Abdominal pain Flashcards
when is an acute abdominal crisis an emergency
if hypovolaemic shock or septic shock
List 8 GI differentials of acute abdominal crisis
Abomasal volvulus
Abomasal displacement
Haemorrhagic jejunitis
Caecal torsion
Primary/secondary bloat
Intestinal torsion/intussusception
Mesenteric torsion
Peritonitis
List 3 non- GI differentials of acute abdominal crisis
Uroliths
uterine torsion
pyelonephritis
What do we see on abdominal silhouette with acute abdominal crisis
look from rear and sides - look for abdominal distension
back position - arched (pained)
what do we look at on abdominal exam in acute abdominal crisis
rumen contractility
percussion ‘pings’
succussion- ‘splashing’
List 3 signs of pain in cows
Bruxism
Abducted elbows
Reluctance to dip on withers pinch
what does Reluctance to dip on withers pinch suggest
cranial abdominal pain
where to take abdominocentesis from in a cow
Avoid midline
hands width away from midline and hands width from sternum
Describe aetiology of peritonitis
primary: associated with systemic infection
secondary- after abdominal surgery
describe what is seen with acute peritonitis
abdominal discomfrot
pyrexia +/- toxaemia
altered faecal output
List 5 examples when peritonitis may be diffuse
Urethral obstruction
Acute acidosis/rumenitits
Toxic mastitis
Postpartum metritis
Perforated abomasal ulcer
List 7 examples when peritonitis may be local
LDA/RDA
caecal torsion
TRP
Intestinal issues
uterine issues
Splenic/hepatic/umbilical abscess
Fat necrosis
List 6 ways to diagnose acute peritonitis
Difficult as non teel you exactly what the cause is
wither test
eric williams test
rectal palpation
clinical pathology
abdominocentesis
exploratory laparotomy
Describe what you get with Eric williams test on acute peritonitis
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
describe what you see on clinical pathology with acute peritonitis
leukopenia and degenerative left shift (increase in immature neutrophils)
increased levels of plasma fibrinogens and low plasma proteins to fibrinogen ratio
Describe what you see on abdominocentesis with acute peritonitis
increased turbidity
increased leukocyte
increased total protein levels
Describe what you can see on rectal palpation with acute peritonitis
adhesions may elicit discomfort or a pain response and may be palpated within the abdominal cavity per rectum (particularly in chronic peritonitis)
Describe how to treat peritonitis
fluid therapy
NSAIDs
antimicrobials - long course (2 weeks if not more)
when do caecal torsions tend to occur
early lactation cows
describe the aeitology of a caecal torsion
poorly understood (increased VFA in intestines –> atony)
List the clinical signs of caecal torsions
lethargic
abdominal pain
no poo
off feed
drop in milk
Describe how to treat caecal torsion
Surgical: Right flank laparotomy, externalise and empty caecum using purse string suture, reposition
Fluids
Calcium borogluconate
NSAIDs
Antibiotics (3 days of cat D)
Describe how to treat caecal dilation
surgical or conservative
- Calcium borogluconate
NASIDs
when can you consider conservative management of caecal torsion
only do conservative with cows you see in morning- so can operate in afternoon if doesn’t get better)
when does Haemorrhagic Jejunitis - (Haemorrhagic Bowel Syndrome) generally occur
early lactation
Describe the signs seen with Haemorrhagic Jejunitis
clots –> obstruction –> colic
dark black blood in faeces
often fatal
Describe how to treat Haemorrhagic Jejunitis
surgery- to remove clots - can do enterectomy
supportive therapy- very important
Describe the clinical presentations of Obstruction, volvulus, strangulation, intussusception, perforation in cattle
they are all rare
Severe abdominal pain
circulatory compromise
abdominal bloat
death in hours
Describe how to treat Obstruction, volvulus, strangulation, intussusception, perforation in cattle
Surgical
Right flank approach
Principles as for other species
what happens with Traumatic Reticulopericarditis
FB is ingested into rumen –> drops into reticulum –> penetrates reticular wall = reticulitis
Penetrates further to pericardial sac (through diaphragm) = pericarditis
what does pain in ruminants often cause
hypomotility og GI
what is the problem with using NSAIDs in GI ileus in cows
NSAIDs in anorexic patients can induce ulcers- more common in calves
