Ruminal Tympany (Bloat, Hoven)

Prodigious volumes of gas are continually generated in the rumen through the process
of microbial fermentation. Normally, the bulk of this gas is eliminated by eructation or
belching, which ruminants are spend a lot of time doing. Certainly, anything that
interferes with eructation will cause major problems for a ruminant. The problem, of
course, is called ruminal tympany or, simply, bloat.
Pathogenesis
Bloat is the overdistension of the rumen and reticulum with gases derived from
fermentation. The disorder is perhaps most commonly seen in cattle, but certainly is not
uncommon in sheep and goats.
Two types of bloat are observed, corresponding to different mechanisms which prevent
normal eructation of gas:
1. Frothy bloat (primary tympany) results when fermentation gases are trapped in a
stable, persistent foam which is not readily eructated. As quantities of this foam build
up, the rumen becomes progressively distended and bloat occurs. This type of bloat
occurs most commonly in two settings:
 Animals on pasture, particularly those containing alfalfa or clover (pasture bloat).
These legumes are rapidly digested in the rumen, which seems to results in a
high concentration of fine particles that trap gas bubbles. Additionally, some of
the soluble proteins from such plants may serve as foaming agents.
 Animals feed high levels of grain, especially when it is finely ground (feedlot
bloat). Again, rapid digestion and an abundance of small particles appear to trap
gas in bubbles. Additionally, some species of bacteria that are abundant in
animals on high concentrate rations produce an insoluble slime that promotes
formation of a stable foam.
Bloat on pasture is frequently associated with "interrupted feeding" - animals that are
taken off pasture, then put back on, or turned out on pasture for the first time in the
spring.
2. Free gas bloat (secondary tympany) occurs when the animal is unable to eructate
free gas in the rumen. The cause of this problem is often not discovered, but conditions
that partially obstruct the esophagus (foreign bodies, abscesses, tumors) or interfere
with rumenoreticular motility (i.e. reticular adhesions, damage to innervation of the
rumen) clearly can be involved.
Another cause of free gas bloat that should be mentioned involves posture. A ruminant
cannot eructate when lying on its back, and if a cow falls into a ditch and is unable to
right itself, she will bloat rapidly. Ruminants that are to undergo surgery in dorsal
recumbancy should be starved for 12 to 24 hours prior to surgery, or by the time the
surgeon is ready to make the incision, the abdomen will already be distended.
Regardless of whether bloat is of the flothy or free gas type, distention of the rumen
compresses thoracic and abdominal organs. Blood flow in abdominal organs is
compromised, and pressure on the diaphragm interferes with lung function. The cause
of death is usually hypoxia due to pulmonary failure.
Clinical Signs
In animals that are not observed frequently, bloat is commonly manifest as sudden
death, reinforcing the concept that this is an acute disease with a short course.
Diagnosis of bloat is typically straightforward, and the clinical picture largely reflects
how long the condition has existed. Signs include:
  abdominal distension: the rumen is on the left side, and hence, distention is
typically most prominent on that side. As distention continues, the entire
abdomen may become distended.
 reluctance to move and cessation of feeding
 signs of distress: anxiety and vocalization
 respiratory distress: rapid breathing, neck extended with protruding tongue
 staggering and recumbancy: once a animal with bloat is recumbant, death occurs
rapidly.

Although bloat is primarily an acute disorder, chronic, recurrent forms are recognized in
calves.
Pathology
Animals that die from bloat have rather characteristic lesions, including congestion and
hemorrhages in the cranial thorax, neck and head, and compression of the lungs.
Pressure from the distended rumen leads to congestion and hemorrhage of the
esophagus in the region of the neck, while the esophagus in the thorax is pale. This
demarcation between congestion and pallor seen in the region of the thoracic inlet is
called the "bloat line". Usually, the liver is also pale because of displaced blood and
interruption of blood supply.
Obvious distension of the rumen is certainly observed in animals that die of bloat, but
also occurs rapidly after death from almost any cause in ruminants, and is not a useful
diagnostic lesion.
Treatment and Control
Bloat is a life threatening condition and must be relieved with haste. For animals in
severe distress, rumen gas should be released immediately by emergency
rumenotomy. Insertion of a rumen trochar through the left flank into rumen is
sometimes advocated, but usually not very effective unless it has a large bore (i.e. 1
inch), and is often followed by complications such as peritonitis.
In less severe cases, a large bore stomach tube should be passed down the
esophagus into the rumen. Free gas will readily flow out the tube, although it may need
to be repositioned repeatedly to effectively relieve the pressure. In the case of frothy
bloat, antifoaming medications can be delivered directly into the rumen through the
tube; the animal should then be closely observed to insure that the treatment is
effective and the animal begins to belch gas, otherwise a rumenotomy may be
indicated.
A variety of antifoaming agents have been used to relieve frothy bloat. These include
common items such as vegetable oils (corn, peanut) or mineral oil, which are
administered in 100-300 ml volumes to cattle. A number of effective commercial
products are available that include such agents as polaxalene (a surfactant) or alcohol
ethoxylate (a detergent).
Control of bloat relies on management coupled sometimes with medications, but
despite best efforts, is rarely totally effective. Also, some of the techniques advocated
may be applicable to small herds, but are too labor intensive to use with large herds.
Many of the techniques used are based on reducing the rate of fermentation that
occurs in the rumen. Examples of control strategies include:
 maintain pastures that have grasses mixed with legumes such as alfalfa
 feed animals hay before turning out on bloat-inducing pastures
 in feedlots, feed roughage such as straw or grass hay in addition to concentrate