Ultrasonographic findings in three cows with cellulitis

CELLULITIS is defined as non-encapsulated diffuse or localised inflammation of the subcutaneous tissues (Schliesser and Weiss 1993, Weiss and Teifke 1999) caused by infection or toxic chemical substances (Gründer 2002). Bacteria may enter the subcutis through minute wounds, which are frequently not visible once the cellulitis has developed. Clostridium chauvoei, Clostridium septicum and other gas-producing bacteria cause anaerobic or gaseous cellulitis. Subcutaneous or paravenous injection of irritating substances such as calcium chloride may also result in cellulitis (Braun 2002). Cellulitis tends to involve adjacent structures, including fascia and muscle, and form abscesses, which commonly rupture through the skin (Weiss and Teifke 1999). Occasionally, extensive cellulitis can lead to septicaemia and death, particularly in dogs and horses. The diagnosis of cellulitis can be based on clinical findings; the differential diagnoses include seroma, haematoma and abscess. To the authors’ knowledge, the ultrasonographic appearance of cellulitis in cattle has not previously been reported. This short communication describes the ultrasonographic findings in three cows with cellulitis in the thoracic or abdominal regions. The cows ranged in age from two to seven years and had been ill for two to seven days. They were referred to the authors’ clinic and were presented with severe swelling of the thoracic or abdominal wall regions. The referring veterinarians had tentatively diagnosed a hernia in cow 1 and a C chauvoei (blackleg) infection in cow 2. In cow 3, the swelling was thought to be associated with an intravenous infusion of calcium into the ipsilateral udder vein (subcutaneous abdominal vein) for the treatment of a puerperal metabolic disturbance. All the cows had fever and reduced or no appetite. Before the onset of signs in cow 1 the skin of the udder ipsilateral to the cellulitis had been injured, and cow 2 had been pastured in a field with thorn bushes. The general behaviour and condition of all the cows was moderately to severely abnormal, and all were anorexic. The rectal temperature varied from 39·0 to 39·7°C, and the heart rate ranged from 72 to 102 bpm. Ruminal and intestinal motility was reduced or absent. Cow 1 had multiple skin wounds, 2 to 5 cm in length, over the caudal aspect of the udder, and the udder was swollen, mainly on the right side. A milk sample appeared macroscopically normal, and the California mastitis test was negative in all four quarters. The swelling extended from the udder along the right ventral abdomen to the sternum and along the right lateral abdominal wall to the level of the stifle. Most of the swelling was hard and painful, although there were some fluctuant areas. In cow 2, the swelling extended from the middle of the neck over the left shoulder to the 10th intercostal space and from the level of the shoulder joint to the ventral midline (Fig 1). In cow 3, the swelling extended from the udder to the sternum and from the ventral midline to the level of the elbow joint on the right side. The swellings were firm and painful in both cows 2 and 3. The most notable haematological and biochemical findings were an elevated fibrinogen concentration of 10 and 8 g/l (reference range 5 to 7 g/l) in cows 1 and 2, respectively. Cow 1 also had an elevated plasma protein concentration of 90 g/l (reference range 60 to 80 g/l) and a markedly reduced clotting time of 2·5 minutes (reference range 10 to 15 minutes) in the glutaraldehyde test. Cow 2 had leucocytosis (10,900 leucocytes/μl blood) with 71 per cent segmented neutrophils (reference range 5000 to 10,000 leucocytes/μl blood with 25 to 45 per cent segmented neutrophils) and a left shift. The results of blood gas analyses, the activities of liver and muscle