Abdominal pain in the small animal
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33 terms
Terms | Definitions |
|---|---|
 Approach to the patient with abdominal pain | 1. Define the problem 2. History and physical exam 3. Consider differential diagnoses 4. Further diagnostic evaluation 5. Decision making 6. Appropriate treatment |
| What can also present similarly to abdominal pain? | Back pain from diseases like intervertebral disc disease or discospondylitis. |
| Why is it important to distinguish back pain from abdominal pain? | The investigations will be totally different, and working up the wrong problem will be costly financially and medically. |
| Clinical signs of abdominal pain | Grunting or groaning Splinting of the abdominal musculature Altered behavior (unpredictability) Prayer position Physiological changes |
| Reasons for abdominal pain | 1. Distention of a hollow viscous or organ capsule 2. Inflammation 3. Ischaemia 4. Traction (pulling or tugging in abdomen) |
| Name some differential diagnoses for the stomach. | Obstruction Rupture GD (gastric dilatation) GDV (gastric dilatation volvulus) Gastritis Ulceration Intoxication Neoplasia |
| Name some differential diagnoses for the intestine. | Obstruction Intussusception Rupture Torsion Inflammation Neoplasia |
| Name some differential diagnoses for the large intestine. | Obstruction Perforation Severe inflammation or infection Neoplasia |
| Name some differential diagnoses for the peritoneum. | Septic peritonitis Uroabdomen Bile periotnitis |
| Name some differential diagnoses for the pancreas. | Acute pancreatitis Neoplasia |
| Name some differential diagnoses for the liver/biliary tract. | Bile peritonitis Bile Duct obstruction Liver lobe torsion Hepatitis Neoplasia |
| Name some differential diagnoses for the spleen. | Torsion Thrombosis Ruptured neoplasm |
| Name some differential diagnoses for the kidneys. | Acute renal failure (caused by toxins, pyelonephritis, obstruction, trauma, vascular events) |
| Name some differential diagnoses for the ureter/urinary bladder/urethra/prostate. | Calculi Ruptured bladder Prostatic abscess Prostatitis Neoplasia |
| Name some differential diagnoses for the ovaries/uterus. | Pyometra (1st thought with intact female with abdominal pain) Cysts Neoplasia |
| Name some differential diagnoses for the testicles. | Torsion Abscess Inflammation Neoplasia |
| Most important diagnostic tools in evaluating a patient with abdominal pain | Signalment History Thorough examination Thorough abdominal palpation Rectal exam (if possible) |
| Common Dx in young animals with abdominal pain | Foreign body ingestion Infectious disease |
| Common dx in female intact animals with abdominal pain | Pyometra until proven otherwise! |
| Common dx in cats with abdominal pain | String foreign body |
| Common dx in middle-aged, obese female dogs with abdominal pain | Acute pancreatitis |
| Important questions to ask when taking a history of an animal with abdominal pain. | 1. When was the patient last normal 2. Progression of clinical signs Helpful to put a timeline on clinical signs! |
| Should abdominal radiographs be taken in an animal with abdominal pain? | Yes, always. |
| Things to look for on an abdominal radiograph | Foreign bodies Evidence of intestinal obstruction (segmental gas or fluid distention) Loss of serosal detail (free abdominal fluid) |
| What are you looking for with an abdominal ultrasound? | Abnormalities in serosal thickness Free abdominal fluid |
| Abdominocentesis technique | Can be blind or with ultrasound guidance Patient is in left lateral recumbency (most effective to avoid the spleen) Manual or chemical restraint Aseptic prep Use open or closed needle technique |
| Closed needle abdominocentesis | 20-22 gauge needle attached to 5ml syringe, insert needle cranial quadrant caudal to liver. |
| Open needle abdominocentesis | Needle alone is inserted, which may help prevent occlusion of needle (fibrin can occlude if present in fluid). Possible to see free gas on radiographs after this procedure. |
| Four quadrant adbominocentesis technique | 4 needles are placed simultaneously centered around the umbilicus, will increase chance of obtaining fluid. |
| Diagnostic peritoneal lavage | Indicated if free abdominal fluid is suspected to be present but not obtained or visualized by previous methods. |
| Diagnostic peritoneal lavage technique | Use 14-16 gauge needle, aseptic technique, restraint as necessary. Local anesthetic infiltration. Stab incision through skin prior to catheter placement. Instill 22 ml/kg of warm saline by gravity and distribute fluid through the abdomen. Remove for cytological exam. |
| cPLI | Canine Pancreatic Lipase Immunoassay |
| What type of analgesia do you use first when treating patient with abdominal pain? | Opioids initially, avoid NSAIDs. |
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