Diagnostic imaging procedures and herd management algorithm in grazing cows affected by chronic enzootic hematuria.

Introduction - Chronic Enzootic Hematuria (CEH) is a bladder disorder due to bracken fern intake and observed in grazing cows of south Italy. Modern imaging techniques such as ultrasound and cystoscopy can be recently applied in alive animals to perform diagnosis. Aim - The goals of present investigation were: to compare the usefulness of ultrasonography and video-cystoscopy in animals affected by CEH, to evaluate the impairment of animal welfare due to the procedures performed, to develop a new diagnostic/decision algorithm based on the analysis of the previous goals. Materials and Methods - After a screening phase performed on 230 Podolic breed cows, 24 cows with hematuria were enrolled. All of them were scored for discomfort status pre- and post- ultrasonography (T0u and T1u, respectively), as well as pre- and post- cystoscopy (T0c and T1c) by means of cumulative scoring system. Results - Ultrasonography allows an easy and early identification of structural changes of the organs involved with low consequences on animals’ welfare; video-cystoscopy guaranteed a direct vision of the bladder’s mucosa and lesions as well as the possibility of biopsy in field achieving a certain diagnosis and staging. Comparing the two techniques (T1u vs. T1c), significant difference were observed for the variables aimless chewing (P<0.05), response to approach (P<0.01) as well as for behaviors such us attention, back position weight shifting, ear position (P<0.0001) and the parameters HR and RR (P<0.0001). Discussion and Conclusions – Independently from disease's severity, ultrasonography was perceived as less stressful by the cows when compared with a video-cystoscopy entailing longer execution times and higher level of animal handling. The combined use of the two imaging techniques produced a diagnostic/decisional algorithm that may aid the practitioners in field to manage the animals affected. Herd grazing in endemic areas should be monitored on regular base and presence of one positive cows should justify further investigations.