Toggle repair of the LDA can be accomplished with or without tranquilization/sedation, depending on the disposition and size of the cow. Other considerations include the amount of help available and the type of facilities. A minimum of 2 persons is recommended ( veterinarian and assistant ), however, 3 persons greatly facilitates the ease with which this procedure can be performed, particularly if the cow is large. It is best to perform this procedure in a pen of adequate size that allows for easy casting and complete roll-over of the cow.

It is recommended that the veterinarian perform a visual inspection of the toggle sutures at the beginning of each procedure to make sure the suture material is not frayed. (Cosmetic bends in the suture material do not interfere with the strength of the suture.) Pull test the suture to make sure it is straight and intact. The toggle suture is designed to break at a pull force of >10-12 kg (22-26 lbs), which will allow the suture to release if internal pressures exceed its capacity. The ‘breaking’ will reduce the likelihood that the toggle will tear a large hole in the cow’s abomasum should problems occur.

1. The cow is cast on her right side (as viewed from the rear), and placed on her back. It is very helpful to do this on a deeply bedded surface or on a soft earth surface, since it is much more difficult to keep her in this position on a hard surface.

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2. Depending on the comfort level of the surgeon and the amount of help available, the front and rear legs may be tied to an immovable object.

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