Effect of orally administered cimetidine and ranitidine on abomasal luminal pH in clinically normal milk-fed calves.

Abstract

To characterize the change of pH in the abomasal lumen throughout a 24-hour period, to determine whether pH of the abomasal body differs from pH of the pyloric antrum, and to determine whether oral administration of cimetidine and ranitidine alters pH of the abomasal lumen in milk-fed calves.
5 male dairy calves (4 Holsteins-Friesian, 1 Ayrshire), 5 to 15 days old.
Cannulas were surgically positioned in the abomasal body and pyloric antrum of each calf. Calves received the following treatments in a randomized crossover design: milk replacer (60 ml/kg of body weight, q 12 h [untreated control calves]), milk replacer and cimetidine (50 or 100 mg/kg, q 8 h), or milk replacer and ranitidine (10 or 50 mg/kg, q 8 h). The pH of the abomasal body and pyloric antrum was measured for 24 hours, using miniature glass pH electrodes.
Suckling of milk replacer immediately increased abomasal luminal pH from 1.4 to 6.0, followed by a gradual decrease to preprandial values by 6 hours. Preprandial and postprandial pH values were not significantly different between the abomasal body and pyloric antrum, indicating lack of pH compartmentalization in the abomasum of milk-fed calves. Administration of cimetidine and ranitidine caused a significant dose-dependent increase in mean 24-hour abomasal luminal pH.
Abomasal acid secretion in milk-fed calves is mediated in part by histamine type-2 receptors. Cimetidine and ranitidine may be efficacious in the treatment of abomasal ulcers in milk-fed calves.

Full text

Page 1

IJVS Vol.: 6; No.: 1,2 Serial No.: 14,15 Year: 2011

17

I RANI AN J OURNAL OF
V ETERI NARY S UR GERY
( I J VS)
W W W.I VSA.I R

Surgery of the Injured Dulla in Dromedary Camels
(Camelus dromedarius)

Fahd A. Al-Sobayil, PhD
Ahmed F. Ahmed∗ ∗, PhD

College of Agriculture and Veterinary Medicine, Qassim University,
Qassim, Saudi Arabia


Abstract

Objectives: to investigate classification and possible causes of dulaa disorders and effect
of surgical removal on male sexual desire.
Animals: Twenty six male camels (age=6-13years) with dulaa injuries were admitted to
the Veterinary Teaching Hospital, Qassim University, Saudi Arabia. Sixteen camels
showed signs of protruding, fluctuating and edematous dulaas. Other ten camels showed
signs of completely entrapped dulaas.
Procedures: Under deep sedation and local infiltration anesthesia, injured dulaa was
surgically amputated. Entrapped dulaa was gently pulled out before performing surgery.
Results: Amputated protruded dulaa had ulcers, edema and hematoma. Entrapped dulaa
had ulcers, impaction with food, fibrosis and penetrating wounds. None of the operated
males showed reducing sexual desire 4 weeks after the operation.
Conclusions and Clinical Relevance: It was concluded that injured dulaa was either
protruded or entrapped. Sharpness of canine teeth may play a role of having dulaa injury
in camels, so it is recommended to perform teeth rasping annually just before the
reproductive season. Amputation of dulaa had no effect on male sexual desire in
dromedary camels.
Keywords: Camel, Dulaa, Protruded, Entrapped, Amputation.



Introduction

The palatine diverticulum (dulaa or gulaa) is a distendable diverticulum on the lower part of
the soft palate usually seen in male dromedary camels.1,2 It is more developed in adult males
than in females and is protruded frequently during rutting season as a form of sexual behavior
of the male. The dulaa is not seen in other animals even in close relatives including the
Bactrian camels or South American llamas.3 The exact mechanism of distension of the dulaa

∗ Corresponding author:
Ahmed F. Ahmed, PhD
College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, 51452 Qassim, Saudi Arabia
email: afahmed70@hotmail.com

Page 2

IJVS Vol.: 6; No.: 1,2 Serial No.: 14,15 Year: 2011

18

is not well understood. However, it has been thought that the dulaa distends during expiration
when the camel closes its nares and air is forced from the lungs into the oral pharynx to inflate
the soft palate.1 With unknown reason, the exteriorized dulaa has been mainly seen in the
right commissure.4
The dulaa is commonly injured in adult male camels during breeding season. It has been
reported that injuries of dulaa occur when male camels chase females for mating or fights
with other males, or as a result of sharp teeth. The dulaa can be affected with lacerated
wounds, hematoma and food impaction.5 This might lead to extravasations of the blood inside
the cavity or at the submucosa of the dulaa. The inflammatory conditions with edematous
swelling of the dulaa affect its withdrawal to the mouth and by the time, the condition
becomes more complicated. Gangrene has been also recorded in the dulaa.6
Surgical removal of the injured dulaa has been described in few cases.5,6 In one study,7
surgical removal of the intact dulaa from male racing camels has been used as a technique to
increase the maximum oxygen uptake at speed, which overall improves track performance.
There are few reports on the detailed classification, etiology and treatment of the injured dulaa
in camels. Therefore, the objectives of this study were to investigate the classification and
possible causes of dulaa disorders and the effect of its surgical removal on sexual desire of
male dromedary camels.

Material and Methods

Animals

Twenty six male camels (Camelus dromedarius) were used in this study with mean age of 10
years (range from 6 to12 years). These camels were referred to the Veterinary Teaching
Hospital, College of Agriculture and Veterinary Medicine at Qassim University in Saudi
Arabia. History of the case, causes, and clinical symptoms were recorded. Treatment was
established by surgical amputation in all cases. Follow up of the cases was done by contacting
camel owners for a period of 6 months with special reference to the effect of amputation on
male sexual desire. The male sexual desire (attention, attraction, willingness and eagerness of
male toward female) and mating techniques (grasping, setting, and pelvic movements) were
compared before and after operation.

Surgical Procedure

Surgery was performed under deep sedation and local infiltration analgesia. The camel was
controlled in kneeling position. Xylazine hydrochloride a (0.2 mg/kg, IV) was first injected for
sedation. The mouth was opened and the oral cavity was washed by a potassium
permanganate solution (0.001%). The entrapped dulaa was gently pulled out with the help of
sponge forceps and gentle pressure on the enlarged throat region. The dulaa was prepared for
aseptic surgery and a local infiltration analgesia using lidocaine HCL 2% b was infiltrated at
the root of the dulaa. Two long artery forcepses were used to hold and crush the major blood
vessels close to the origin of the dulaa. A purse string suture pattern using Polydiaxanone No.
2 c was applied approximately 1 cm outside the location of the artery forcepses. About 2 cm
away from the purse string suture, the dissection was performed. The dulaa was removed and
the stump was closed by Cushing suture pattern using Polydiaxanone No. 2 c. In some cases,
interrupted, overlapping horizontal mattress stitches were used before amputation and the
wound was further closed by simple continuous sutures.

Page 3

IJVS Vol.: 6; No.: 1,2 Serial No.: 14,15 Year: 2011

19

The postoperative management consists of administering a systemic antibiotic (penicillin-
streptomycin at a dose of 30,000 IU/kg penicillin and 10 mg/kg streptomycin) d, for five days,
rasping the sharp teeth by using dental rasp and withholding food for 24 hours.

Results

Dulaa injuries were classified into two categories, protrusion (n=16) and entrapment (n=10).
The mean (±SD) ages of camels with protruded and entrapped dulaa were 9.1 (±3.1) and 8.6
(±2.4) years, respectively. The mean time elapsed between the occurrence of dulaa injury and
presentation to the hospital (history of the case) for protruded and entrapped dulaa was 2.8
(±1.8) and 9.8 (±4.7) days, respectively. All cases, except one, presented to the hospital
during the breeding season. All camels had long and sharp teeth especially canines (Fig. 1E).
The protruded dulaa was ulcerated, edematous and in 13 (out of 16) cases with hematomas
(Fig. 1A). Camels showed signs of protruded, fluctuating and edematous dulaas. Camels were
unable to withdraw the dulaa inside the mouth. The owners stated that the conditions appeared
gradually during the reproduction (rutting) season (November-February). On the other hand,
the dulaa was completely entrapped at its normal position in ten camels. These camels showed
signs of dysphagia and mild dyspnea. The entrapped dulaa had signs of ulceration, impaction
with food, fibrosis and penetrating wounds (Fig. 1C and 1F).
Successful surgical amputation of the dulaa was performed in 25 (out of 26) camels. One
camel died during exteriorization of the entrapped dulaa. No postoperative complication was
recorded in all cases. Twenty four animals returned to normal life within two weeks
postoperatively. The operation had no effect on the male sexual desire in 21 cases. The
information about postoperative male sexual desire could not be obtained in 4 cases.



Figure 1. A) A protruded dulaa in a male camel with ulceration, edema and hematoma. B) A palpable and
observable swelling at the throat region as a result of dulaa entrapment with signs of severe dyspnea. C)
Impacted dulaa with food. D) An entrapped portion of the dulaa in the canine tooth. E) The sharpness of the
canine teeth in a male camel. F) Ulcers and penetrating wound in an entrapped dulaa after amputation.

Page 4

IJVS Vol.: 6; No.: 1,2 Serial No.: 14,15 Year: 2011

20

Discussion

The major owner complains of injured dulaa were dysphagia and dyspnea (Fig. 1B).
Dysphagia has been reported as a characteristic sign seen in cases of soft palate injuries.8 The
dulaa was unable to balloon out (entrapped type) or stays hanging outside the mouth
(protruded type). It has been reported that a camel with protruded dulaa doesn't eat or drink,
whereas a camel with entrapped dulaa can drink but cannot eat.9 The other sign that can be
seen in case of protruded or entrapped dulaa is stretched neck.8 In addition, the entrapped
dulaa may adhere with its nearest structures that negatively affect its inflating.8
It has been reported that injuries of dulaa occur when male camels chase females for mating
or fights with other males, or as a result of sharp teeth. The dulaa can be affected with
lacerated wounds, hematoma and food impaction.5 In the present study, the canine and
premolar teeth of all camels were very sharp (Fig. 1E). In some cases, the camel showed a
portion of its dulaa entrapped in a tooth (Fig. 1D). The present study showed that the injured
dulaa had ulceration, and/or penetrating wound with subsequent entrapment (Fig. 1D). It
seems that these wounds and ulceration occurred as a result of sharp teeth. Therefore, rasping
or trimming of sharp teeth in male camels might decrease the chance of having the dulaa
injuries. This can be performed as a routine task once a year just before the beginning of the
reproductive season.
In the present study, cases of protruded dulaa were ulcerated, edematous, and in most cases
with hematomas (Fig. 1A). It has been reported that the injuries of dulaa cause tear to the
mucosa and rupture of its blood vessels.8 As a result of that, a daily increase in the size of the
protruded dulaa might be seen. The delay of performing surgical amputation of the injured
dulaa may lead to its gangrene.6
In case of entrapped dulaa, a palpable and observable swelling is seen externally at the throat
region (Fig. 1B). A long hook has been used to pull out and then a towel was used to catch the
pulled portion of the entrapped dulaa.8 In this study, the dulaa was entrapped as a result of
food impaction or wound penetration (Fig. 1C). Regurgitated food during rumination may
enter the injured palatine diverticulum retrogradly resulted in its impaction and subsequent
entrapment. For expulsion of the entrapped dulaa, the sedated camel was positioned in a
lateral recumbency. The mouth was opened and the tongue was gently pulled out. The area of
pharynx was gently pressed upward by an assistant and the displayed portion of the dulaa was
used to pull it out completely. Lowering the rostrum facilitated exteriorization. Withdrawing
the food-impacted and entrapped dulaa showed signs of asphyxia. Therefore, the food inside
the dulaa was first removed by using water hose to facilitate its withdrawal.
Surgical amputation of dulaa has been reported elsewhere.5,6 Temporary tracheotomy has
been reported as a procedure preceded the surgical removal of the impacted dulaa.5 In this
study, tracheotomy was not performed and the entrapped dulaa of all the camels were
successfully removed except in one camel. This camel had difficulty to breath and died during
surgery while trying to withdraw the dulaa out of the throat. Asphyxia was thought to be the
cause of death. Temporary tracheotomy was not performed to this camel prior to the surgery.
It can be concluded that temporary tracheotomy should be performed prior to surgical
amputation of an entrapped dulaa in camels that show signs of severe dyspenea. Another
study has reported the death of one camel due to severe bleeding leading to occlusion of the
airway by blood clots.10
The effects of dulaa amputation on the reproductive behavior and performance of the male
camels have not been studied yet. Although the exact function of dulaa is not known, it
becomes more active and well developed during the reproductive season in adult male camels.

Page 5

IJVS Vol.: 6; No.: 1,2 Serial No.: 14,15 Year: 2011

21

In the present study, the vast majority of male camels resumed their normal sexual desired
during the follow up period. Follow up was lost in 4 cases because of selling and transport. It
has been shown that the histological structure of the dulaa consists of several mucous glands.
However, the exact secretions of these glands have not been determined yet.2
In conclusion, injuries of the dulaa occur commonly during the breeding season of dromedary
camels. These injuries are classified as protrusion and entrapment. Sharp teeth are the primary
cause of injured dulaa. It is recommended to rasp or trim these sharp teeth annually just before
the rutting season. Amputation of the dulaa had no effect on male sexual desire in dromedary
camel.

Acknowledgments

Authors would thank the staff of the Veterinary Teaching Hospital, College of Agriculture
and Veterinary Medicine, Qassim University for their technical help.

Footnotes

a Bomazine 10%, BOMAC Laboratories Ltd, New Zealand
b Norbrook Laboratories, UK
c PDS, NO. 2, Ethicon, UK
d Pen&strep, Norbrook Laboratories, UK

References

1. Arnautovic I, Abdel Magid AM. Anatomy and mechanism of distension of the dulaa
of the one-humped camel. Acta Anat 1974; 88: 115-124.
2. Smuts MMS, Bezuidenhout AJ, Mazierski D. Anatomy of the Dromedary. Clarendon
press, Oxford, 1987:113-114.
3. Tibary A, Anouassi A. Theriogenology in Camelidae. Abu Dhabi Printing and
Publishing Company. Mina, Abu Dhabi, 1997.
4. Khan AA, Kohli IS. A note on the sexual behavior of the male camel (Camelus
dromedarius). Indian J Anim Sci 1973;43:1092-1094.
5. Ramadan RO. Soft palate and its disorders. In: Ramadan RO ed. Surgery and
Radiology of the Dromedary Camel. Al-Jawad Printing press. Al-Ahsa, Saudi Arabia,
1994:91-98.
6. Gahlot TK, Chouhan DS, Choudhary RJ. Soft palate gangrene in camels (Camelus
dromedarius). Indian Vet J 1988;65: 527-528.
7. Kuhad KS, Tinson AH, Rehman A, et al., New technique for soft palatectomy in one-
humped male racing camels, In Proceedings. 3rd Anim Meet Anim Prod Under Arid
Cond, UAE University, UAE, 1998; 2:145-153.
8. Gahlot TK. Soft palate injuries. In: Gahlot TK, ed. Selected Topics on Camelids. The
Camelid Publishers. Bikaner, India, 2000:318-319.
9. Kohler-Rollefson I, Mundy P, Mathias E. A Field Manual of Camel Diseases. ITDG
Publishing. London, UK, 2001:106-107.
10. Gahlot TK, Chouhan DS. Camel Surgery. Gyan Prakashan Mandir, Bikaner, India.
1992:47-52.

Page 6

IJVS Vol.: 6; No.: 1,2 Serial No.: 14,15 Year: 2011

22

هﺪﻴﻜﭼ

ﻪﻧﺎﻫﻮﻛ ﻚﻳ يﺎﻫﺮﺘﺷ رد هﺪﻳد ﺐﻴﺳآ ﻻود ﻲﺣاﺮﺟ

ﺪﻤﺣا ف ﺪﻤﺣا ،ﻲﻠﻴﺒﺴﻟا ﺪﻬﻓ

يدﻮﻌﺻ نﺎﺘﺴﺑﺮﻋ ،ﻢﻴﺼﻗ ،ﻢﻴﺼﻗ هﺎﮕﺸﻧاد ،ﻲﻜﺷﺰﭙﻣاد و يزروﺎﺸﻛ هﺪﻜﺸﻧاد

ﻚﻤﻛ ﺎﺑ نآ ﺖﺷادﺮﺑ ﺮﻴﺛﺎﺗ و ﻻود تﻻﻼﺘﺧا ﻲﻟﺎﻤﺘﺣا ﻞﻠﻋ يﺪﻨﺑ ﻲﺴﻨﺟ ﻞﻴﻣ يور ﻲﺣاﺮﺟ

فﺪﻫ- ﻢﻴﺴﻘﺗ ﻲﺳرﺮﺑ
تﺎﻧاﻮﻴﺣ-
26 ﺮﻧ ﺮﺘﺷ ﺮﻔﻧ)ﺤﻣ ﻲﻨﺳ هدوﺪ6 -13 لﺎﺳ ( هﺎﮕﺸﻧاد ﻲﻜﺷﺰﭙﻣاد هﺪﻜﺸﻧاد ﻲﺷزﻮﻣآ نﺎﺘﺳرﺎﻤﻴﺑ رد ﻻود يﺎﻫ ﺐﻴﺳآ ﺎﺑ
ﺪﻧﺪﺷ شﺮﻳﺬﭘ يدﻮﻌﺻ نﺎﺘﺴﺑﺮﻋ ﻢﻴﺼﻗ
دﻮﺑ هدﺎﺘﻓا ﺮﻴﮔ ﻞﻣﺎﻛ.
.16 ﺪﻧداد نﺎﺸﻧ ار ﻻود مدا و ﻲﮔدز نوﺮﻴﺑ ﻢﺋﻼﻋ ﺎﻫﺮﺘﺷ زا ﺮﻔﻧ . رﻮﻄﺑ ﻻود ﺮﮕﻳد ﺮﻔﻧ هد رد
رﺎﻛ شور- مارآ ﺖﺤﺗﻲﺑ و ﻖﻴﻤﻋ ﻲﺸﺨﺑ ﻮﻣ ﻲﺴﺣ ﺶﻴﭘ هدﺎﺘﻓا ﺮﻴﮔ يﻻود و ﺪﺷ ﻊﻄﻗ ﻲﺣاﺮﺟ ﻖﻳﺮﻃ زا هﺪﻳد ﺐﻴﺳآ يﻻود ،ﻲﻌﺿ
ﺪﺷ هﺪﻴﺸﻛ نوﺮﻴﺑ ﻢﻳﻼﻣ رﻮﻄﺑ ﻲﺣاﺮﺟ زا.
ﺞﻳﺎﺘﻧ- ﺖﺷاد مﻮﺗﺎﻤﻫ و مدا ،ﻢﺧز ،هﺪﺷ ﻊﻄﻗ هدز نوﺮﻴﺑ يﻻود . ار هﺬﻓﺎﻧ ﻢﺧز و زوﺮﺒﻴﻓ ،اﺬﻏ ﺎﺑ ﻲﮕﺘﺷﺎﺒﻧا ،ﻢﺧز هدﺎﺘﻓا ﺮﻴﮔ يﻻود
داد نﺎﺸﻧ . ماﺪﻜﭽﻴﻫ ﺎﺗ هﺪﺷ ﻞﻤﻋ ﺮﻧ تﺎﻧاﻮﻴﺣ زا 4 ﺪﻧداﺪﻧ نﺎﺸﻧ ﻲﺴﻨﺟ ﻞﻴﻛ ﺶﻫﺎﻛ ﻲﺣاﺮﺟ زا ﺪﻌﺑ ﻪﺘﻔﻫ.
ﻲﻨﻴﻟﺎﺑ دﺮﺑرﺎﻛ و يﺮﻴﮔ ﻪﺠﻴﺘﻧ- ﺖﺳا هدﺎﺘﻓا ﺮﻴﮔ ﺎﻳ هدز نوﺮﻴﺑ ،هﺪﻳد ﺐﻴﺳآ يﻻود . ناﺪﻧد يﺰﻴﺗ رد ﺖﺳا ﻦﻜﻤﻣ ﺶﻴﻧ يﺎﻫ
ﻲﻣ ﻪﻴﺻﻮﺗ و ﺪﺷﺎﺑ ﺶﻘﻧ ﺪﺟاو ﺮﺘﺷ رد ﻻود ﺐﻴﺳآ
ﺖﺷاﺪﻧ ﻪﻧﺎﻫﻮﻛ ﻚﻳ يﺎﻫﺮﺘﺷ رد ﻲﺴﻨﺟ ﻞﻴﻣ يور يﺮﺛا.
.
ﻮﺗ ﻞﺼﻓ زا ﻞﺒﻗ ﻪﻧﺎﻴﻟﺎﺳ ﺎﻬﻧاﺪﻧد ﻪﻛ دﻮﺷدﻮﺷ هدز نﺎﻫﻮﺳ ﻲﻠﺜﻣﺪﻴﻟ . ﻻود ﻊﻄﻗ
يﺪﻴﻠﻛ تﺎﻤﻠﻛ- ﻊﻄﻗ ،هدﺎﺘﻓا ﺮﻴﮔ ،هدز نوﺮﻴﺑ ،ﻻود ،ﺮﺘﺷ