1983) also observed that 65% cases of injuries of muscles, nerves and hind limbs terminate as downers.
• Fenwick (1969) observed that there was definite increase in number of downers and deaths with decreasing potassium concentration.  

One of the most challenging problem for Veterinarians is management of recumbent/ downer animals. Prolonged recumbency due to inadequately treated and unresponsive hypocalcaemia is one of the common causes of downers syndrome. 

Clinical Signs

• The cow may show  bright and alert with normal appetite, defecation and urination. Milk production  may be  reduced.
• All the physiological and clinical parameter  may be  within normal range at the time of presentation such as body temperature 100.5 F, heart rate 56 per minute, pulse rate 66 per minute and respiratory rate 21 breaths per minute.
• Cow may show  in sternal recumbency and frequently try  to get up. She may  unable to put up weight on hindquarters.
• Cow may  able to stand with some assistance by lifting the tail and head or with the help of wooden sticks below thorax and abdomen with precaution to avoid any injury to udder. 
• All the limbs may be  checked for sensitivity to pain by pricking with a needle to rule out nerve paralysis. All the fore limbs and hind limbs  may show sensitivity to pain.

Prevention

• excellent nutritional management
• Adequate bedding in calving area, stalls
• prompt treatment of milk fever to avoid prolonged recumbency
• Monitor treated cows closely for 24-48 hrs. post-treatment
• Prevent trauma
• Supervise parturition & provide appropriate assistance to avoid prolonged calving 

Prognosis

Prognosis frequently guarded & depends on:

•  Cause of recumbency

•  Duration of recumbency

Prognosis mostly found is

• Mortality 20-67%

• Many die within 7-10 days due to sepsis or shock

• 33 % recover between 3-30 days

• May continue treatment if no obvious physical abnormalities, bright, eating, and continued attempts to rise.

Helping the cow rise:

        On every day of the recumbency, an attempt should be made to bring the cow to its feet. Several simple but effective techniques can be tried.

         In one method, the clinician stands with feet pressed under the cow at a point below the scapulohumeral joint. A sharp blow is delivered by driving the knees into the muscle mass below and caudal to the scapula. This method must not be used on the thoracic wall unprotected by the muscle mass to avoid fracturing the ribs. If the animal struggles to rise, an assistant should grasp the root of the tailhead with both hands and lift. Lifting on any other part of the tail may cause damage.

         The value of hip clamps is controversial. Their proper use requires experience, skill, and a delicate touch. Continual use causes trauma and pain that is counterproductive. The forelimbs support 60 per cent of a cow’s weight and, therefore, the use of a canvas sling under the sternum is almost mandatory for consistent success.

Even if the cow does not stand, the lifted position provides an opportunity to manipulate the limbs, auscultate for crepitation, and perform vaginal and rectal examinations.

Supporting the downer cow:

           It is vital that recumbent cows be provided with clean water at all times. A shallow rubber feed bowl prevents spillage. If the cow does not drink, she must be given fluid therapy either by drench or parenterally. Every effort must be made to roll the cow from one side onto the other every 3 hr. If this is not done, the weight of the cow results in ischemia in the muscles of the hindlimb. This pathology precedes various myopathies and may precipitate the compartment syndrome.

            Protection from the elements is essential. Rain and wind can reduce body temperature considerably and worsen shock if present. A windbreak of straw bales is vital. Straw bedding should be provided to help insulate the cow from the ground. A recumbent cow does not require a warm environment; however, in a cold environment, an inactive animal can gradually succumb to hypothermia.

   

      

                 The downer cows most difficult to treat are those that do not try to eat. A cow that salivates on its feed will not eat it later. Rather than being offered large amounts of feed, the cow should be tempted with sweet hay. This should be cleared away every 30 min if not accepted. Placing bitter-tasting weeds such as ivy or dandelion in the mouth may provoke salivation and an interest in eating. Lettuce and cabbage leaves are accepted by some cows. In extreme cases, the cow can be drenched with rumen contents. Sometimes drenching with a thin gruel to which powdered ginger and/or gentian has been added can be helpful.