Abnormal Abdomen Flashcards
With hepatomegaly there is a _________ shift to the gastric axis
Caudal
With microhepatica there is a _______ shift to the gastric axis
Cranial
What are the differentials for hepatomegaly
Venous congestion
Acute Hepatitis
Fat/ glycogen infiltration
Steroid (vacuolar hepatomegaly)
Biliary dz
Primary neoplasia
Secondary/ metastatic neoplasia
Benign masses
Nodular hyperplasia
Copper storage dz (Bedlingtons)
What are the differentials for microhepatica?
Congenital
Cirrhosis or fibrosis
Portosystemic shunts
Fibrosis
Replacement of the hepatic parenchyma with extracellular matrix, collagen and CT
Cirrhosis
Diffuse fibrosis + regenerative nodules
Findings of fibrosis and cirrhosis
Irreversible loss of functional parenchyma
Ascites (hypoalbuminenia) or CS of HE
Portosystemic shunts
Blood entering from the hepatic portal vein shunted into the CdVC
CS: HE, straining to urinate due to ammonium biurate urolithiasis (radiolucent)
Types of portosystemic shunts
Intrahepatic (patent ductus venosus): large breeds
Extrahepatic: small breeds
Congenital or acquired
Which breeds are predisposed to hemangiosarcoma?
GSD, golden and labs (large breeds)
Splenic hemangiosarcoma
Originates from vascular endothelium
Highly metastatic
Non-cutaneous (visceral) → splenic. right atrium, hepatic
CS associated with splenic hemangiosarcoma
Distended abdomen (palpable abdominal mass)
Dull and depressed, lethargic, pale mm
How to approach abdominal masses
Identify (radiopacity or radiolucency)
Location
Structures displaced
Structures it’s originating from
Categorizing masses
CHANG (cysts, hematomas, abscesses, neoplasia, granulomas)
For mass effects, where could masses be originating from?
Head of spleen, kidney, adrenals, ovaries, fundus of stomach, pancreas and omentum
What causes loss of serosal detail?
Peritoneal effusion
Peritonitis
Diffuse metastatic dz
Lack or loss of fat in emaciated animals
Brown fat in young animals
Pneumoperitoneum
Free gas between liver and diaphragm, pockets of gas adjacent to crus of diaphragm and around organs
Sx emergency if suspicious of an intestinal perforation
What view should pneumoperitoneum be taken in?
Left lateral decubital view
What causes pneumoperitoneum?
Ruptured GI, interruption of abdominal wall, iatrogenic (sx into abdomen)
GDV (rotation and dilation)
Large breed, deep chested
180 degrees- stomach rotates clockwise along axis, pylorus moves ventrally and from right to left becomes displaced between esophagus and stomach
What does GDV cause?
Acute retching, shock and collapse
Abdominal pain and distention
Ptyalism
Radiographic findings associated with GDV
Compartmentalization (fundus located ventrally and on right side
Free abdominal gas if gastric necrosis and rupture
Splenomegaly and paralytic ileus
What causes small abdominal obstruction
FB, intussusception, masses (intra and extraluminal), adhesions, herniation, volvulus
What’s significant about sublumbar masses?
LNs present → medial and lateral iliac/ sublumbar
Differentials for enlarged medial and lateral iliac LNs (sublumbar)
Lymphadentitis
Lymphoma
Metastatic from neoplasia of the prostate, anal sac and urinary bladder
Sublumbar masses with bone involvement (proliferation/ lysis)
Differentials: metastatic dz from prostate, anal sac or urinary bladder
Spondylitis or Spondylosis
Symmetrical protostatic enlargement
Displaces bladder cranially and colon dorsally
BPH, prostatitis, neoplasia, intraparenchymal cysts and abscesses
Asymmetrical protostatic enlargement
Displaces bladder dorsally, ventrally or laterally
Paraprostatic cysts, abscesses
Which protostatic enlargement causes pain upon palpation?
Prostatitis, abscesses, neoplasia
Retained testicle
ST opacity in the cd abdomen
Cryptorchids
Confirm with US or cystogram
Prostatic neoplasia
Parenchymal mineralization, sublumbar lymphadenopathy, lumbar spondylitis (metastasis)
What causes uteromegally?
Gravid (early pregnancy) or post-partum uterus
Pyometra, hydrometra, mucometra, cystic endometrial hyperplasia (CEH)
Uterine mass or torsion
Fetal calcification
42-45d in dog and 35-39d in cats
Pyometra signalment
Female intact (middle aged to older) or incompletely neutered (stump pyometra)
CS of open pyometra
Mucoid, purulent or hemorrhagic discharge
CS of closed pyometra
Non vulval discharge
Anorexia, lethargy, depression, vomiting, PU/PD
Signs of fetal death
Gas with uterus or fetus
Overlapping of frontal and parietal bones of skull
Abnormal angulation of fetus
Mummification-uterine mass with mineralized fetal parts
