Student Case Presentation
When Routine Surgery Takes a Turn: Incisional Infection, Retroperitoneal Abscess, and Peritonitis Following LDA Surgery in a Holstein Cow
| Date/Time: |
8/27/2026 Poster 15
|
| Presenter: |
Emma Guasta |
| Veterinary School: |
COR |
Abstract:
A two-year-old first-lactation Holstein cow presented with progressive lethargy to Cornell Nemo Farm Animal Hospital on March 13, 2025. Two weeks prior, she underwent a right paralumbar laparotomy for correction of a left displaced abomasum (LDA) and reportedly did not recover well from her procedure per the owner. The patient arrived bright, nervous, and responsive. She was afebrile, with hypomotile gastrointestinal sounds and small areas of tympanitic resonance around the prior incision site. On rectal palpation, a soft tissue-like structure was palpated on the right side of the abdomen. Ultrasound of the previous incision site showed a large hyperechoic structure with swirling hyperechoic material within and deep to the body wall. Initial diagnostics included CBC with fibrinogen and serum chemistry, including ketones and lactate. Results were consistent with acute inflammation and hyperlactemia, with no signs of ketosis evident.
The patient was taken to surgery same-day to explore the previous surgical site. Upon incision through skin and subsequent muscle layers, purulent and malodorous fibrinous material exuded from the incision and peritoneal cavity. Attempts were made to manually break down the adhesions surrounding the omasum, but were unsuccessful. Ultimately, the abscess and peritonitis were deemed too significant to resolve, and the patient was closed in a two-layer closure, with the owner electing for at-home euthanasia.
While improvements in management have drastically decreased the incidence of LDAs, this surgery remains one of the most routine procedures in dairy practice. This case study emphasizes the importance of mindful case selection, careful surgical technique, and close postoperative follow-up in patients with systemic compromise. Timely recognition of surgical complications by either client or veterinarian is crucial to support positive patient outcomes, no matter how “hardy” the animal.
