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Examination of
Digestive System

General considerations
Appetite
Prehension
Mastication
Deglutition
Eructation
Vomiting
Rumination
Oral cavity
Esophagus
Stomach of ruminants
Rumen
Reticulum
Omasum
Abomasum
Stomach of horse
Stomach of dog
Intestines
Rectum
Cattle and buffaloes
Horses
Dogs
Defecation
Liver
Jaundice
Liver function tests
BSP clearance test

GENERAL CONSIDERATIONS
The digestive system is an important system
of body as it is an open system which has

two openings. This hollow system is more

liable to suffer from diseases, as it comes in
contact with external environment more
frequently. The main function of the digestive
system is prehension, digestion and absorption
of food and water. The disease conditions of
the system affecting its basic functions should
be examined thoroughly in order to make a
quick and accurate diagnosis. The examination
of digestive system organs should be
performed after assessing animals appetite,
feed, fodder and water intake. Feed and
fodder must be examined for its quality,
quantity, amount of concentrate, its palatability, etc. which is beyond the scope of this
chapter. Here, the problems related with
animal are described.
APPETITE
Normally, the appetite of animal is assessed
by consumption of food. Alteration in
appetite is associated with poor food quality,
lack of desire for food intake and inability
to prehension and mastication. The alteration
of appetite are:
1. Inappetence: Inappetence is the partial reduction in appetite associated with diseases of
digestive system and reduced hunger.
2. Anophagia: Anophagia is the decreased
food intake associated with toxemia and
fever.

Examination of Digestive System

3. Anorexia: In anorexia, the appetite is
completely lost. The hunger sensation are
not felt due to fear, excitement, pain and
fever.
4. Hyperorexia: Hyperorexia is increased
appetite characterized by increased food
intake. Such conditions are observed in
pancreatic deficiency, chronic gastritis,
diarrhea and diabetes mellitus.
5. Polydipsia: Polydipsia is the increased
intake of water due to dehydration,
diabetes insipidus, diabetes mellitus and
chronic interstitial nephritis. Water
consumption is also increased during early
stage of fever.
6. Depraved appetite: This is an abnormality in
appetite in which animal ingests the
substances other than food. It is
manifested by pica. Pica is associated with
phosphorus deficiency, cobalt deficiency
and strongylosis. In rabies due to
disturbance in nervous system, pica occurs
in dogs. Cattle suffering from ketosis may
ingest inanimate substances which are normally not included in food. On the basis
of altered eating habits, the pica is
classified as under:
a. Coprophagia: In coprophagia, animal
eats its own feces like young puppies
and young horses.
b. Osteophagia: Animals eat the bones; it
occurs due to deficiency of calcium and
phosphorus.
c. Infantophagia: In this condition, the
animal eats its own newly born
offsprings, e.g. sow and cat eat their
offsprings.
d. Allotriophagia: Allotriophagia is the
eating of earth usually associated with
phosphorus deficiency and intestinal
parasitism.
Appetite is affected if there is trauma or
inflammation in lips, teeth, tongue, oral
mucosa, palate, tonsil, pharynx, esophagus,

59

stomach and difficulty in prehension and

mastication.
PREHENSION
Prehension is the grasping of food by using
lips, tongue and teeth. Animal normally takes
food by this method. In sheep, goat and
horses, the prehension is performed with
teeth and lips while in cattle the food is seized
by tongue. The pigs take their food with the
help of lower lips and teeth. Animals drink
water by suction. An altered prehension is
seen due to pain or malformations of these
organs and it is lowered in stomatitis,
glossitis, gingivitis, and paralysis of lips.
MASTICATION
Mastication is an act of chewing the food in
oral cavity. Normally, there are 60-100
masticatory movements per minute in horse
and cattle. An altered or incomplete mastication is characterized by diminishing
masticatory movements, presence of
undigested food in feces and dropping of
semimasticated food from mouth. The
movements of jaws for mastication are altered due to stomatitis, glossitis, gingivitis,
fracture of mandible bones, myositis,
paralysis, actinobacillosis and actinomycosis.
Facial nerve paralysis leads to difficult
mastication. Retarded mastication has been
observed in fever and cerebral diseases.
Mastication is completely stopped when
splinters, nails, needles and wool are taken
by animal.
DEGLUTITION
This is the process of swallowing of food from
mouth to stomach through esophagus. Animal
may feel difficulty in swallowing in pharyngitis, esophageal dilatation, esophageal diverticulum, paralysis of esophagus, presence of
tumor, enlargement of lymph node and

60 Textbook of Veterinary Clinical and Laboratory Diagnosis

thyroid. Difficulty in swallowing leads to
anorexia in animals.
ERUCTATION
Eructation is the expulsion of gases from
stomach via mouth through esophagus. It
occurs when excessive air is accumulated in
stomach. In ruminants, some eructation is
normal or physiological, which occurs due to
gas pressure in rumen. The gases are expelled
when esophageal cardia is relaxed. In cattle
normally 60 liter gases are formed daily,
which passes through eructation process
occurs 15-20 times per hour. The eructation
process is inhibited by esophageal obstruction, stenosis and traumatic reticuloperitonitis. The inhibited eructation leads to
tympany in animals.
VOMITING
Vomiting is the forceful ejection of gastrointestinal contents through esophagus, mouth
and nostrils. Vomiting may occur due to
direct stimulation of vomiting center in
medulla oblongata; which has been observed
in diseases of brain, uremia, nephritis and
hepatitis. Reflex vomiting may occur due to
irritation caused by pharyngitis, esophageal
obstruction, presence of foreign body in
stomach, gastric distention, intestinal
obstruction, pyometra, and peritonitis.
Vomiting is a pathological condition in all
animals except in dogs and cats in which it
may occur as a normal practice. While
examining the animal, the frequency and time
gap of last feeding of animal should be noted.
The nature of vomitus including foreign body,
blood, pus, parasite, fecal matter, etc. should
be examined carefully. The pH of the vomitus
should be determined in order to find out
that the vomitus is from stomach or from
esophageal diverticulum. In equines, the
vomited material is regurgitated through

nostrils due to long soft palate while in other

animals it takes place through mouth. In
ruminant animals, the vomitus material is
ruminal contents and usually the cause of
vomiting is spoiled food.
RUMINATION
Rumination is normal physiological act of
digestion in ruminants. The ruminants take
food and hurriedly swallow with little or no
mastication. Such food is partially mixed with
saliva and accumulated in rumen. After
sometime, animal remasticate this food; the
food is forced out into mouth by a forced
contraction of reticulum. After remastication,
the food is again swallowed directly to
omasum and abomasum. The whole process
of rumination takes about 1-2 hours. The size
of ruminated bolus, that is forced out of
remastication is 20-120 gm. There are about
360-790 ruminated bolus per day, which
animal remasticates. Rumination starts after
30 minute to 90 minute of feeding. In animal
diseases like fever, toxemia and disorders of
gastrointestinal tract, animal does not ruminate properly. In fact in ruminants, it is the
first sign of illness observed by the owner
or farmer that animal is not ruminating due
to some illness.
ORAL CAVITY
Oral cavity examination is performed by
careful handling of animal. One should be
cautious that he should not get injury of bite
due to teeth of animal; the use of mouth gag
is indicated in horses for examination of oral
cavity (Fig. 9.1). Care must be taken to avoid
the infection from oral cavity examination
particularly for rabies. The main organs in
oral cavity are lips, tongue, gums, teeth,
palate, salivary gland and tonsils, which
should be carefully examined. The inflammation of lips is cheilitis. Both upper and

Examination of Digestive System

lower lips should be examined for the
presence of any lesion; the inside of the lips
is examined by lifting and turning back the
lips.

Fig. 9.1: Diagram of a gag, used for examination

of oral cavity in horses

The oral mucosa is examined for its colour

like yellowish in jaundice, bluish/cyanotic in
blue tongue, watery or pale in anemia,
congested and hemorrhagic in toxemic and
septicemic diseases. The inflammation of the
buccal mucosa is known as stomatitis. It
includes inflammation of tongue, palate,
gums, salivary gland, etc. The inflammation
of tongue is known as glossitis. Inflammation
of palate is termed as lampas or palatitis
while inflammation of gums is gingivitis.
Clinically, the stomatitis is characterized by
loss of appetite, smacking of lips, increased
salivation, slow and painful mastication,
drooling of saliva, erosive (Fig. 9.2, Plate 2)
and vesicular lesions and sometimes white
velvety deposits on the lesions of oral mucosa,
which occurs mainly in mycotic infections.
The stomatitis in animals is caused by trauma,
irritant chemicals, bacteria like Sphaerophorus/
necrophorus , Actinobacillus ligniresi, Borrelia suilla
and Nocardia dermatonomus and virus like foot
and mouth disease, vesicular stomatitis,
vesicular exanthema, rinderpest and
contagious ecthyma. Vesicular stomatitis is
reportedly caused by foot and mouth disease,
vesicular stomatitis and exanthema is virus

61

while erosive stomatitis caused by rinderpest

virus. The ulcers in oral mucosa occurs due
to sheep pox and contagious ecthyma virus.
The inflammation of salivary gland is
known as sialadenitis, which is caused by
trauma, virus or bacteria and resulted into
obstruction of salivary duct or its dilatation.
The inflammatory conditions of salivary
gland leads to formation of calculi also known
as sialoliths. It occurs due to chronic
inflammation, which provides desquamated
cells consolidated exudate as nidus for
deposition of calcium salts. Foreign body may
also serve the same purpose and occludes the
duct leading to atrophy of gland and
formation of sublingual cysts also called as
ranula.
In gastric disorders, white, viscous and
mucoid covering appears on tongue,
especially on its dorsal aspect which results
into decreased food intake. This condition is
known as fur formation. In this condition
the mucosa becomes dry with unpleasant
odour. The brick red colour of tongue is seen
in toxemia and uremia in dogs. Paralysis of
tongue may result in reduction in its size and
mobility. Hardening of tongue has been
observed in Actinobacillus ligniresi infection
also called as wooden tongue. The tongue
can be examined in oral cavity by catching
and pulling out by hand.
Dental calculus may occur in teeth in dogs
and cats which is characterized as hard
yellowish brown deposit on the teeth. It may
cause alveolar periostitis and periodonitis. A
missing teeth may be observed during old
age in dogs and cats or due to trauma caused
by stony soil in sheep. In cattle and sheep,
mottling and pitting of enamel of teeth may
occur due to diet containing excessive
fluorine; dirty, yellowish brown colour teeth
are observed in canine distemper. In ruminants, the deciduous molar teeth retained on

62 Textbook of Veterinary Clinical and Laboratory Diagnosis

the crown of erupting permanent teeth in
lower jaw may cause impairment in mastication. Narrowing of mandible is responsible
for shear mouth in horses and sheep in which
the lower molar teeth are very sharp and
pointed.
Tonsils are present at the base of tongue.
In bovines, the tonsils are bean shaped mass
of lymphoid tissue. In dogs, it is 2.5 cm long,
red coloured, covered by mucous membrane
and can be seen by pressing the tongue at
its base. The tonsils should be examined for
its size, shape, colour, presence of abscess,
hemorrhages, neoplasms and foreign body.
The inflammation of tonsils is known as
tonsilitis, occurs due to various infectious
agents causing stomatitis. During stomatitis
and other infections of upper respiratory and
digestive tract, it becomes swollen and
enlarged.
Thrush is the deposition of grey or yellowish thick material on the mucous
membrane of oral cavity in birds.
ESOPHAGUS
Esophagus is a muscular tube which starts
from pharynx and ends into stomach. It is on
the left side of trachea at the level of 4th
cervical vertebrae, from where it is examined
in the depth of jugular furrow. Difficulty in
swallowing occurs due to obstruction in
esophagus caused by swelling, pain, tumors
or foreign body. In dysphagia, the forceful
attempts to swallow occurs, which can be
detected during ingestion of food or water.
Animal takes more time to swallow or ingest
food. The esophagitis is the inflammation of
the esophagus, caused by chemicals or physical irritants and usually occurs alongwith
stomatitis and pharyngitis. Achalasia is
responsible for dilatation of esophagus which
may occur due to abnormal innervation at the
lower esophagus and cardia. The constriction
and obstruction of the esophagus can be

examined by placing a flexible stomach tube

which can determine the presence of foreign
body, food mass, neoplasm, compression and
stenosis. The stenosis and constriction may
occur due to actinobacillosis, tuberculosis or
leucosis of the mediastinal lymph nodes. In
horse and cattle, the stomach tube is
introduced through nasal cavity and in other
animals through mouth.
Ingluvitis is the inflammation of crop in
poultry. It is caused by trauma, chemicals,
toxins, infectious agents like bacteria and
viruses and parasites such as Acuaria sp. and
Capillaria sp. The inflammation of crop is
characterized by its congestion, edema and
tympany.
STOMACH OF RUMINANTS
Rumen
The clinical examination of rumen is performed through palpation, percussion and
auscultation on left flank. During general
examination of animal, one can observe the
buldging of rumen in left para-lumbar fossa
due to excessive accumulation of gases in
rumen causing tympany. Rumen can be
palpated by fingers on left flank by applying
sufficient pressure, which may reveal the
frequency, strength and cyclic pattern of
ruminal movements. Normally, there are
1-2 ruminal movements occur per minute.
However, hypermotility may occur due to
bloat and gastric stenosis and hypomotility
due to poor fiber content in food, traumatic
reticulo-peritonitis and rumen acidosis. If
rumen is excessively filled with food or gases
then palpation becomes difficult. The
frequency of ruminal movements is altered
in indigestion, impaction, tumors of rumen
and reticulum. The inflammation of rumen is
known as ruminitis characterized by pain
reaction during palpation. On percussion, the
tympanic sounds can be heard, if rumen is
filled with gases. Excessive feeding of

Examination of Digestive System

legumes, stenosis or obstruction of esophagus, vagus nerve paralysis and gastric
stenosis leads to tympany or bloat. Frothy
bloat is characterized by resonant percussion
sounds which may occur due to heavy
feeding of saponin containing plants and
legumes. Auscultation of rumen reveals the
decrease in frequency and sounds of rumen
contractions indicating its impaction, fever,
indigestion, ruminitis and traumatic reticuloperitonitis. The ruminal fluid is also examined
in suspected diseases of the rumen and reticulum. It can be collected by using a
20 ml syringe and needle through puncture
of rumen at the left flank. The ruminal fluid
is examined for its colour, consistency, odour
and acidity. The normal colour of ruminal
fluid is grey to olive to brownish green in
stall fed animals and pure green in grazing
animals. It becomes milky grey in ruminal
acidosis and greenish black when decomposition of ruminal contents occur. The
ruminal fluid is slight viscous in normal
animals, which becomes watery in inactive
rumen and extremely viscous when more
saliva is added. It contains bubbles in case
of bloat in animal. Normally, the odour of
ruminal fluid is aromatic, which becomes
musty if the rumen is slightly inactive and
mild ammonical in rumen alkalosis. The
ammonical or fecal odour is the characteristic
of rumen decomposition. Acidic odour comes
from ruminal fluid collected from animal
having latent ruminal acidosis while it is
penetrating acidic in clinically recognizable
ruminal acidosis in animals. The pH of rumen
fluid is 5.5 to 6.8 in normal animal, which may
go upto 8.5 in ruminal alkalosis and down
to 3.8 in acidosis in animals.
Reticulum
Reticulum can be palpated for pain reaction
due to traumatic reticulitis at sternal region
at the point of attachment of diaphragm to

63

xiphoid cartilage. Cattle suffering from

traumatic reticulitis shows the signs of
abdominal pain during defecation, urination
and rumination. Unselective eating habits of
cattle and buffaloes are responsible for traumatic reticulo-peritonitis; the foreign body
penetration in reticulum occurs in the lower
part of the anterior wall. Rarely the foreign
body may cause penetration laterally towards
the spleen or medially towards the liver.
Anterior penetration of the foreign body
with progressive onward movement of
diaphragm, the foreign body may cause
traumatic pericarditis, peritonitis and diaphragmatic hernia and abscess formation.
Reticular sounds can be felt by auscultation
at costochondral junction of the left rib about
10 cm behind the elbow. The biphasic
contractions of reticulum over the reticuloruminal folds produces a soft fluid sound. In
reticular diseases, the frequency of contractions of reticulum is reduced. Normally, it is
one contraction per 40-60 second which is
characterized as one partial contraction
followed by a pause and complete contraction.
Ruminal affections, fever and toxemia may
have adverse effect on reticular movements,
which affects both frequency and quality of
sounds. Irregular contractions of reticulum
produce a grunt, which is an indication of
pain. In traumatic reticulo-peritonitis, the
persistent increase in monocyte count is very
important for diagnosis. Similarly, if it is
accompanied with pericarditis, the number
of neutrophils may also go up. Since the
reticulum is very much prone to have
traumatic injury due to metallic objects, being
its favourable structure to lodge such object.
There are certain tests which can diagnose
the presence of metallic foreign body in
reticulum.
1. Back grip method: In this method, a fold of
skin over withers is pulled up which
causes pressing down of the back leading

64 Textbook of Veterinary Clinical and Laboratory Diagnosis

to pain, if fibrous adhesions are present
in the xiphoid cartilage region. In this test,
one should try a light grip first followed
by a strong grip.
2. Pole test: A pole of about 1-2 meter long
and 4-5 cm in diameter is placed under
the animal and hold by two persons. The
pole is pulled forward and slowly upward
pressing the area of xiphoid cartilage.
Tenderness in the area indicates foreign
body penetration which also shows a pain
reaction.
3. Pain percussion: A piece of wood covered
with rubber is placed at the xiphoid
cartilage area and strike out by percussion
hammer. The ventral chest wall will show
a pain reaction on application of hammer
in traumatic reticulo-peritonitis condition.
4. Ferroscopy: Ferroscope is a metal detector
which is applied to the ventral or ventrolateral chest and abdomen to detect the
iron, steel or nickel bodies with a distance
of 8-12 cm distance.
Actinobacillosis
Actinobacillosis of the reticulum shows partial
anorexia, depressed rumination, reduced
rumen and reticular motility and recurrent
tympany. On palpation, no pain feeling is
observed, while no grunt is heard on
auscultation. Reticular hernia in thorax may
also occur through rupture of diaphragm.
Clinically, it is characterized by loss of body
condition, ruminal tympany, hypermotility
and capricious appetite. On auscultation, a
systolic murmur can be heard due to
displacement of heart. The nerve supply to
reticulum is affected in vagus indigestion
causing paralysis of reticulum, which is
characterized by ruminal distension, anorexia,
retarded passage of ingesta, evacuation of
soft, pasty feces in small quantity. This occurs
as a result of achalasia of reticulo-omasal and

pyloric sphincters and characterized by

distension of rumen with hypermotility or
atony.
Omasum
Omasum can be palpated at the right costal
arch or in the seventh to ninth right
intercostal spaces. Clinically, the examination
of omasum has little value as it is unlikely
to have any abnormality. The affections of
omasum occurs due to problem in other
compartment of stomach like rumen, reticulum, or abomasum. Enlargement of omasum
occurs due to chronic impaction of rumen in
cattle fed on tough dry or fibrous feed. In
sheep, the enlargement of omasum occurs due
to accumulation of soil. In mucosal disease,
malignant catarrhal fever, rinderpest and
chlorinated naphthalene intoxication, the
omasum shows the signs of pain on palpation.
Abomasum
The abomasum can be palpated from the right
side ventral to the 7th to 10th rib by applying
relatively more pressure in adult animals. In
calves, it can be easily palpated because of
low abdominal pressure. The pain in
abomasum is manifested by the grinding of
teeth by animal. Impairment of abomasum
also leads to the reduced rumen motility. In
calves, the enlargement of abomasum has
been observed due to obstruction of pylorus
by undigestible substances such as hair balls
or rubbery undigested curd which occurs due
to irregular feeding of calves. Due to pyloric
obstruction, the calves become weak emaciated and pot bellied appearance. Impaction of
abomasum occurs in adult cattle due to
chopped straw which does not pass through
pyloric sphincters and characterized by
anorexia, dullness and abdominal distension.
Vagus indigestion also results in impaction
of abomasum, which is manifested by

Examination of Digestive System

anorexia, reduced volume of pasty feces,
increased pulse rate and reduced ruminal
motility. Anterior displacement of abomasum
occurs shortly after parturition in female
animals fed on heavy grain or concentrate
containing feed during late pregnancy. This
displacement is characterized by reduced
appetite and moderate ruminal tympany. The
left displacement causes tympanic abomasum
bulging towards the paralumbar fossa. The
distention of abomasum can be palpated
through rectal examination which almost fills
the right side of the abdomen. The distended
abomasum has about equal size of the rumen
and can be differentiated by the tenseness of
the wall.
Torsion
The torsion of the abomasum occurs mostly
after one month of parturition at a 180-270
angle. Abomasal torsion is more serious than
its dilatation. It may be clockwise or anticlockwise. In mild rotation the blood supply is not
affected. Clinically, it is manifested by sudden
onset of the abdominal pain with kicking of
the belly, restlessness and distress. The temperature becomes subnormal, pulse increase,
to 100/min and ruminal motility stops. Feces
pass in less quantity and usually blood
stained. Distention of abomasum occurs as a
result of abomasal tympany which causes
bulging at the right flank. Death of animal
occurs due to shock and dehydration within
2-4 days. Abomasal ulcers may present in
calves when their diet is changed from milk
to solids. Superficial erosions develop in the
mucosa of the abomasum in rinderpest,
mucosal disease, malignant catarrhal fever,
hyperkeratosis, and bracken fern poisoning.
Abomasal fluid is collected by inserting
4-8 cm long needle through skin midway
between xiphoid cartilage and umbilicus. The
fluid is sucked by applying syringe. If the

65

displacement is suspected, the puncture is

made in lower half of area giving tympanic
percussion sounds. The abomasal fluid is
normally greyish/yellow green/olive green
or watery with pH 2-4. It may become rust
red due to hemorrhages; greenish and mucoid
due to bile; decomposed having foul smell;
having grating sound due to presence of sand;
acidic fluid with gas and milky green colour
in left displacement and dark brown with
small bone glue and pH 1.6-8.3 in right
displacement.
STOMACH OF HORSE
In horses, the stomach is situated in the
concavity of the diaphragm and it does not
come into contact with the abdominal wall due
to its small size. The dilatation of stomach is
manifested by continuous pain with fever,
increased pulse and shallow breathing. Horse
adopts a dog sitting posture with profuse
sweating. The dilatation of stomach occurs due
to impaction, excessive accumulation of gas, or
consumption of large quantity of hay or cold
water. Tympany of stomach occurs due to
accumulation of gas in the stomach due to
impaction and failure of eructation. The gases
can be removed by passing a stomach tube.
STOMACH OF DOG
Stomach of dog can be palpated in the ventral
abdomen by elevating forelegs which allows
the stomach to fall out from the concavity of
the diaphragm. Acute gastritis is characterized
by vomiting and abdominal pain and caused
by ingestion of decomposed food, allergy or
irritants or foreign bodies. Fever is associated
with canine distemper associated stomach lesions. The presence of foreign body in
stomach of dogs can be detected by radiographic examination.
Chronic gastritis is characterized by
intermittent vomiting, reduced appetite and

66 Textbook of Veterinary Clinical and Laboratory Diagnosis

loss of body condition and it is caused by
smooth foreign bodies, uremia, pyloric
disease, poor quality food and tumor. Gastric
dilatation is observed after feeding, exercise
and reduced intestinal motility. Torsion of
stomach occurs in clockwise or anticlockwise
direction which causes occlusion of esophagus
and pylorus. Clinically, the torsion is manifested by restlessness, retching without
vomition, pain, shock, prostration and gastric
dilatation. Pyloric stenosis occurs due to hypertrophy of pyloric mucosa or fibrosis following trauma. The clinical signs depend on
the severity of obstruction which induces
vomiting, dilation of stomach, pain and
reduces intestinal motility.
INTESTINES
Intestines are examined through inspection/
physical examination of right side of
abdomen, which has not much significance.
However, the functional status of the
intestines can be indirectly adjudged through
character of feces. Constipation occurs due
to reduced tone of the intestinal muscles
which is observed in general debility and
inflammation of other abdominal organs.
Feces of such animals is dry, firm, coated with
mucous and have a glazed appearance.
Constipation may also occur due to
dehydration, deficient diet and intestinal
obstruction. Obstruction of intestines is
caused by volvulus, intussusception and
strangulation which is characterized by
absence of feces, blood stained mucous and
abdominal pain.
Increased motility of intestine due to
gastritis and enteritis results in diarrhea. The
hypermotility of intestines are responsible
for malabsorption, hypersecretion due to
inflamed mucosa, resulting in more fluid in
the feces. Enteritis always leads to diarrhea.
Diarrhea occurs in fascioliasis, molybdenosis,
anthrax, colibacillosis, rotavirus, coronavirus,

salmonellosis, rinderpest, bovine viral diarrhea, malignant catarrhal fever, coccidiosis

and other helminthic infections. The clinical
manifestation of enteritis are diarrhea, abdominal pain, dysentery, yellowish feces (Fig.
9.3, Plate 2), incoordination and nystagmus.
It may lead to dehydration and death.
Septicemic pasteurellosis, campylobacteriosis,
and clostridial infections may cause acute
enteritis. Johnes disease due to Mycobacterium paratuberculosis causes chronic enteritis
characterized by fluidy feces alongwith gases,
loss of condition, emaciation, hide bound
condition, and reduced milk yield. Rinderpest virus may cause erosive mouth lesions,
diarrhea, dysentery (Fig. 9.4, Plate 2) and
death. Malignant catarrhal fever is characterized by diarrhea along with catarrhal
inflammation of the upper respiratory tract
and keratoconjunctivitis. The chemical cause
of enteritis includes arsenic, phosphorus,
mercury, copper, molybdenum, nitrates and
lead, which is diagnosed by analysis of blood,
feces or body tissues for the presence of
chemicals. Certain plant poisons like bracken
fern may also lead to diarrhea.
Rectal palpation of intestines can be
performed for the diagnosis of intestinal
diseases. In acute enteritis the mesenteric
lymph node becomes enlarged and edematous while in chronic enteritis the mesenteric
lymph glands are enlarged, firm, elastic and
smooth. These becomes hard in tuberculosis
and Johnes disease. The wall of intestines
becomes thickened due to Mycobacterium
paratuberculosis. Rectal palpation may reveal
the presence of intussusception which is
characterized by greatly thickened firm
portion of intestine coiled like snails shell in
front of pelvis. The volvulus or strangulation
can be detected by presence of tense band
of mesentry, distention of intestines due to
gas and presence of peritoneal adhesions. The
obstruction of intestine is determined by

Examination of Digestive System

Fig. 9.5: Diagrammatic illustration of D-xylose malabsorption test. Note the reduction in D-xylose
absorption on the day of diarrhoea

67

68 Textbook of Veterinary Clinical and Laboratory Diagnosis

feeling of the firm, cylindrical enlarged
portion of the intestine. The intestinal torsion is observed by the presence of concentric
parallel loops of intestines, which are tense,
filled with gases and are in spiral shape
present in right half of abdominal cavity. The
peritoneum becomes velvety or sticky with
adhesions during rupture of intestines and
peritonitis which can be palpated through
rectal examination.
The functional activity particularly absorptive activity can be measured by D-xylose
malabsorption test, which determines the
abnormal absorption rate of the intestines.
In this test 25.0 gm of D-xylose is dissolved
in 500 ml distilled water and sterilized by
filtration. The filtered solution of D-xylose
is given orally to the animal kept 17 hour off
feed; this animal is not given food/water for
6 hours after the D-xylose administration. The
blood samples are collected at hourly intervals
till 6 or 7 hours of D-xylose feeding and
plasma is separated. The concentration of Dxylose is measured in plasma by diluting 0.4
ml plasma in 2.8 ml distilled water and adding 0.4 ml of 10% zinc sulfate and 0.4 ml of
0.5 N sodium hydroxide. Of this 1 ml
supernatent is added to 5 ml of 2% pbromoaniline in glacial acetic acid saturated
with thiourea. This mixture is kept at 70C
for 10 minute and then cooled at 20C for 70
minute in dark. The reaction colour is
measured by spectrophotometer at 520 nm.
The control tubes include standard consisting
10 mg D-xylose in 100 ml benzoic acid, a water
blank and an unheated mixture of each
plasma with p-bromoaniline. The concentration of D-xylose in each blood sample is
calculated from the following formula:
Reading of test sample
D-xylose in mg
= 100
per 100 ml of blood
Reading of standard

D-xylose is a pentose sugar which is, on

oral administration, absorbed by same route

Fig. 9.6: Scanning electronmicrograph of intestine

showing normal length and smoothness of villi

as glucose partly by active and partly by

passive process. During decreased capacity
of absorption due to enteritis, the amount of
D-xylose is reduced in plasma (Fig. 9.5). The
decreased absorption is directly related with
the inflammation of intestinal mucosa and reduced height of villi, which can be measured
by scanning electronmicroscopy (Figs 9.6 and
9.7) or morphometry.

Fig. 9.7: Scanning electronmicrograph of intestine

showing reduced length and rough surface of villi

RECTUM
Cattle and Buffaloes
In cattle and buffaloes, examination of rectum
can be performed through palpation. Rectal

Examination of Digestive System

palpation is also useful for determination of
the diseases of digestive tract, abdominal
cavity and in pregnancy diagnosis is performed through rectal examination. The rumen
can be palpated through rectal examination.
However, the anterior part of rumen,
omasum and reticulum are not palpable.
Abomasal displacement to the left is palpable
through rectum and the conditions of
abomasum like torsion and enlargement can
be diagnosed. Intestines are examined
through rectum; the intestinal obstruction
may lead to straining and pain reaction in
animal. During intestinal obstruction, the
rectum is empty or having small quantity of
feces admixed with mucous. Besides intussusception, torsion and gaseous distention can
also be palpable. Urinary bladder and urethra
are also palpable for the presence of
urolithiasis, tumors of urogenital tract and
pyometra which can be diagnosed through
rectal palpation.
The rectal mucosa is examined for jaundice,
anemia or congestion/hemorrhages. The
rectal mucosa is examined microscopically for
the presence of acid-fast bacilli in the
diagnosis of Johnes disease.
Horses
In horses, the rectal examination is performed
for the presence of greyish deposit on anal
region which occurs due to Oxyuris equi. In
intestinal obstruction, the quantity of feces
is reduced in rectum. The rectal palpation may
reveal the fracture of pelvic bones and disease
of urinary bladder. Small portion of intestine
can be palpable alongwith colon through
rectum. The colic obstruction at ileocecal
valve region can be diagnosed through
rectum. The enlargement of spleen and left
kidney abnormalities are palpable during
rectal examination. The distended ureter is
felt on rectal palpation. Anterior mesenteric

69

artery with verminous aneurysm becomes

rough with uneven surface and thickened
wall and pain feeling on rectal palpation. The
uterus, ovary, cervix and fallopian tubes are
also palpable in rectal examination.
Dogs
The rectal examination in dogs has little value
as one cannot pass hand through anus in small
animals. In dogs, the rectal examination is
performed by using index finger or by probe
like blunt end thermometer. The finger
should be covered with rubber gloves as the
nails of finger may cause injury to the rectal
mucosa. The finger should be properly
lubricated. In paralysis of rectum, the
flaccidity and absence of contractions may
occur. In constipation, it may become hard
and impacted due to accumulation of feces.
Finger can also determine the presence of foreign body in the rectum. Pelvic bones can be
palpable for the presence of fracture,
misalignment of hip joint or hip joint dislocation. Prostate glands are also palpable in
median longitudinal groove for its enlargement, cyst formation and inflammation.
During prostatitis, the animal feels pain on
touch. The nodular enlargement of prostrate
is an indication of carcinoma. Urethra and
bladder can be palpable for the presence of
calculi and neoplasm through rectal
examination.
DEFECATION
When the ampulla of rectum is filled with
feces, it stimulates the sensory nerve endings
in the anus. The controlling center for anal
sphincters are situated in the posterior portion
of the lumbar parts of spinal cord. The
defection center is present on the fourth
ventricle near vomiting center which overall
controls the process of defecation. The abdominal muscles through voluntary contraction

70 Textbook of Veterinary Clinical and Laboratory Diagnosis

also assist the process of defecation. In large
animals, during the act of defecation, the hind
legs are abducted and the contractions of
abdominal muscles takes place. Small animals
like dogs have squat down posture for
defecation. After defecation, dogs scrap the
ground with hind legs while cat uses its
forelegs for the same act. Normally, the
horses defecate 8-12 times, the cattle 12-24
times and camels 1-3 times in a day. The
frequency of the defecation depends on the
type of feed ingested. Usually it takes 1-4
days to travel the feed in alimentary canal
to come out as feces. Defecation may become
abnormal during hypomotility and hypermotility of the intestines. It gets affected due
to gastritis, enteritis, colitis and proctitis and
other disease conditions of gastrointestinal
tract. In old age, due to general debility the
anal sphincter gets relaxed which are responsible for increased frequency of defecation.

3. Detoxification of the toxins/poisons.

4. Production of fibrinogen, prothrombin
and heparin.
5. Formation of vitamin A from carotene.
6. Regulation of blood volume.
7. Storage of iron and copper.
The physical examination of liver has not
much importance. In hepatomegaly, the liver
can be palpable in animals at the ventral to
costal arch or xiphoid cartilage where the edge
of liver is thickened and rounded. In horse
and pigs, it is not palpable because of rigidity
of abdominal wall. The enlargement of liver
may occur in poisoning, abscess formation,
neoplasia, hydatidosis and in certain infectious
diseases (Fig. 9.8, Plate 2). Cirrhosis occurs
as a sequelae to hepatitis in which it gives
a rigid irregular lining on its borders on
palpation (Fig. 9.9). The abnormality in liver
may lead to occurrence of jaundice or icterus.

LIVER
Liver is the largest gland of body and it has
larger factor of safety, even 15% of the total
liver is capable of maintaining its normal
function. The liver is situated in the concavity
of the diaphragm. In animals it is on the right
side of the median plane. In cattle, the liver
is in contact with right portion of diaphragm
and some of its portion is in contact with last
2-3 ribs. In horse, it is opposite to the sternal
extremity of the 7th or 8th rib on the left side
while the right thin border extends upto 16th
rib just below its middle and it is separated
from the ribs by the diaphragm. In pigs, the
liver is in contact with the abdominal floor
in the xiphoid cartilage ventral to the right
costal arch. In dogs, the ventral lobes are
behind the xiphoid cartilage above the rectus
abdominus muscle.
The functions of liver include:
1. Secretion and excretion of bile.
2. Protein, fat, and carbohydrate metabolism.

Fig. 9.9: Chronic hepatitis in goat. Note the presence

of multiple nodules on the surface of liver (Courtesy
Dr R Somvanshi, IVRI, Izatnagar)

Jaundice
The liver produces bile, which is composed of
bile salts, pigments, alkaline phosphatase and

Examination of Digestive System

lipids. The bile is involved in the digestion of
fat in intestines. In the affections of liver, the
bile pigments come out in blood, urine, feces
and in other body tissue giving the orange
yellow discolouration of the mucous membranes, submucosa and skin which is called as
jaundice. Jaundice occurs in three forms:
Obstructive Jaundice
This occurs due to obstruction of bile ducts.
The tissues become greenish yellow and
bile pigments are absent from feces. The
bilirubin level increases in serum and urine.
Obstruction of bile duct may occur due to
parasite or inflammation in the wall of duct
or neoplasia. In pigs, Ascaris suim causes bile
duct obstruction while in cattle and sheep,
cholangitis and cholecystitis caused by Fasciola
is responsible for obstruction of bile duct.
Hemolytic Jaundice
In this type of jaundice, the skin and mucous
membrane of the animal becomes yellow
coloured with anemia and hemoglobinuria.
Urobilinogen level increases in urine while
bilirubin is absent in urine. It occurs due to
intravascular hemolysis due to leptospirosis,
anaplasmosis, babesiosis, equine infectious
anemia, and chronic copper poisoning.
Toxic Jaundice
Toxic jaundice occurs due to damage of liver
parenchyma which is not able to produce and
eliminate the bile. In this condition, the serum
bilirubin level increases and urine have both
bilirubin and urobilinogen. The skin and
mucous membrane appears reddish yellow
or brownish yellow. It occurs due to chronic
or acute hepatitis.
Liver Function Tests
Liver functions are arrested if there is liver
disease like hepatitis, suppurative hepatitis

71

and cirrhosis. Certain liver function tests are

carried out for the differential diagnosis of
jaundice and to determine the prognosis of
liver disease.
Icterus Index
The hemobilirubin or cholibilirubin gives the
yellow colour to serum. Therefore, the
intensity of colour of serum is compared with
standard potassium dichromate solution. The
cholibilirubin gives deeper colour than
hemobilirubin. The test must be carried out
on fasting, serum should be free from
hemolysis and animal should not be given any
food containing yellow pigment like carrots
before 24-48 hours of the test.
Interpretation
Normal value 4-6 unit
Latent type jaundice 6-15 unit
Clinical jaundice due to infectious hepatitis
> 15 unit
Vanden Bergs Reaction
In this test, one ml serum is taken in a test
tube and 0.5 ml diazo reagent is added on
surface slowly. After 30 second reddish
purple coloured ring appears in case of direct
positive test. If the colour of ring develops
after 30 second then it is due to indirect
bilirubin giving the test positive colour. To
differentiate the direct and indirect tests
further add 3.0 ml of 95% alcohol, mix and
observe for development of colour:
No colour before addition of alcohol, but
becomes pink after alcohol is added
indirect.
Pink colour before adding of alcohol which
is intensified laterdirect.
Absence of colour in both situation
negative.
The chief bile pigment is bilirubin which
is derived from hemoglobin of the

72 Textbook of Veterinary Clinical and Laboratory Diagnosis

erythrocytes. The hemoglobin breaks into
iron containing part hemosiderin and iron
free hemotoidin. Hemotoidin binds with large
protein molecule and forms hemobilirubin.
This comes into circulation and does not pass
through kidneys and thus transported to liver,
in which it is separated from protein molecule
and conjugated with glucuronic acid to form
cholibilirubin which is secreted by hepatic cells
and carried away by bile duct system into
the duodenum. In duodenum, it is reduced
by bacteria into mesobilirubinogen and
stercobilirubinogen which are oxidised and
changed to urobilin and stercobilin respectively and are present in feces. The cholibilirubin present in circulation filters through
kidneys in the form of mesobilirubinogen and
stercobilirubinogen.
Vanden Bergs reaction is based on the
ability of bilirubin to couple with diazobenzo
sulfochloride (diazo reagent) to form a
characteristic red violet pigment. Since unconjugated bilirubin requires the use of alcohol
in which both diazo reagent and bilirubin are
soluble. The addition of alcohol and reagent
mixture to serum thus gives the indirect
reaction which is specific for unconjugated
bilirubin. Conjugated bilirubin is detected by
direct test without addition of alcohol.
In dogs, the increased amount of free
bilirubin is an indicative of hemolytic jaundice
and increased conjugated bilirubin contents
are suggestive of obstructive jaundice while
increased amount of both the conjugated and
unconjugated bilirubin shows hepatocellular
or toxic jaundice. To summarise the interpretation of Vanden Bergs reaction following
Table 9.1 should be referred:
Besides, the jaundice can also be tested
by detecting the presence of bile pigment in
urine described in chapter 18. Indirectly the
liver functions can be tested by dye clearance
tests like BSP clearance.

Table 9.1: Vanden Bergs reaction

Sr.
No.

Type of
reaction

Type of
jaundice

Type of
pigment

1.

Direct reaction
(+)
Indirect reaction
(+)
Biphasic reaction
(+)

Obstructive

Cholibilirubin

Hemolytic

Hemobilirubin

2.
3.

Toxic/Hepato- Both
cellular
present

BSP Clearance Test

In this test the, BSP dye is injected in animal
2 mg/kg body weight intravenously. Before
dye administration, serum is collected and
after 25 minute of dye injection, second sample
of serum is collected. In the 2 ml of serum
2 drops of 10% sodium hydroxide is added
and amount of dye is measured by detecting
colour using spectrophotometer.
In mild liver diseases 5-10% retention of
dye is observed, 10-25% retention is moderate
and above 25% dye retention is seen in severe
liver diseases.
Other dyes used for clearance tests are
Rose Bengal, Indocyanine Green and PSP for
the detection of liver diseases.
Certain enzymes like SGOT, SGPT, arginase, cholinesterase, alkaline phosphatase
are also measured for the assessment of liver
damage. The liver functions can also be
assessed by protein metabolism, carbohydrate
metabolism and lipid metabolism tests which
are not so common in veterinary practice. The
determination of blood uric acid, ammonia,
prothrombin may also give an idea about the
liver damage.
Liver biopsy can be taken by using
20-30 cm long needle inserted at 11th or 12th
intercostal space at the right of the midline
of the back and examined for the structural
changes in the liver parenchyma. Intraperitoneal fluid, sometimes gives an idea about liver
disease, is sucked through syringe and needle
and examined for the presence of leukocytes
and other cells.

Examination of Digestive System

QUESTIONS
Q 1. Indicate whether the following statements are True or False.
1. ________ Partial reduction in appetite and
reduced hunger is known as anorexia.
2. _______ Vomiting is a pathological condition
in all animals except dogs and cats in
which it may occur as a normal practice.
3. _______ Inflammation of tongue is called
glossitis.
4. _______ Vesicular stomatitis occurs in foot
and mouth disease in cattle.
5. ______ Erosive stomatitis is a feature of
rinderpest in cattle.
6. _______ Hardening of tongue has been
observed is Actinomyces bovis infection.
7. ________ Inflammation of crop in birds is
known as proctitis.
8. _______ The colour of ruminal fluid becomes
milky grey in ruminal acidosis.
9. __________ In traumatic reticulopericarditis
persistent increase in monocyte count is
a special feature.
10. _________ D-xylose malabsorption test is
helpful to measure the absorptive
activity of the stomach.
Q 2. Fill in the spaces below with most
appropriate word/words.
1. Complete loss of appetite is known as
_______
.
2. Increased intake of water due to
dehydration is called ______.
3. The condition when animal eats its own
feces is called ______.
4. The forceful ejection of gastrointestinal
contents through mouth and nostrils is
known as ______.
5. The use of mouth _____ is recommended
in horses for examination of oral cavity.
6. The inflammation of salivary gland is
called ______.
7. Wooden tongue, in cattle is caused by
________
.

73

8. Abomasal fluid is collected by inserting

4-8 cm long needle through skin midway
between xiphoid cartilage and ________.
9. Obstructive jaundice is also known as
________
jaundice.
10. ________ jaundice occurs due to damage of
liver parenchyma.
Q 3. Select the most appropriate answer
from the four choices given in each
question.
1. Abnormality in appetite in which animal
ingests the substances other than food is
known as:
A. Anorexia
B. Inappetence
C. Anophagia D. Depraved appetite
2. Inflammation of palate in cattle is
known as:
A. Glossitis
B. Gingivitis
C. Cheilitis
D. Lampas
3. Vesicular stomatitis is observed in cattle
in:
A. Foot and mouth disease
B. Rinderpest
C. Rotavirus diarrhoea
D. Wooden tongue
4. The deposition of grey or yellowish thick
material on the mucous membrane of oral
cavity in birds is known as:
A. Carie
B. Thrush
C. Dental pad D. Pyrrhoea
5. Diazo reagent is used in the liver function
test like:
A. Icterus index
B. Vanden Bergs reaction
C. BSP clearance test
D. D-xylose malabsorption test
Q
1.
3.
5.

4. Define the following terms.

Osteophagia
2. Anophagia
Rumination
4. Sialoliths
Stomatitis