Abdominal pain in Small animals Flashcards
causes
Distension of hollow viscous or organ capsule
Inflammation
ischaemia
Traction
DDx - stomach
obstruction, rupture, gastric dilation, GDV, ulceration, gastritis, intoxication, neoplasia
DDx - small intestine
obstruction, intussusception, rupture, torsion, inflammation, neoplasia
DDx - large intestine
obstruction, perforation, severe inflammation or infection, neoplasia
DDx - peritoneum
septic peritonitis, uroabdomen, bile peritonitis
DDx - pancreas
acute pancreatitis
DDx - liver/biliary tract
bile peritonitis, bile duct obstruction, live lobe torsion, hepatitis, neoplasia
DDx - spleen
torsion, thrombosis, ruptured neoplasm
DDx - kindneys
acute injury (toxins, pyelonephritis, obstrucion, trauma, vascular events)
DDx - ureter/prostate/bladder/urethra
calculi (obstruction), ruptured bladder, prostate abscess, prostitis, neoplasia
DDx - ovaries/uterus
pyometra, cysts, neoplasia
DDx - testicles
torsion, abscess, inflammation, neoplasia
surgical emergencies
Intestinal obstruction (complete or partial)
Pyometra – usually less urgent if open
Dystocia if medical management ineffective or contraindicated
Gastric dilatation ± volvulus (GDV)
Septic peritonitis, e.g. due to: Gastrointestinal tract
rupture/perforation, Dehiscence of surgical GIT wound, Uterine rupture, Prostatic abscess rupture
Intussusception
Penetrating abdominal wound
Abdominal bite injury/crush injury
Uroabdomen
Urethral obstruction if catheterisation unsuccessful
Bile peritonitis
Splenic torsion
Strangulated hernia
Intractable haemorrhage
Mesenteric torsion
medical disorders
Pancreatitis
Gastroenteritis, especially - Haemorrhagic gastroenteritis (HGE) + Parvoviral enteritis
Gastrointestinal ulceration without perforation
Ileus
Acute hepatitis/cholangiohepatitis
Pyelonephritis
Hypoadrenocorticism (Addison’s)
what looks similar to abdominal pain?
spinal pain
history
“prayer position”
gruting/groaning
pain when being handled by owners
physical exam
Physiological changes may be present
pain detected during ultrasonography?
If absent initially, reassess regularly
Generally harder to detect in cats
classifying pain
Severity
Location:
Diffuse/generalised often associated with peritonitis – primary cause?
Focal/localised
palpation limitations
limited by recumbency
unremarkable abdominal palpation doesnt exclude potentially severe disease
free fluid scanning
Manual palpation insensitive + false positives
Radiography better but not great
Ultrasonography - Much more sensitive and patient-friendly, Perform in ALL patients with suspected
abdominal pain
Aspirate and analyse
Patient management – Priorities
Address life-threatening problems
stabilize major body systems - acute abdominal presentation often have cardio compromise
analgesia
signalment
Young animals e.g. Foreign body ingestion, Infectious disease
Female intact animals: pyometra
Cats - String foreign body, Acute cholangitis/cholangiohepatitis
Middle-aged, obese female dogs: acute pancreatitis
history - important questions
ingestion of foreign bodies/toxins other animals affected vaccines other medical conditions + medication general demeanor duration of clinical signs
things to look out for an radiograph
foreign bodies, obstruction, loss of serosal detail, pancreatitis, masses, neoplasia, peritoneal gas
