Abdominal pain

Question 1

when is an acute abdominal crisis an emergency

Answer 1

if hypovolaemic shock or septic shock

Question 2

List 8 GI differentials of acute abdominal crisis

Answer 2

Abomasal volvulus
Abomasal displacement
Haemorrhagic jejunitis
Caecal torsion
Primary/secondary bloat
Intestinal torsion/intussusception
Mesenteric torsion
Peritonitis

Question 3

List 3 non- GI differentials of acute abdominal crisis

Answer 3

Uroliths
uterine torsion
pyelonephritis

Question 4

What do we see on abdominal silhouette with acute abdominal crisis

Answer 4

look from rear and sides - look for abdominal distension
back position - arched (pained)

Question 5

what do we look at on abdominal exam in acute abdominal crisis

Answer 5

rumen contractility
percussion ‘pings’
succussion- ‘splashing’

Question 6

List 3 signs of pain in cows

Answer 6

Bruxism
Abducted elbows
Reluctance to dip on withers pinch

Question 7

what does Reluctance to dip on withers pinch suggest

Answer 7

cranial abdominal pain

Question 8

where to take abdominocentesis from in a cow

Answer 8

Avoid midline
hands width away from midline and hands width from sternum

Question 9

Describe aetiology of peritonitis

Answer 9

primary: associated with systemic infection
secondary- after abdominal surgery

Question 10

describe what is seen with acute peritonitis

Answer 10

abdominal discomfrot
pyrexia +/- toxaemia
altered faecal output

Question 11

List 5 examples when peritonitis may be diffuse

Answer 11

Urethral obstruction
Acute acidosis/rumenitits
Toxic mastitis
Postpartum metritis
Perforated abomasal ulcer

Question 12

List 7 examples when peritonitis may be local

Answer 12

LDA/RDA
caecal torsion
TRP
Intestinal issues
uterine issues
Splenic/hepatic/umbilical abscess
Fat necrosis

Question 13

List 6 ways to diagnose acute peritonitis

Answer 13

Difficult as non teel you exactly what the cause is

wither test
eric williams test
rectal palpation
clinical pathology
abdominocentesis
exploratory laparotomy

Question 14

Describe what you get with Eric williams test on acute peritonitis

Answer 14

A quiet grunt may be heard just before the ruminal A wave contraction, due to the pain from the biphasic reticular contraction
Needs 2 people

Question 15

describe what you see on clinical pathology with acute peritonitis

Answer 15

leukopenia and degenerative left shift (increase in immature neutrophils)
increased levels of plasma fibrinogens and low plasma proteins to fibrinogen ratio

Question 16

Describe what you see on abdominocentesis with acute peritonitis

Answer 16

increased turbidity
increased leukocyte
increased total protein levels

Question 17

Describe what you can see on rectal palpation with acute peritonitis

Answer 17

adhesions may elicit discomfort or a pain response and may be palpated within the abdominal cavity per rectum (particularly in chronic peritonitis)

Question 18

Describe how to treat peritonitis

Answer 18

fluid therapy
NSAIDs
antimicrobials - long course (2 weeks if not more)

Question 19

when do caecal torsions tend to occur

Answer 19

early lactation cows

Question 20

describe the aeitology of a caecal torsion

Answer 20

poorly understood (increased VFA in intestines –> atony)

Question 21

List the clinical signs of caecal torsions

Answer 21

lethargic
abdominal pain
no poo
off feed
drop in milk

Question 22

Describe how to treat caecal torsion

Answer 22

Surgical: Right flank laparotomy, externalise and empty caecum using purse string suture, reposition
Fluids
Calcium borogluconate
NSAIDs
Antibiotics (3 days of cat D)

Question 23

Describe how to treat caecal dilation

Answer 23

surgical or conservative
- Calcium borogluconate
NASIDs

Question 24

when can you consider conservative management of caecal torsion

Answer 24

only do conservative with cows you see in morning- so can operate in afternoon if doesn’t get better)

Question 25

when does Haemorrhagic Jejunitis - (Haemorrhagic Bowel Syndrome) generally occur

Answer 25

early lactation

Question 26

Describe the signs seen with Haemorrhagic Jejunitis

Answer 26

clots –> obstruction –> colic
dark black blood in faeces
often fatal

Question 27

Describe how to treat Haemorrhagic Jejunitis

Answer 27

surgery- to remove clots - can do enterectomy
supportive therapy- very important

Question 28

Describe the clinical presentations of Obstruction, volvulus, strangulation, intussusception, perforation in cattle

Answer 28

they are all rare

Severe abdominal pain
circulatory compromise
abdominal bloat
death in hours

Question 29

Describe how to treat Obstruction, volvulus, strangulation, intussusception, perforation in cattle

Answer 29

Surgical
Right flank approach
Principles as for other species

Question 30

what happens with Traumatic Reticulopericarditis

Answer 30

FB is ingested into rumen –> drops into reticulum –> penetrates reticular wall = reticulitis
Penetrates further to pericardial sac (through diaphragm) = pericarditis

Question 31

what does pain in ruminants often cause

Answer 31

hypomotility og GI

Question 32

what is the problem with using NSAIDs in GI ileus in cows

Answer 32

NSAIDs in anorexic patients can induce ulcers- more common in calves