Lecture 25 3/31/25-4/1/25 Flashcards
What is an acute abdomen and why is it important?
-very rapid onset of severe clinical signs
-severe, life threatening condition
-animal welfare concerns
-emotional distress for producer and animal
What questions should you ask yourself to determine the best approach to an acute abdomen case?
-where does the pain originate from?
-is it a medical or surgical problem?
-is medical therapy needed before surgery?
-what is the likelihood of survival and productivity?
What is the first step to approaching an acute abdomen?
-identify life-threatening problems and take rapid action
-conduct a rapid PE to distinguish stable patient from critical patient that needs emergent stabilization
What are some of the indicators that an animal is in hypovolemic/septic shock?
-tachycardic
-tachypneic
-temperature deregulation
-dehydration
-depressed state
Which conditions are surgical emergencies?
-abomasal volvulus
-abomasal bloat
-mesenteric root torsion
-intestinal volvulus/incarceration
-cecal volvulus
Which conditions only require medical treatment?
-paralytic ileus
-enteritis/enterotoxemia
-pyelonephritis
-cystitis/urinary tract dz
-acute liver dz
-pleuropneumonia
Which conditions require medical intervention to stabilize prior to surgery?
-intestinal FB/obstruction
-intussusception
-atresia coli
-urolithiasis
-ruptured bladder
-uterine torsion
Which conditions typically only require medical treatment, but may benefit from surgery in some cases?
-cecal dilatation
-hemorrhagic bowel syndrome
-fat necrosis
-peritonitis
-hardware dz
-abomasal ulceration
What are the clinical indications that a stable animal needs to be taken to surgery?
-severe, active colic
-deterioration of vital signs
-HR > 100 bpm
-suspicion of strangulation/devitalization
-distended organ on rectal
-absent fecal production
What can be done in a stable patient that does not have clinical indications for surgery?
-delay surgical exploration for 24 to 36 hours
-frequently monitor
-provide supportive treatment
What are the steps to a physical exam for acute abdomen patients?
*TPR
*auscultation
-percussion and succession (pinging +/- ballotment)
-localization of ping
*transrectal palpation
What are the ancillary diagnostics done for acute abdomen cases?
-PCV/TP
-lactate measurements
-glucose measurements
-abdominocentesis
-ultrasonography
What is evaluated on an abdominocentesis?
-color
-consistency
-protein conc.
-glucose/lactate
What are the mechanical obstructive intestinal diseases?
-volvulus of duodenal sigmoid flexure
-mesenteric root volvulus
-intestinal atresia or stenosis
-intussusception
-mesenteric fat necrosis
-intestinal incarceration/herniation
-hemorrhagic bowel syndrome
-cecal volvulus
What are the functional obstructive intestinal diseases?
-cecal dilatation
-ileus
-peritonitis
How does the treatment approach differ between mechanical and functional obstruction?
-mechanical obstructions have something physically blocking movement and often require surgery
-functional obstructions have decreased motility and require medical management
What are the clinical signs of obstructive intestinal dz?
-decreased fecal production
-abdominal distention
-tympanic resonance
-colic
-forestomach atony
-circulatory shock
-electrolyte disturbances; hypoCl, hypoK, hypoCa
What are the two types of physical obstructions that can occur?
-digestive tract lesions
-extra-digestive lesions
What are the characteristics of volvulus of duodenal sigmoid flexure?
-only occurs in DAIRY COWS with PREVIOUS OMENTOPEXY
-treatment is surgical correction
-animal can return to production
What does a ping in this location correlate with?
volvulus of duodenal sigmoid flexure
What are the characteristics of mesenteric root volvulus?
-can occur in all ruminants
-most commonly seen in calves and dairy cattle
-very painful
-present with colic, rapid abdominal distention, and shock/collapse
-often euthanized due to poor prognosis
-if surgically corrected, procedure is done standing to provide momentum to correct the mesentery
What does a ping in this location correlate with?
mesenteric root volvulus
What are the characteristics of intestinal atresia or stenosis?
-intestinal atresia has worse diagnosis than stenosis; these animals often drop dead
-congenital; affects neonates within first 48 hours of life
-clinical signs include no fecal production and abdominal distention
What are the characteristics of intestinal atresia/stenosis treatment and prognosis?
-intestinal atresia must be euthanized
-atresia ani can be treated by surgically creating a rectum; animal will be incontinent
-prognosis is poor
