Bloat in Ruminants

In primary ruminal tympany, or frothy bloat, the cause is entrapment of normal gases of fermentation in a stable foam. Coalescence of the small gas bubbles is inhibited, and intraruminal pressure increases because eructation cannot occur. Several factors, both animal and plant, influence formation of a stable foam. Soluble leaf proteins, saponins, and hemicelluloses are believed to be the primary foaming agents and to form a monomolecular layer around gas rumen bubbles that has its greatest stability at about pH 6. Salivary mucin is antifoaming, but saliva production is reduced with succulent forages. Bloat-producing pastures are more rapidly digested and may release a greater amount of small chloroplast particles that trap gas bubbles and prevent their coalescence. The immediate effect of feeding is probably to supply nutrients for a burst of microbial fermentation. However, the major factor that determines whether bloat will occur is the nature of the ruminal contents. Protein content and rates of digestion and ruminal passage reflect the forage’s potential for causing bloat. Over a 24-hour period, the bloat-causing forage and unknown animal factors combine to maintain an increased concentration of small feed particles and enhance the susceptibility to bloat.

Bloat is most common in animals grazing legume or legume-dominant pastures, particularly alfalfa, ladino, and red and white clovers, but also is seen with grazing of young green cereal crops, rape, kale, turnips, and legume vegetable crops. Legume forages such as alfalfa and clover have a higher percentage of protein and are digested more quickly. Other legumes, such as sainfoin, crown vetch, milk vetch, fenugreek, and birdsfoot trefoil, are high in protein but do not cause bloat, probably because they contain condensed tannins, which precipitate protein and are digested more slowly than alfalfa or clover. Leguminous bloat is most common when cattle are placed on lush pastures, particularly those dominated by rapidly growing leguminous plants in the vegetative and early bud stages, but can also be seen when high-quality hay is fed.

Frothy bloat also is seen in feedlot cattle, and less commonly in dairy cattle, on high-grain diets. The cause of the foam in feedlot bloat is uncertain but is thought to be either the production of insoluble slime by certain species of rumen bacteria in cattle fed high-carbohydrate diets or the entrapment of the gases of fermentation by the fine particle size of ground feed. Fine particulate matter, such as in finely ground grain, can markedly affect foam stability, as can a low roughage intake. Feedlot bloat is most common in cattle that have been on a grain diet for 1–2 months. This timing may be due to the increase in the level of grain feeding or to the time it takes for the slime-producing rumen bacteria to proliferate to large enough numbers.

In secondary ruminal tympany, or free-gas bloat, physical obstruction of eructation is caused by esophageal obstruction due to a foreign body (eg, potatoes, apples, turnips, kiwifruit), stenosis, or pressure from enlargement outside the esophagus (as from lymphadenopathy or sporadic juvenile thymic lymphoma). Interference with esophageal groove function in vagal indigestion and diaphragmatic hernia may cause chronic ruminal tympany. This also occurs in tetanus. Tumors and other lesions, such as those caused by infection of the esophageal groove or the reticular wall, are less common causes of obstructive bloat. There also may be interference with the nerve pathways involved in the eructation reflex. Lesions of the wall of the reticulum (which contains tension receptors and receptors that discriminate between gas, foam, and liquid) may interrupt the normal reflex essential for escape of gas from the rumen.

Ruminal tympany also can be secondary to the acute onset of ruminal atony that occurs in anaphylaxis and in grain overload; this causes a decrease in rumen pH and possibly an esophagitis and rumenitis that can interfere with eructation. Ruminal tympany also develops with hypocalcemia. Chronic ruminal tympany is relatively frequent in calves up to 6 months old without apparent cause; this form usually resolves spontaneously.

Unusual postures, particularly lateral recumbency, are commonly associated with secondary tympany. Ruminants may die of bloat if they become accidentally cast in dorsal recumbency or other restrictive positions in handling facilities, crowded transportation vehicles, or irrigation ditches.

Bloat is a common cause of sudden death in feedlot cattle. Cattle not observed closely, such as pastured and feedlot cattle and dry dairy cattle, usually are found dead. In lactating dairy cattle, which are observed regularly, bloat commonly begins within 1 hour after being turned onto a bloat-producing pasture. Bloat may develop on the first day after being placed on the pasture but more commonly develops on the second or third day.

In primary pasture bloat, the rumen becomes obviously distended suddenly, and the left flank may be so distended that the contour of the paralumbar fossa protrudes above the vertebral column; the entire abdomen is enlarged. As the bloat progresses, the skin over the left flank becomes progressively more taut and, in severe cases, cannot be tented. Dyspnea and grunting are marked and are accompanied by mouth breathing, protrusion of the tongue, extension of the head, and frequent urination. Rumen motility does not decrease until bloat is severe. If the tympany continues to worsen, the animal will collapse and die. Death may occur within 1 hour after grazing began but is more common ~3–4 hours after onset of clinical signs. In a group of affected cattle, there are usually several with clinical bloat and some with mild to moderate abdominal distention.

In secondary bloat, the excess gas is usually free on top of the solid and fluid ruminal contents, although frothy bloat may be seen in vagal indigestion when there is increased ruminal activity. Secondary bloat is seen sporadically. There is tympanic resonance over the dorsal abdomen left of the midline. Free gas produces a higher pitched ping on percussion than frothy bloat. The distention of the rumen can be detected on rectal examination. In free-gas bloat, the passage of a stomach tube or trocarization releases large quantities of gas and alleviates distention.

• Primary ruminal tympany (frothy bloat) is not relieved by passage of an ororuminal tube; a stable foam is present in the tube after removal

• Confirmed by rapid correction of bloat after ororuminal administration of an antifoaming agent

• Secondary ruminal tympany (free-gas bloat) is immediately relieved by passage of an ororuminal tube or insertion of a rumen trocar

Usually, the clinical diagnosis of frothy bloat is obvious. The causes of secondary bloat must be ascertained by clinical examination to determine the cause of the failure of eructation.

• Frothy bloat: antifoaming agents, administered ororuminally

• Free-gas bloat: placement of a rumen fistula or removal of an esophageal obstruction

In life-threatening cases of bloat, an emergency rumenotomy may be necessary; it is accompanied by an explosive release of ruminal contents and, thus, marked relief for the cow. Recovery is usually uneventful, with only occasional minor complications.

A trocar and cannula may be used for emergency relief of free-gas bloat, although the standard-sized instrument is not large enough to allow the viscous, stable foam in peracute cases to escape quickly enough. A larger-bore instrument (2.5 cm in diameter) is necessary, but an incision through the skin must be made before it can be inserted through the muscle layers and into the rumen. If the cannula fails to reduce the bloat and the patient’s life is threatened, an emergency rumenotomy should be performed. If the cannula provides some relief, an antifoaming agent (availability varies from country to country) can be administered through the cannula, which can remain in place until the patient has returned to normal, usually within several hours.

Cannulation of Rumen, Cow

Illustration of cannulation of a cow rumen. The ideal location to ensure optimal free-gas release is midway in the paralumbar fossa and 5–10 cm below the transverse processes of the lumbar vertebrae. Illustration by Dr. Gheorghe Constantinescu.

When the animal’s life is not immediately threatened, passing a stomach tube of the largest bore possible is recommended. A few attempts should be made to clear the tube by blowing and moving it back and forth in an attempt to find large pockets of rumen gas that can be released. In frothy bloat, it may be impossible to reduce the pressure with the tube, and an antifoaming agent should be administered while the tube is in place. If the bloat is not relieved quickly by the antifoaming agent, the animal must be observed carefully for the next hour to determine whether the treatment has been successful or whether an alternative treatment is necessary.

A variety of antifoaming agents are effective, including vegetable oils (eg, peanut, corn, soybean) and mineral oils (paraffins), at doses of 250–500 mL. In general, any nontoxic oil that is not rapidly metabolized is effective, because they all reduce surface tension and foam. Dioctyl sodium sulfosuccinate, a surfactant, is commonly incorporated into one of the above oils and sold as a proprietary antibloat remedy, which is effective if administered early (1,000 mg, PO via drench or stomach tube, every 24 hours as needed; meat withholding time, 3 days; milk withholding time, 96 hours). Poloxalene (25–50 g, PO as a drench, as needed for emergency treatment of ruminal tympany in cattle) is effective in treating legume bloat but not feedlot bloat (minimum withholding, 48 hours). Alcohol ethoxylates (40 mL of a 50% solution of alcohol ethoxylate and pluronic detergents [vol/vol], PO intraruminally 1 h before feeding, every 24 hours) are also used as antifoaming agents in some countries (no established withholding times). Placement of a rumen fistula provides short-term relief for cases of free-gas bloat associated with external obstruction of the esophagus.

Prevention of pasture bloat can be difficult. Management practices used to reduce the risk of bloat include feeding hay, particularly orchard grass, before turning cattle on pasture, maintaining grass dominance in the sward, or using strip grazing to restrict intake, with movement of animals to a new strip in the afternoon, not the early morning. Hay must constitute at least one-third of the diet to effectively reduce risk of bloat. Feeding hay or strip grazing may be reliable when the pasture is only moderately dangerous, but these methods are less reliable when the pasture is in the prebloom stage and the bloat potential is high. Mature pastures are less likely to cause bloat than immature or rapidly growing pastures.

The only satisfactory method available to prevent pasture bloating is continual administration of an antifoaming agent during the risk period. This is widely practiced in grassland countries such as Australia and New Zealand. The most reliable method is drenching twice daily (eg, at milking times) with an antifoaming agent. Spraying the agent onto the pasture is equally effective, provided the animals have access only to treated pasture. This method is ideal for strip grazing but not when grazing is uncontrolled. The antifoaming agent can be added to the feed or water or incorporated into feed blocks, but success with this method depends on adequate individual intake. The agent can be painted on the flanks of the animals, from which it is licked during the day, but animals that do not lick will be unprotected.

Available antifoaming agents include oils and fats (60–120 mL/head and up to 240 mL/head during dangerous periods, PO, every 24 hours) and synthetic nonionic surfactants. These agents facilitate the solubilization of water-insoluble factors that contribute to formation of a stable foam. Poloxalene, a synthetic polyoxythylene-polyoxypropylene block polymer, is a highly effective nonionic surfactant that is effective in treating legume bloat but not feedlot bloat (10–20 g/head and up to 40 g/head, PO as a drench, every 24 hours in high-risk situations; minimum withholding, 48 hours). It is safe and economical to use and is administered daily through the susceptible period by adding to water, feed grain mixtures, or molasses. An antifoaming detergent and a water-soluble mixture of alcohol ethoxylate and antifoaming detergents also are effective, but they are not available in all countries. Ionophores effectively prevent bloat, and monensin sustained-release capsules protect against pasture bloat and improve milk production on bloat-prone pastures (expected release rate, 300 mg, intraruminally, every 24 hours for a 100-day period; no established withholding times).

The ultimate aim in control is development of a pasture that permits high production, while keeping incidence of bloat low. The use of pastures of clover and grasses in equal amounts comes closest to achieving this goal. Bloat potential varies between cultivars of alfalfa, and low-risk LIRD (low initial rate of digestion) cultivars are available commercially. The addition of legumes with high condensed tannins to the pasture seeding mix (10% sainfoin) can reduce the risk of bloat where there is strip grazing, as can the feeding of sainfoin pellets.

To prevent feedlot bloat, rations should contain ≥10–15% cut or chopped roughage mixed into the complete feed. Preferably, the roughage should be a cereal, grain straw, grass hay, or equivalent. Grains should be rolled or cracked, not finely ground. Pelleted rations made from finely ground grain should be avoided. The addition of tallow (3%–5% of the total ration) may be successful occasionally, but it was not effective in controlled trials. The nonionic surfactants, such as poloxalene, have been ineffective in preventing feedlot bloat, but the ionophore lasalocid (approx 1 mg/kg, PO by oral gavage, every 24 hours for 28 days; no established withholding times) is effective in control.

• Fubini SL, Yeager AE, Divers TJ. Noninfectious diseases of the gastrointestinal tract. In: Divers TJ, Peek SF, eds. Rebhun's Diseases of Dairy Cattle. 3rd ed. Elsevier; 2018:168–248.