Luis H. Tello, DVM, MSc
In veterinary medicine, the main causes for abdominal emergencies may be divided as traumatic or non-traumatic. A high percentage of these cases defined as abdominal emergencies are surgical cases that should be rushed into operation rooms, however the clinicians must be aware that not all of them are surgical, and often the decision can be very difficult. In general there are 3 situations that can be described as abdominal emergencies: Intra-abdominal lesions that require urgent surgical intervention after previous stabilization, medical conditions that not require immediate surgical intervention and other conditions that simulate an abdominal emergency. Please refer to the lecture of abdominal emergencies.
Perform a gentle physical exam including obtaining a detailed history from the owner
Assess and categorize abdominal pain
Place an IV catheter and start fluids at 10 ml/kg/hr in dogs and 5 ml/kg/hr in cats. Normosol-R.
Provide oxygen 100 ml/kg/minute through a non-stressful device
Evaluate the need for pain control: Butorphanol, Buprenorphine, Fentanyl
Obtain samples for CBC, chemistry (including CPL), electrolytes, blood gases and coagulation panel
Obtain survey radiographs of the abdomen and an ultrasound if there is not too much gas
Tap the abdomen. If fluid is obtained, perform further analysis: cytology & chemistry
If the radiographs reveal loss of details and no fluid is obtained, perform a abdominocentesis with ultrasound guidance or a peritoneal lavage
Evaluate the need for surgery
If a surgery is need, assess the patient for anesthesia: ECG, blood pressure, pulse oxymetry, blood gases and electrolytes (repeated).
Discuss with the owner about the condition, the therapy plan, the prognosis, the cost and the long term care required
Proceed with the surgery / procedure
Re evaluate the patient after the surgery and plan the ICU care. Discuss the findings and prognosis with the owner again
Provide hospital/ICU care with special emphasis in the nursing care