Abdominal pain/bloat

Question 1

DDx for abdominal pain in small animals…

Answer 1

1. Stomach/intestines
   GDV, infarction, FB, toxin, intussusception, parvo/HGE, ulceration, mesenteric torsion
2. Pancreas
   Pancreatitis, abscess, neoplasia
3. Liver
   Torsion, cholangiohepatitis, abscess, bile obstruction, neoplasia
4. Spleen
   Torsion infarct, haemotoma, neoplasia, abscess
5. Cavity
   Septic peritonitis, uroperitoneum, bile peritonitis, tansudate, haemabdoemen, trauma
6. Renal
   Infarction, pyelonephritis, nephroliths, obstruction
7. Reproductive
   Pyometra, dystocia, prostatic issues
8. Bladder/urthera
   Cystitis, calculi, urethral obstruction

Question 2

What would you see on radiographs of a GDV?

Answer 2

double bubble in right later

Rotation of pylorus to left of the midline in DV

Question 3

Risk factors for pancreatitis?

Answer 3

Ingestion of high fat foods, bile reflux, pancreatic duct blockage, drugs, ischaemia

Question 4

Clinical signs of pancreatitis

Answer 4

Anorexia, abdominal pain, vomiting, pyrexia (DOGS)

Lethargy, anorexia, hypothermia, hypoadrenocorticism (CATS)

Question 5

Diagnostics of pancreatitis?

Answer 5

Biochemistry amylase >3-4x normal, lipase increased 3-4x, hyperlipidaemia, azotaemia

U/S

Pancreatic lipase immunoreactivity

Question 6

Tx of pancreatitis?

Answer 6

Antibiotics, analgesia, fluids and electrolytes, anti-emtics, gastroprotectancts

Question 7

Diagnostics of uroperitoneum?

Answer 7

Peritoneal:blood creatinine >2:1
Peritoneal:blood K >1.4:1

Question 8

Diagnostics of bile peritonitis?

Answer 8

Peritoneal > blood bile

Bile pigments or crystals

Question 9

Diagnotics of haemabdomen?

Answer 9

Abdominal fluid PCV similar to that of blood

Question 10

DDx for colic types in the horse?

Answer 10

Non strangulating:
Spasmodic
Impaction
Displacement
Enteritis/ileus
Typhlocolitis 
Peritonitis

Strangulating:
Volvulus
Strangulating lipoma
Epiploic foramen entrapment
Inguinal hernia
Intussusceptions
Diaphragmatic hernia
Mesenteric root
Colon torsion
Intussusception (LI)

Question 11

Approach to a colic?

Answer 11

1. History
2. Clinical signs and physical exam (strangulating - refer!)
3. Pass a NGT (>2L refer!)
4. Rectal examination
5. Administer medical management (flunixin @ 0.25-1.1mg/kg or xylazine @ 0.1 - 1.1mg/kg), Laxatives, fluids (NGT or IV), buscopan
6. Adominocentesis
   ABNORMAL
   Serosangious cell count >5000/UL protein over 25g/l and bacteria or feed material on cytology
7. Ultrasonography

Question 12

An increased temperature on a colic may indicate?

Answer 12

Colitis, peritonitis, enteritis

Question 13

Important history in a colic?

Answer 13

Age
time of colic onset
degree of colic shown
any treatment given
previous colics
last faeces passed
management
worming regime

Question 14

DDx for abdominal pain/bloat in ruminants?

Answer 14

Gaseous bloat
Frothy bloat
Acute ruminal acidosis
Hardware disease
LDA
RDA
Caecal dilation
Abomasal ulcer

Question 15

Cause of gaseous bloat?

Answer 15

Excessive carbohydrate intake or oesophageal obstruction

Question 16

Treatment of gaseous bloat?

Answer 16

Stomach tube or rumen puncture (trochar and cannula)

Question 17

Cause of frothy bloat?

Answer 17

Legumes, clovers, alfafa, rich lush pastures and cereal rich diets

Question 18

Treatment of frothy bloat?

Answer 18

Anti-foaming agents (surfactant), poloxalene, mineral oil

Question 19

Cause of acute ruminal acidosis?

Answer 19

Sudden ingestion of fermentable carbohydrates, lack of forage, straw bedding, breaking into feed stores

Question 20

Clinicals signs of acute ruminal acidosis?

Answer 20

Dull +/- recumbent, ataxic, anorexia, blind, dehydration, rumen stasis, bloat, sucken eyes

Question 21

Treatment of acute ruminal acidosis?

Answer 21

5% sodium bicrbonate IV slowly (5L per 450KG over 30mins), IV fluids isotonicNaCl 150ml/kg over 6-12 hours, oral magnesium hydroxide 500g/450kg

Question 22

Cause of traumatic recticulo-peritonitis…

Answer 22

Sharp metal object penetrating the wall of reticulum

Question 23

Traumatic reticulo-peritonitis may cause….

Answer 23

Local or diffuse peritonitis, pericarditis, liver abcesses

Question 24

Clinical signs of hardware disease?

Answer 24

Decreased milk yield, anorexia, increased temp, arching back, rumen stasis, juglar pulse, splashing sounds over heart

Question 25

Diagnosis of hardware disease?

Answer 25

Withers pimch
pole test
Eric williams test

Question 26

Treatment of hardware disease?

Answer 26

Conservative - ABS and pain relief, rumentomoty to remove offending product.