Abnormal Abdomen

Question 1

With hepatomegaly there is a _________ shift to the gastric axis

Answer 1

Caudal

Question 2

With microhepatica there is a _______ shift to the gastric axis

Answer 2

Cranial

Question 3

What are the differentials for hepatomegaly

Answer 3

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)

Question 4

What are the differentials for microhepatica?

Answer 4

Congenital
Cirrhosis or fibrosis
Portosystemic shunts

Question 5

Fibrosis

Answer 5

Replacement of the hepatic parenchyma with extracellular matrix, collagen and CT

Question 6

Cirrhosis

Answer 6

Diffuse fibrosis + regenerative nodules

Question 7

Findings of fibrosis and cirrhosis

Answer 7

Irreversible loss of functional parenchyma
Ascites (hypoalbuminenia) or CS of HE

Question 8

Portosystemic shunts

Answer 8

Blood entering from the hepatic portal vein shunted into the CdVC
CS: HE, straining to urinate due to ammonium biurate urolithiasis (radiolucent)

Question 9

Types of portosystemic shunts

Answer 9

Intrahepatic (patent ductus venosus): large breeds
Extrahepatic: small breeds
Congenital or acquired

Question 10

Which breeds are predisposed to hemangiosarcoma?

Answer 10

GSD, golden and labs (large breeds)

Question 11

Splenic hemangiosarcoma

Answer 11

Originates from vascular endothelium
Highly metastatic
Non-cutaneous (visceral) → splenic. right atrium, hepatic

Question 12

CS associated with splenic hemangiosarcoma

Answer 12

Distended abdomen (palpable abdominal mass)
Dull and depressed, lethargic, pale mm

Question 13

How to approach abdominal masses

Answer 13

Identify (radiopacity or radiolucency)
Location
Structures displaced
Structures it’s originating from

Question 14

Categorizing masses

Answer 14

CHANG (cysts, hematomas, abscesses, neoplasia, granulomas)

Question 15

For mass effects, where could masses be originating from?

Answer 15

Head of spleen, kidney, adrenals, ovaries, fundus of stomach, pancreas and omentum

Question 16

What causes loss of serosal detail?

Answer 16

Peritoneal effusion
Peritonitis
Diffuse metastatic dz
Lack or loss of fat in emaciated animals
Brown fat in young animals

Question 17

Pneumoperitoneum

Answer 17

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

Question 18

What view should pneumoperitoneum be taken in?

Answer 18

Left lateral decubital view

Question 19

What causes pneumoperitoneum?

Answer 19

Ruptured GI, interruption of abdominal wall, iatrogenic (sx into abdomen)

Question 20

GDV (rotation and dilation)

Answer 20

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

Question 21

What does GDV cause?

Answer 21

Acute retching, shock and collapse
Abdominal pain and distention
Ptyalism

Question 22

Radiographic findings associated with GDV

Answer 22

Compartmentalization (fundus located ventrally and on right side
Free abdominal gas if gastric necrosis and rupture
Splenomegaly and paralytic ileus

Question 23

What causes small abdominal obstruction

Answer 23

FB, intussusception, masses (intra and extraluminal), adhesions, herniation, volvulus

Question 24

What’s significant about sublumbar masses?

Answer 24

LNs present → medial and lateral iliac/ sublumbar

Question 25

Differentials for enlarged medial and lateral iliac LNs (sublumbar)

Answer 25

Lymphadentitis Lymphoma Metastatic from neoplasia of the prostate, anal sac and urinary bladder

Question 26

Sublumbar masses with bone involvement (proliferation/ lysis)

Answer 26

Differentials: metastatic dz from prostate, anal sac or urinary bladder Spondylitis or Spondylosis

Question 27

Symmetrical protostatic enlargement

Answer 27

Displaces bladder cranially and colon dorsally BPH, prostatitis, neoplasia, intraparenchymal cysts and abscesses

Question 28

Asymmetrical protostatic enlargement

Answer 28

Displaces bladder dorsally, ventrally or laterally Paraprostatic cysts, abscesses

Question 29

Which protostatic enlargement causes pain upon palpation?

Answer 29

Prostatitis, abscesses, neoplasia

Question 30

Retained testicle

Answer 30

ST opacity in the cd abdomen Cryptorchids Confirm with US or cystogram

Question 31

Prostatic neoplasia

Answer 31

Parenchymal mineralization, sublumbar lymphadenopathy, lumbar spondylitis (metastasis)

Question 32

What causes uteromegally?

Answer 32

Gravid (early pregnancy) or post-partum uterus Pyometra, hydrometra, mucometra, cystic endometrial hyperplasia (CEH) Uterine mass or torsion

Question 33

Fetal calcification

Answer 33

42-45d in dog and 35-39d in cats

Question 34

Pyometra signalment

Answer 34

Female intact (middle aged to older) or incompletely neutered (stump pyometra)

Question 35

CS of open pyometra

Answer 35

Mucoid, purulent or hemorrhagic discharge

Question 36

CS of closed pyometra

Answer 36

Non vulval discharge Anorexia, lethargy, depression, vomiting, PU/PD

Question 37

Signs of fetal death

Answer 37

Gas with uterus or fetus Overlapping of frontal and parietal bones of skull Abnormal angulation of fetus Mummification-uterine mass with mineralized fetal parts