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BVetMed3 Alimentary > Abdominal Pain In Small Animals > Flashcards

Abdominal Pain In Small Animals Flashcards

1
Q

How severe is the problem likely to be if an animal presents with abdominal pain?

A

Not all are emergencies by MOST ARE

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2
Q

What is meant by the term ‘acute abdomen’?

What does this indicate about future treatment?

A

Dog/cat with acute marked abdominal pain

Patient requires emergency stabilisation

Surgery may or may not be necessary

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3
Q

What information should be gathered from an EMERGENCY patient?

A

Capsule history:
Signalment, primary problem, duration
Eating/drinking/urinating/ defaecating
Any drugs administered?

MBS assessment
CVRS
neuro

— MAKE SURE PATIENT IS STABILISED —

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4
Q

What should you do following your emergency assessment if the patient is stable?

A 
Take a full history 
Appetite/diet
Vomiting
Diarrhoea
Lethargy/behaviour/gait 
Scavenger/drug administration/ toxin access
Urination/defaecation 
Vaccination/anthelmintic treatment 
Neutering status/last season
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5
Q

Why might it be important to ask about the diet in a patient with abdominal pain?

A

Raw food - bones

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6
Q

What is the goal of abdominal palpation?

A

Pain - localised or generalised

Masses - organomegaly or foreign body

Fluid thrill

Tympani

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7
Q

What can be palpated cranially in the abdomen?

A

Liver, Spleen

Potentially stomach and kidneys

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8
Q

What can be palpated in the mid-abdomen?

A

Intestinal loops

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9
Q

What can be palpated in the caudal abdomen?

A

Bladder
Prostate
Colon

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10
Q

What might generalised abdominal pain suggest?

A

Inflamed peritoneum

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11
Q

What can be confused with masses upon palpation?

A

Faeces

Cat’s kidneys

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12
Q

How could you tell whether you had palpated a mass or faeces?

A

If you compress the faeces, they stay compressed.

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13
Q

What is fluid thrill?

A

Push on one side of the abdomen and feel reverberation on the other

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14
Q

What is tympany?

A

Gas filled area

Feels taught like a drum,

Generally associated with a GI issue

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15
Q

What might you look for during an oral examination?

A

Foreign body under tongue

Ulcers

Ptyalism

Icterus

Pallor

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16
Q

What is meant by the term ptyalism?

A

Excess salivation

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17
Q

What should be checked for in oral examination of cats?

A

Linear foreign bodies - STRING

Often anchored to tongue

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18
Q

What other type of pain is typically confused with abdominal pain?

A

Spinal pain

Also, respiratory distress and stress

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19
Q

How could you differentiate between spinal and abdominal pain?

A

Push down on spine

20
Q

How can you assess the reproductive system of a small animal?

A

Observe external genitalia

Perform rectal examination

21
Q

What would you expect to palpate during a small animal rectal exam?

A 
Prostate (male)
Uterus (female)
Urethra (runs ventrally)
Sublumbar lymph nodes 
Faeces 
Foreign material
22
Q

Why might it be important to palpate the uterus?

A

Check for pyrometra

23
Q

Why might it be important to palpate the urethra?

A

Check for obstructions

24
Q

Why might it be important to palpate the sublumbar lymph nodes?

A

Neoplasia

25
Q

What mechanisms can cause abdominal pain? How can these come about?

A

Distension of an organ /capsule (dilation)

Traction - twisting/pulling (torsion)

Ischaemia - Infarction/necrosis

Inflammation - Gastroenteritis

26
Q

What can cause Intra-abdominal pain?

A 
Stomach/intestines 
Pancreas 
Uterus
Prostate
Kidneys/ureters/bladder
Liver 
Spleen 
Effusions
27
Q

What can cause extra-abdominal pain?

A

Cutaneous/muscular

28
Q

What are the ddx for stomach/intestinal pain?

A 
GDV
Mesenteric torsion
Infarction
Ulceration 
GIT infection (e.g. parvo, HGE)
Foreign body 
Intussuception
Toxin 
Neoplasia
29
Q

What are the ddx for pancreas pain?

A

Pancreatitis,
Abcess,
Neoplasia

30
Q

What are the ddx for liver pain?

A

torsion (rare)
Cholangiohepatitis
Abcess
Biliary obstruction (inflammation, gall bladder mucocoele)

31
Q

What are the ddx for spleen pain?

A 
Torsion
Infarction 
Haematoma 
Abscess
Neoplasia
32
Q

What are the ddx for cavity pain?

A 
Septic peritonitis 
Uroperitoneum
Bile peritonitis
Severe distension from transudate/ haemabdomen 
Abdominal wall trauma
33
Q

What are the ddx for renal pain?

A 
Infarction 
Pyelonephritis 
Neoplasia 
Nephroliths
Ureteric obstruction
34
Q

What are the ddx for bladder/urethra pain?

A

Cystitis,
Calculi
Urethral obstruction

35
Q

what are the ddx for reproductive pain?

A

Pyometra
Dystocia
Prostatic abcess
Prostatitis

36
Q

How could you further investigate abdominal pain?

A

Diagnostic imaging - radiography and ultrasound
Cytology of abdominal fluid
Blood tests - CBC and biochem, CPLi/Parvo etc

37
Q

What does FAST stand for ?

A

Focused
Assessment with
Sonography for
Trauma/Triage/Tracking (see if things change)

38
Q

What is a FAST ultrasound?

A

Brief examination of the abdomen looking for free abdominal fluid

39
Q

How do you conduct a FAST ultrasound?

A

Four positions:
(Start from diaphragm move round clockwise)

Diaphragmaticohepatic
Spleno-renal
Cysto-colic
Hepatorenal

Score the amount of fluid present from 0-4

40
Q

What are some surgical emergencies associated with abdominal pain?

A

Septic peritonitis due to: GIT problems, uterine rupture, prostatic abscess rupture, body wall rupture

Risk of SP due to: intestinal obstruction, intussusception, penetrating abdominal wound, abdominal bite/crush injury

GDV

Metabolic emergency - uroperitoneum or bile peritonitis

Vascular emergency - splenic torsion, strangulated hernia, mesenteric torsion, intractable haemorrhage

Pyometra

Dystocia

41
Q

When would a presentation of pyometra be less severe?

A

If the pyometra is open and pus can drip out of the vulva

42
Q

Name some common antiemetics.

A

Maropitant
Metoclopramide
Ondansetron

43
Q

What analgesia should be given to patients with abdominal pain?

A

Pure opioids (e.g. methadone, morphine, fentanyl)
Partial agonist opioid (e.g. buprenorphine)
Ketamine infusion
Lidocaine infusion

44
Q

What analgesics should NOT be given to patients with abdominal pain?

Why?

A

NSAIDS

Risk of GI ulcers
Risk of kidney injury
May need surgery - contraindicated in anaesthesia

45
Q

How should patients be managed post op?

A

Monitoring: Physical exam, continuous ECG, PCV TS 24 hours, electrolytes

Treatment: IV fluids, Analgesia (methadone), antiemetic (maropitant), gastric protectant (omeprazole), Nutrition

46
Q

Describe an outline of the approach to a patient with acute abdomen.

A
  1. Capsule history and MBS assessment
  2. IF STABLE, take full history
  3. Physical exam - Abdominal palpation, oral examination, spinal pain?, reproductive system, rectal exam
  4. Diagnostic imaging (FAST), Cytology of abdominal fluid and CBC+Biochem +/- CPLi/Parvo
  5. Surgical and medical management inc. analgesia
  6. Post op care

BVetMed3 Alimentary (16 decks)

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