Podcast
Questions and Answers
Which condition is a contraindication for performing an abdominocentesis?
Which condition is a contraindication for performing an abdominocentesis?
What is the appropriate needle gauge for a small dog or cat during abdominocentesis?
What is the appropriate needle gauge for a small dog or cat during abdominocentesis?
What type of fluid would appear clear and colorless on analysis?
What type of fluid would appear clear and colorless on analysis?
When should the abdomen not be drained during abdominocentesis?
When should the abdomen not be drained during abdominocentesis?
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Which cause is associated with modified transudate that is yellow or blood-tinged?
Which cause is associated with modified transudate that is yellow or blood-tinged?
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What is the primary procedure performed following a diagnosis of ascites on ultrasonography?
What is the primary procedure performed following a diagnosis of ascites on ultrasonography?
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Which of the following factors is NOT typically considered in the history taking for abdominal distension?
Which of the following factors is NOT typically considered in the history taking for abdominal distension?
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Which sign is associated with cardiovascular examination in cases of abdominal distension?
Which sign is associated with cardiovascular examination in cases of abdominal distension?
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What laboratory result may indicate the need for abdominocentesis if it is at 15 g/l or lower?
What laboratory result may indicate the need for abdominocentesis if it is at 15 g/l or lower?
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What diagnostic imaging technique is mentioned as being utilized for assessing abdominal distension?
What diagnostic imaging technique is mentioned as being utilized for assessing abdominal distension?
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What is the primary goal of surgery for GDV?
What is the primary goal of surgery for GDV?
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Which method is commonly used to differentiate between gastric dilation and volvulus?
Which method is commonly used to differentiate between gastric dilation and volvulus?
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What immediate step is important in the initial stabilization of a patient with GDV?
What immediate step is important in the initial stabilization of a patient with GDV?
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Why is serum lactate considered a useful marker in GDV cases?
Why is serum lactate considered a useful marker in GDV cases?
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What does acute abdominal distension typically indicate in regards to underlying conditions?
What does acute abdominal distension typically indicate in regards to underlying conditions?
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What characteristic radiographic finding is associated with gastric dilation and volvulus (GDV)?
What characteristic radiographic finding is associated with gastric dilation and volvulus (GDV)?
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Which of the following is NOT a potential complication of gastric distension?
Which of the following is NOT a potential complication of gastric distension?
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What factor is a significant consideration before performing a liver biopsy?
What factor is a significant consideration before performing a liver biopsy?
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In which situation would a percutaneous core biopsy NOT be appropriate?
In which situation would a percutaneous core biopsy NOT be appropriate?
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What breed of dog is most commonly associated with gastric dilation and volvulus (GDV)?
What breed of dog is most commonly associated with gastric dilation and volvulus (GDV)?
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What is the primary symptom indicating the possibility of gastric dilation?
What is the primary symptom indicating the possibility of gastric dilation?
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Which of the following conditions is often linked to gastric dilation complications?
Which of the following conditions is often linked to gastric dilation complications?
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Which aspect of gastric dilation affects respiration and oxygenation?
Which aspect of gastric dilation affects respiration and oxygenation?
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Which of the following is a potential cause of abdominal distension due to true distension?
Which of the following is a potential cause of abdominal distension due to true distension?
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Which of these conditions is associated with gastric dilatation/volvulus syndrome?
Which of these conditions is associated with gastric dilatation/volvulus syndrome?
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What is a complication that may arise from diagnostic techniques related to abdominal distension?
What is a complication that may arise from diagnostic techniques related to abdominal distension?
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Which diagnostic procedure is commonly performed to assess fluid accumulation in the abdominal cavity?
Which diagnostic procedure is commonly performed to assess fluid accumulation in the abdominal cavity?
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What is a true characteristic of ascites?
What is a true characteristic of ascites?
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Which of the following can result from a rupture of the abdominal wall?
Which of the following can result from a rupture of the abdominal wall?
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Which condition is least likely to cause abdominal distension?
Which condition is least likely to cause abdominal distension?
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Which factor can lead to organomegaly contributing to abdominal distension?
Which factor can lead to organomegaly contributing to abdominal distension?
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Study Notes
Approach to the Distended Abdomen
- Distended abdomen can be caused by gas, fluid or solid objects
- It's a symptom of an underlying disease requiring diagnosis
- Common diagnostic methods include radiography, ultrasonography, and abdominocentesis
- Fluid analysis in ascites aids diagnosis
- Gastric dilation volvulus (GDV) is a life-threatening condition requiring urgent intervention
Learning Objectives
- Identify potential causes of distended abdomen in companion animals
- Outline the diagnostic process for distended abdomen
- Recognize limitations and complications of diagnostic techniques
- Describe the abdominocentesis procedure
- Identify signs and pathogenesis of gastric dilation/volvulus syndrome
- Describe the therapeutic approach for gastric dilation/volvulus syndrome
Abdominal Distension: Causes
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True Distension: Issues within the abdominal cavity
- Pneumoperitoneum (air or gas in abdominal cavity)
- Obesity
- Neoplasia (tumors)
- Ascites (fluid accumulation)
- Transudate (clear fluid)
- Exudate (cloudy fluid)
- Chyle (milky fluid containing fat)
- Blood
- Urine
- Bile
-
Apparent Distension: Issues outside the abdominal cavity
- Rupture of the abdominal wall (muscle or tendon rupture)
- Weakness of the abdominal wall (e.g., hyperadrenocorticism, diabetes mellitus)
-
Organomegaly: Enlarged organs
- Bladder obstruction/neoplasia
- Kidney hydronephrosis/neoplasia
- Spleen neoplasia
- Liver disease/drug-induced issues
- Stomach dilation/volvulus, distension
- Intestine dilation/volvulus, obstipation
- Uterus (pregnancy, pyometra, neoplasia)
Approach to Diagnosis
- Signalment: Species, breed, age, sex, body condition score
- Cardiovascular: Jugular distension, mucous membrane color/pallor/jaundice, respiratory rate and effort
- Abdominal Palpation: Palpation of individual organs, ballottement (assessing for fluid thrill), percussion (assessing for gas)
-
Laboratory Investigations:
- Haematology (PCV, RBC, WBC)
- Biochemistry (TP, albumin, ALT, ALP, bilirubin, creatinine, urea for liver, kidney, bladder)
- Serum Albumin (<15g/L suggests ascites, >15g/L likely to aid with abdominocentesis)
-
Imaging:
- Radiography (X-rays)
- Ultrasonography (for visceral structures, fluid, organ size)
-
Abdominocentesis:
- Procedure performed to obtain fluid samples (ascites) from abdomen
- Useful after diagnosing ascites via imaging
- Minimally invasive
- Contraindicated in coagulopathy, severe organomegaly, marked distension
Fluid Analysis
-
Fluid Type & Appearance:
- Transudate: Clear
- Modified transudate: Yellow/blood-tinged
- Exudate (Sterile): Turbid
- Exudate (Septic): Turbid (maybe blood-tinged)
- Bile: Yellow/brown/green
- Blood: Red/sanguinous
- Chyle: Cloudy white/cream
- Possible Causes: Fluid analysis linked to specific potential causes as shown in the slide list (e.g., liver failure, portal hypertension)
Further Diagnostic Procedures
- Fine needle aspirate (ultrasound-guided): Useful for liver, spleen, prostate, kidneys
- Percutaneous core biopsy (for liver, renal cortex, superficial masses)
- Trucut needle
- Surgical biopsy (liver biopsies)
- Coagulation profile
- General anesthesia
- Risk of hemorrhage if hypoalbuminemic – potential wound healing impairment
Gastric Dilation/Volvulus (GDV)
-
Aetiology:
- Giant/large breed dogs
- Familial history
- Multifactorial (excessive exercise, overeating, water intake, aerophagia)
- Stretching of gastrohepatic ligament (with age)
-
Pathogenesis:
- Intragastric pressure increases
- Small blood vessel compression leading to gastric necrosis
- Oesophageal and vena cava compression and occlusion
- Hypovolaemic shock and impaired diaphragmatic function
-
Clinical Signs:
- Unproductive retching, salivation
- Abdominal distension; respiratory distress; hypo perfusion, pallor, tachycardia, weakpulses; shock
- Diagnosis: Signalment and clinical signs; radiography (to differentiate from simple dilation)
- Initial Stabilization: Decompression (stomach tube, trocharization/percutaneous gastrocentesis); intravenous fluids(2cephalic catheters); analgesia (iv opioid); lab work (minimum database; serum; lactate, ECG for arrhythmias)
- Surgery: Emergency laparotomy (positioning & de-rotation of stomach; gastric & splenic ischaemia assessment; prevention of recurrence - gastropexy)
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Description
Test your knowledge on the causes, diagnosis, and treatment of distended abdomen in companion animals. This quiz covers essential diagnostic methods, procedures like abdominocentesis, and life-threatening conditions such as gastric dilation volvulus (GDV). Enhance your understanding of this critical veterinary topic.
