Never Make Assumptions - A Case Study

In the middle of a busy bank holiday on call, a concerned farmer contacted me about a heifer bleeding from the nose. I got in the jeep and headed out, assuming from his description that it was a condition called thrombosis. He told me she had calved the day before and had suddenly gone off form. Vena cava thrombosis means that a large abscess has developed in the main blood vessel in the chest, causing it to rupture and blood to issue from both nostrils. It has a terrible prognosis, usually in the short term.

First Impression: Not a Thrombosis

When I arrived at the farm, my opinion changed. The heifer was notably nervous and hyperaesthetic (wild), which he said was strange because she calved down fine and was usually a quiet animal. She was bleeding from only one nostril, which made it more likely to be trauma due to her agitated state. At this stage my trail of thought turned to meningitis or maybe nervous ketosis.

Physical Exam

The next stage was the all-important physical exam. I ruled out meningitis because, even though she was standing, she showed some of the clinical signs of grass tetany. Mg controls nerve function, so a drop in blood concentrations can lead to agitation, which would naturally lead to eventual collapse quite quickly. Her heart rate was also twice the normal rate, which is common with grass tetany. She was in some distress and did not quite fit the bill for nervous ketosis. This is a condition caused by certain by-products of acute negative energy in the blood and causes severe nervous symptoms. It is a relatively uncommon condition, however.


Having weighed up all the possibilities, and because conditions were perfect for grass tetany, we decided to treat her with Mg. Grass tetany can strike when bad weather causes reduced intake, and the very low levels of Mg in spring grasses aggravates matters. We gave her some subcutaneous Mg, some Chanatol, and anti-inflammatories to make sure we covered ketosis.


The farmer called me three hours later to say she was a different animal and was eating. I don’t always get the right result like this but what the case highlights is:

  • the risk of grass tetany in spring
  • the importance of never making assumptions
  • the value of experience

When cows suddenly go off there usually something wrong, and with most of these conditions the earlier intervention the better.

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