Approach to acute abdomen- workshop

Question 1

Define acute abdomen

Answer 1

severe abdominal pain
acute onset
enlarged abdomen

Question 2

List 8 clinical signs of hypovolaemic shock

Answer 2

prolonged CRT
collapse
pale MM
poor perfusion
hypothermia
tachycardia

Question 3

distributive shock

Answer 3

something caused systemic vascular resistance to drop - sepsis/SIRS or anaphylaxis

Question 4

signs of distributive shock

Answer 4

red mm
short CRT
pyrexia
weak or bounding pulses
tachycardia/pnoea

Question 5

Define cardiogenic shock

Answer 5

the pump failing- heart not working properly - signs look similar to hypovolaemic shock need to differentiate

Question 6

List the clinical signs of cardiogenic shock

Answer 6

pale mm
slow CRT
hypothermia
pulse deficits
tachypnoea
variable HR

Question 7

Decsrbe obstructive shock

Answer 7

e.g. cardiac tamponade - fluid around heart reduces contractility or GDV (compress vena cava)- output of heart drops

Question 8

Clinical signs of obstructive shock

Answer 8

pale mm
slow CRT
tachycardia
hypothermia
weak pulses
tachypnoea

Question 9

How do we figure out what the issue is in a patient with an acute abdomen

Answer 9

POCUS

Question 10

how do we assess hypovolaemia on ultrasound

Answer 10

look at the CVC - should have a change by around 25% as the animal breathes

Question 11

how can we assess if the animal is in cardiogenic shock

Answer 11

look at the heart on ultrasound or do an ECG

Question 12

what do we want to assess on bloods in a patient with an acute abdomen

Answer 12

perfusion (lactate, BP)
neutrophils
PCV
liver/kidney/adrenal values
electrolyte levels
blood gasses
blood glucose