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PAPERS
Ultrasonographic evaluation of reticular
motility in 144 cattle with vagal
indigestion
U. Braun, S. Rauch, M. Hässig
The reticular motility in 144 cattle with vagal
indigestion was evaluated by ultrasonography; 97 had
proximal functional stenosis (reticulo-omasal stenosis)
and 47 had distal functional stenosis (pyloric stenosis).
A 3·5 MHz linear transducer was used to measure
the frequency, amplitude, duration and speed of the
reticular contractions per three minutes while the
animals were standing and unsedated. The mean (sd)
number of contractions per three minutes was 4·3
(2·09) with a range from 0 to 12; nine of the cattle had
one or two contractions, 17 had three contractions,
59 had four or five contractions, 37 had more than
five contractions and 12 had reticular atony. The
cattle with proximal functional stenosis had 4·6 (2·01)
contractions per three minutes, significantly more
(P<0·05) than those with distal functional stenosis
(3·6 [2·16]). The position, contour and size of the
reticulum, the amplitude and speed of the contractions
and the area surrounding the reticulum did not differ
significantly between the two groups.
VAGAL indigestion in cattle, also referred to as Hoflund’s syndrome, is
characterised by impaired emptying of the forestomach, the abomasum,
or both; its causes and clinical signs have been described by Dirksen
(2002) and Radostits and others (2007). There are two main types of
vagal indigestion: proximal functional stenosis between the reticulum
and omasum, and distal functional stenosis between the abomasum and
duodenum. Proximal functional stenosis is also called reticulo-omasal
stenosis (Kuiper and Breukink 1986) or failure of omasal transport
(Whitlock 1980, Fubini and others 1989), and another term for distal
functional stenosis is pyloric stenosis. Affected animals gradually lose
weight, their appetite declines and their abdomen becomes distended,
Veterinary Record (2009) 164, 11-13
U. Braun, DrMedVet, E-mail for correspondence:
S. Rauch, DrMedVet, ubraun@vetclinics.uzh.ch
M. Hässig, DrMedVet,
Department of Farm Animals,
University of Zurich,
Winterthurerstrasse 260,
CH-8057 Zurich, Switzerland
causing the typical ‘papple’ (pear plus apple) contour as viewed from
behind. The rumen becomes distended and has an L-shape on transrectal
palpation. Ruminal motility may be normal, decreased or increased.
Recurring tympany is common. There is reduced faecal output and the
faeces may contain undigested material. Other common findings include
bradycardia and markedly reduced or absent rumination. Rectal temper-
ature is normal or slightly below normal. Conventional treatments do
not usually resolve the disorder. Differential diagnoses include chronic
traumatic reticuloperitonitis, straw or sand impaction of the abomasum,
pyloric obstruction by a phytobezoar, abomasal ulcer and omasal impac-
tion (Radostits and others 2007).
Many of the changes associated with vagal indigestion have not been
well characterised; one example is reticular motility. Reticular motility,
measured with pressure gauges, has been described in detail in healthy
cows (Sellers and Stevens 1966, Constable and others 1990), and ultra-
sonography has been used to make a visual assessment of the frequency,
duration, amplitude and speed of reticular contractions (Götz 1992,
Braun and Götz 1994). Recent ultrasonographic studies have shown
that reticular motility was different in cows while they were at rest, eat-
ing, ruminating and under stress (Rauch 2007, Braun and Rauch 2008).
The reticulum and its motility have also been described in cows with
traumatic reticuloperitonitis and reticular abscesses (Braun and others
1993, 1998). The aim of the present study was to assess the reticular
motility of cattle with vagal indigestion by ultrasonography.
Materials and methods
A total of 144 cattle with vagal indigestion were studied. Their clini-
cal, haematological and biochemical characteristics have been described
by Rauch (2007). The clinical findings were similar to those described
by Dirksen (2002) and Radostits and others (2007). The postmortem
findings in 120 of them have been described in detail by Rauch (2007).
There were 142 females and two males, and there were 100 Swiss
Braunvieh, 21 Holstein-Friesian, 19 Simmental and four crossbred cat-
tle. They ranged in age from 13 weeks to 13 years, with a mean (sd) of
4·6 (2·39) years. The criteria used to differentiate proximal from distal
functional stenosis were the clinical signs and the chloride concentra-
tion of ruminal fluid (Kuiper and Breukink 1986). Proximal functional
stenosis (reticulo-omasal stenosis) was diagnosed in 97 animals that had
the characteristic clinical signs and a rumen chloride concentration of
less than 30 mmol/l. Distal functional stenosis (pyloric stenosis) was
diagnosed in 47 cattle with the typical clinical signs and a rumen chlo-
ride concentration of more than 30 mmol/l.
Ultrasonographic examination
The ultrasonographic examinations were carried out while the animals
were standing and unsedated. A 3·5 MHz linear transducer was used
as described by Götz (1992), Braun and Götz (1994) Braun and others
(1998) and Braun (2003). The outer contour of the reticulum was assessed
first. Echogenic lesions with or without a central hypoechogenic area were
recorded. The numbers of reticular contractions per three minutes were
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PAPERS

35
TABLE 1: Ultrasonographic findings in 97 cattle with proximal Proximal functional stenosis
functional stenosis (PFS) (reticulo-omasal stenosis) and 47 cattle with Distal functional stenosis
30
distal functional stenosis (DFS) (pyloric stenosis)
25

Percentage of cows
Number of cattle (percentage)
Variable Total PFS DFS
20
Position of reticulum relative to peritoneum
Adjacent 129 (89·6) 91 (93·8) 38 (80·9) 15
Displaced 15 (10·4) 6 (6·2) 9 (19·1)
Size of reticulum 10
Normal 110 (76·4) 73 (75·3) 37 (78·7)
Enlarged 29 (20·1) 22 (22·7) 7 (14·9) 5
Not assessed 5 (3·5) 2 (2·0) 3 (6·4)
Contour of reticulum 0
Smooth 122 (84·6) 83 (85·6) 39 (83·0) 0 1 2 3 4 5 6 7 8 12
Irregular 1 (0·7) 0 (0·0) 1 (2·1) Number of contractions per three minutes
Adhesions 8 (5·6) 6 (6·2) 2 (4·3)
Three layers 7 (4·9) 6 (6·2) 1 (2·1)
FIG 1: Percentages of 97 cattle with proximal functional stenosis
Not assessed 6 (4·2) 2 (2·0) 4 (8·5) (reticulo-omasal stenosis) and 47 cattle with distal functional
Number of contractions per 3 minutes* stenosis (pyloric stenosis) that had different numbers of reticular
Mean (sd) 4·3 (2·09) 4·6 (2·01) 3·6 (2·16) contractions per three minutes
0 12 (8·3) 6 (6·2) 6 (12·8)
1-2 9 (6·3) 3 (3·1) 6 (12·8)
3-4 54 (37·5) 41 (42·3) 13 (27·7) abdominal wall in 15 (Table 1). The size of the reticulum was normal
5-6 45 (31·3) 33 (34·0) 12 (25·5) in 110, enlarged in 29 and could not be assessed in five. The reticular
7-12 14 (9·7) 12 (12·4) 2 (4·3)
contour was smooth in 122 animals and irregular in one. Fibrinous adhe-
Not assessed 10 (6·9) 2 (2·1) 8 (17·0)
Reticular contraction sions were observed on the reticulum of eight of the cattle, and in seven
Biphasic complete 96 (66·6) 68 (70·1) 28 (59·6) animals the reticular wall appeared as three distinct layers. The reticular
Biphasic incomplete 26 (18·1) 19 (19·6) 7 (14·9) contour could not be assessed in six cattle.
Monophasic 2 (1·4) 2 (2·0) 0 (0·0) In the 134 cattle in which the reticular motility could be assessed,
None or vague 12 (8·3) 5 (5·2) 7 (14·9)
there were 4·3 (2·09) contractions per three minutes (range 0 to 12).
Not assessed 8 (5·6) 3 (3·1) 5 (10·6)
Speed of contraction Twelve cattle had reticular atony. Nine of the cattle had one or two
Normal 93 (64·6) 68 (70·1) 25 (53·2) contractions, 17 had three contractions, 59 had four or five contrac-
Slower than normal 41 (28·5) 25 (25·8) 16 (34·0) tions and 37 had six to 12 contractions per three minutes. The reticular
Not assessed 10 (6·9) 4 (4·1) 6 (12·8) contractions were biphasic and complete in 96 of the cattle, as described
Area surrounding reticulum
by Braun and Götz (1994) and Braun and Rauch (2008), biphasic and
Unremarkable 107 (74·3) 70 (72·2) 37 (78·7)
Fluid accumulation 19 (13·2) 14 (14·4) 5 (10·7) incomplete in 26 (that is, the first and second reticular contractions
Fibrin 10 (6·9) 6 (6·2) 4 (8·5) were of only a few centimetres), monophasic and incomplete in two
Abscess 8 (5·6) 7 (7·2) 1 (2·1) (that is, only one reticular contraction of only a few centimetres instead
* Significant difference between PFS and DFS (P<0·05)
of a biphasic reticular contraction), and there were no or only very
vague reticular contractions in 12.
The speed of the reticular contractions was assessed as normal in 93
of the cattle and as slower than normal in 41. The area surrounding the
counted and the size of the reticulum and the speed of the contractions reticulum appeared normal in 107 of the cattle, and contained a larger
were assessed subjectively. The speed of the contractions was considered than normal volume of free fluid in 19, fibrinous structures in 10 and
to be slower than normal if the first contraction lasted longer than 3·5 abscesses in eight.
seconds (mean range in healthy cows at rest 2·2 to 3·4 seconds [Rauch Reticular motility differed significantly between cattle with proximal
2007, Braun and Rauch 2008]). The entire ventral thoracic region on and distal functional stenosis (paired t test, P<0·05) (Table 1, Fig 1). The
both sides of the sternum and the lateral thorax to the level of the elbow cattle with proximal functional stenosis had significantly more reticular
joints were examined. By moving the transducer caudally on the left side, contractions per three minutes than those with distal functional stenosis
the reticuloruminal groove, the anterior blind sac of the rumen and the (4·6 [2·01] v 3·6 [2·16]) (P<0·05). There were no significant differences
cranial part of the ventral sac of the rumen were evaluated. The distal between the cattle with proximal and distal functional stenosis in terms
part of the spleen was visualised on the left, and the transitions to the of the position, contour and size of the reticulum, the amplitude and
omasum, the abomasum and the liver were observed when the transducer speed of the contractions, or the ultrasonographic appearance of the
was moved medially and to the right of the paramedian. area surrounding the reticulum.

Statistical analysis Discussion

The data were analysed using a commercial software program (StatView
5.1; SAS Institute). Frequency distributions were calculated for all the
variables, and the mean (sd) were calculated for the numbers of reticu-
lar contractions per three minutes. Data from the cows with proximal
and distal functional stenosis were compared by analysis of variance and
a paired t test for the numbers of reticular contractions and the chi-
squared test for the other variables described in Table 1. Differences
were considered statistically significant at P<0·05.
Results
A complete ultrasonographic examination of the reticulum was pos-
sible in 134 of the 144 cattle; in the other 10 some variables could not
be evaluated and as a result the total number of observations differs
among the variables. The reticulum was located directly adjacent to the
ventral abdominal wall in 129 of the cattle and was displaced from the
The frequency of reticular contractions in cattle at rest varies between
2·7 and 4·5 per three minutes (mean 3·6) (Rauch 2007, Braun and
Rauch 2008). In the majority of these cattle with vagal indigestion,
there were either only one or two, or five or more contractions per
three minutes. Twenty-one (14·6 per cent) of the cattle had either no
reticular motility or only one or two contractions per three minutes,
and 59 (41·0 per cent) had between five and 12 contractions per three
minutes. Only 54 (37·5 per cent) had a normal frequency of three to
four contractions. Forty (27·8 per cent) cattle also had changes in the
amplitude of the contractions, attributable to incomplete, monopha-
sic or absent contractions. Another abnormality was the speed of the
contractions, which was slower than normal in 41 (28·5 per cent) of
the cattle.
The mean number of contractions per three minutes was significantly
different between the cattle with proximal and distal functional steno-

the VETERINARY RECORD | January 3, 2009

 Downloaded from http://veterinaryrecord.bmj.com/ on November 19, 2014 - Published by group.bmj.com
sis, but the difference did not make it possible to differentiate reliably
between the two disorders. However, a larger number of contractions
usually indicated proximal functional stenosis. The cattle with proximal
functional stenosis had marked reticular hypermotility, with a mean of
4·6 contractions per three minutes, whereas those with distal functional
stenosis had mild hypermotility, with a mean of 3·6 contractions per
three minutes. This finding agrees with the observations by Hoflund
(1940), who commonly found reticular hypermotility in cows with prox-
imal functional stenosis. Hoflund (1940) classified these cows as having
functional stenosis between the reticulum and omasum with normal or
increased reticular and ruminal motility, but in contrast, reported that
cows with distal functional stenosis commonly had reticular atony or at
least hypomotility. The cows were classified as having permanent func-
tional stenosis of the pylorus with reticular atony or hypomotility. With
respect to other variables, there was a trend towards more incomplete
(19·6 per cent v 14·9 per cent) or absent (12·8 per cent v 6·2 per cent)
reticular contractions and slower contractions (34·0 per cent v 25·8 per
cent) among the cattle with distal functional stenosis than among the
cattle with proximal stenosis.
In the 144 cattle in the present study, reticular motility was notice-
ably abnormal, but vagal indigestion could not be diagnosed solely on
the basis of this finding. Furthermore, it was not possible to differentiate
between the cattle with proximal and distal functional stenosis because
the differences between the variables assessed were not sufficiently
consistent. Reduced or absent reticular motility may also occur in cat-
tle with traumatic reticuloperitonitis, peritonitis attributable to other
causes or other severe diseases. Normal reticular motility does not rule
out vagal indigestion. However, reticular hypermotility and character-
istic clinical signs support a tentative diagnosis of vagal indigestion. The
results of this study provide a useful adjunct to the understanding of
reticular function and vagal indigestion in cattle.
PAPERS
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January 3, 2009 | the VETERINARY RECORD
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Ultrasonographic evaluation of reticular

motility in 144 cattle with vagal indigestion
U. Braun, S. Rauch and M. Hässig

Veterinary Record 2009 164: 11-13

doi: 10.1136/vr.164.1.11

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