Abdominal pain in Small animals Flashcards Preview

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Flashcards in Abdominal pain in Small animals Deck (24):
1

causes

Distension of hollow viscous or organ capsule
Inflammation
ischaemia
Traction

2

DDx - stomach

obstruction, rupture, gastric dilation, GDV, ulceration, gastritis, intoxication, neoplasia

3

DDx - small intestine

obstruction, intussusception, rupture, torsion, inflammation, neoplasia

4

DDx - large intestine

obstruction, perforation, severe inflammation or infection, neoplasia

5

DDx - peritoneum

septic peritonitis, uroabdomen, bile peritonitis

6

DDx - pancreas

acute pancreatitis

7

DDx - liver/biliary tract

bile peritonitis, bile duct obstruction, live lobe torsion, hepatitis, neoplasia

8

DDx - spleen

torsion, thrombosis, ruptured neoplasm

9

DDx - kindneys

acute injury (toxins, pyelonephritis, obstrucion, trauma, vascular events)

10

DDx - ureter/prostate/bladder/urethra

calculi (obstruction), ruptured bladder, prostate abscess, prostitis, neoplasia

11

DDx - ovaries/uterus

pyometra, cysts, neoplasia

12

DDx - testicles

torsion, abscess, inflammation, neoplasia

13

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

14

medical disorders

Pancreatitis
Gastroenteritis, especially - Haemorrhagic gastroenteritis (HGE) + Parvoviral enteritis
Gastrointestinal ulceration without perforation
Ileus
Acute hepatitis/cholangiohepatitis
Pyelonephritis
Hypoadrenocorticism (Addison’s)

15

what looks similar to abdominal pain?

spinal pain

16

history

"prayer position"
gruting/groaning
pain when being handled by owners

17

physical exam

Physiological changes may be present
pain detected during ultrasonography?
If absent initially, reassess regularly
Generally harder to detect in cats

18

classifying pain

Severity
Location:
Diffuse/generalised often associated with peritonitis – primary cause?
Focal/localised

19

palpation limitations

limited by recumbency
unremarkable abdominal palpation doesnt exclude potentially severe disease

20

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

21

Patient management – Priorities

Address life-threatening problems
stabilize major body systems - acute abdominal presentation often have cardio compromise
analgesia

22

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

23

history - important questions

ingestion of foreign bodies/toxins
other animals affected
vaccines
other medical conditions + medication
general demeanor
duration of clinical signs

24

things to look out for an radiograph

foreign bodies, obstruction, loss of serosal detail, pancreatitis, masses, neoplasia, peritoneal gas