Jejunal Haemorrhagic Syndrome

This is probably something that most of you will (hopefully!) never have heard of, but  we have seen a handful of cases of this unusual syndrome recently. While many of you will never see a case on your farm, if you do it will certainly stick in the memory. Not much is known about the causes of Jejunal
Haemorrhagic Syndrome (JHS) – it appears to be a disease predominantly of dairy cattle, and while recent research has ruled out clostridial disease as a possible cause, the actual cause is still unknown and remains under
investigation. Cows present as having abdominal (belly) pain (grinding teeth is often a sign of this), they appear bloated with reduced faecal output, they have a sudden drop in milk production and are lethargic with a rapid heart rate and either normal or low temperature.

These signs are quite non-specific, and examination is needed to rule out RDA,
intestinal obstruction, caecal dilation and other causes of abdominal pain. Veterinary examination of the cases we have seen recently has revealed gas filled intestines and clots of fresh/slightly digested blood in the faeces. This appears slightly different to the tarry, stinking black sticky faeces you may have seen in a cow with an ulcer, and indicates a bleed further along the digestive tract. This is indeed what is taking place, the jejunum is the second part of the cow’s small intestine, and in this syndrome large scale bleeding takes place across the lining of this part of the gut. The blood then clots in the lumen (inside) of the intestine and the cow cannot move this clot to pass it out. This explains the belly pain (cramping intestines) high heart rate, lethargy and drop in milk production (loss of blood and fluid leads to signs of shock) and the abdominal bloating (the clot blocks the intestine and gas builds up behind it).

Rapid loss of blood into the intestines reduces the amount of blood circulating which will lead to the cow being unable to stand, and rapid deterioration is seen in these cases. Blood samples taken from our most recent case showed biochemical disruption: low chloride, low phosphorus, disrupted acid base balance and low blood sugar all contribute to a cow feeling pretty rotten and being unable/unwilling to stand.

Unfortunately the prognosis even with early and wide ranging attempts at treatment is exceptionally poor in these cases – 85-100% die and confident diagnosis of JHS can only be made by post mortem, where the carcass is very pale and when the jejunum is opened up long thick black ropes of solid clotted blood are found which have blocked the intestines.

Fingers crossed this is the last most of you ever hear or think about Jejunal Haemorrhagic Syndrome!