Acute Abdomen

Now and again pet owners are faced with emergency situations when their pets are suddenly in severe belly pain. Unexpectedly, both the owner and the pet are in a moment of anxiety and distress. So what could possibly be going on? This sudden severe belly pain is what veterinarians call an acute abdomen.

What is acute abdomen?

Acute means to happen suddenly, while the abdomen is the lower part of the trunk of the body, often referred to as the belly. The term acute abdomen refers to sudden pain in the belly. This sudden, severe pain in an animal’s belly should be treated as an emergency and requires immediate evaluation and response by the vet.

Pet owners will often report that their dog or cat was fine yesterday or earlier in the day before showing the sudden signs of terrible belly pain. The pain could arise from any of the following:

  • gastrointestinal tract (GIT) and inner lining of the abdominal body wall
  • other organs in the abdominal cavity (liver, pancreas, spleen, kidneys, reproductive tract, lymph nodes, diaphragm)
  • muscle and skin around the abdominal cavity
  • emanating from other systems outside the abdominal area such as back pain.

Acute abdomen can be life-threatening and should be considered an emergency.

What will I see if my pet has an acute abdomen?

Since there are so many possible causes of acute abdomen, it is not surprising that its symptoms will be equally diverse. Further complicating the situation is the fact that the symptoms may be non-specific to any one particular cause. So, how can a pet owner judge from home that their pet is in a crisis situation? To help pet owners reach the decision to take their pet to the vet for examination, below is a summary of possible symptoms of acute abdomen.

Pet owners should look out for:

  • restlessness
  • unusual panting
  • arching of the back
  • body posture changes such as assuming the praying position (with their front legs on the ground and their rear end in the air)
  • retching or trying to vomit without success
  • loss of appetite
  • marked sensitivity when owners attempt to stroke their pets in the belly area
  • distention of the belly such as with advanced pregnancy, or when there is a marked accumulation of fluids in the abdominal cavity

With very painful conditions or when shock sets in, the respiratory rate and heart rate might be elevated and there may be a loss of colour in the mucous membranes.

What can cause an acute abdomen?

Acute abdomen can be caused by problems in any of the various systems located inside and/or (less frequently) outside the abdominal cavity. Potential causes of the syndrome range from injury, infection, swelling or inflammation, blockages in organ systems, to cancer.

Trauma

The pet owner may have missed potential injury or incidents of trauma. Forces from a kick, bump or a fall can lead to organs shifting to unusual positions in the body, which would normally be impossible for a pet owner to realise. These incidents can cause excruciating pain. Examples of this include diaphragmatic hernias, where internal organs punch up into the chest cavity and cannot slip back out. This is commonly seen when a pet is bumped by a car.

GIT obstruction

Pain in the belly can also originate from the GIT. Blockages in the stomach or intestines can be caused when objects such as toys or bones are swallowed whole. Pain and injury to these organs can occur when the stomach or intestines twist around themselves or even ‘telescope’. Other organs such as the spleen can also twist in association with the stomach torsion – another emergency and cause of acute abdomen in itself.

Inflammation/Disease

Life-threatening inflammatory conditions affecting the liver or pancreas are also frequently seen as causes of acute abdomen. Pancreatitis or liver disease (abscesses or cancer, as examples) are also a common cause of acute abdomen.

Examples of other possible causes of this syndrome include peritonitis, stomach ulcers, kidney disease and infections and cancer of the reproductive tract – in both male and female patients. Disc disease (back pain) is an example of pain outside the abdomen that can present as acute abdomen. 

What should I do if I suspect my pet has an acute abdomen?

Severe belly pain should be treated as a medical emergency. Take your pet to the nearest vet ASAP. Any delay can have fatal consequences.

What can I expect when I get to the vet?

Sequence of events at the veterinary hospital:

Upon arrival at the veterinary hospital, the patient will be attended to as an emergency in line with the pet owner’s complaint. The vet will then seek to confirm if the symptoms are truly suggestive of acute abdomen.

To confirm the vet’s speculation of acute abdomen, the pet owner would need to give an accurate and detailed history of the pet’s condition and lifestyle. The vet will ask many in-depth questions to get a better idea of the pet’s medical history and what might be causing their discomfort. Information will be requested regarding the names of current medications the pet is receiving, recent abdominal surgery the pet would have undergone, time estimate of when they noticed signs of pain or distress as well as the progression of the symptoms. As much as it might feel like an interrogation by the vet, this detailed information assists in speeding up the process of providing the best care for the pet.

Depending on initial findings by the vet, some pets would require stabilisation before he can do a more thorough physical examination. Once this examination is completed, a diagnostic workup plan is designed by the vet and discussed with the owner. The findings from the diagnostic tests performed will inform the staff on how best to care for the pet patient. The best care for the patient with acute abdomen can only be achieved through in-hospital care for a couple of days.

Which steps will my veterinarian take in order to find the problem?

Acute abdomen affects other body systems apart from the gut. Systems that put the patient’s life at risk that are commonly affected are the cardiovascular system, respiratory system, central nervous system, renal (kidney) system and the hepatic (liver) system. Blood tests will assist in providing an overview of the state of health of most systems. Imaging (x-ray and ultrasound scan) of the abdomen and chest areas also forms part of the diagnostic tests.

Depending on what is found on these tests, the vet may recommend surgical intervention. This may include an exploratory laparascopy where all the organs can be visualised and surgically corrected where appropriate. A host of other tests might be ordered if deemed necessary for the survival of the patient. Some tests might be repeated in the days to follow as part of monitoring the patient’s response to treatment.

How is acute abdomen treated?

A good diagnostic workup informs the decision on how to treat or manage the case. Having a diagnosis helps to categorise whether the case will be managed medically, as a surgical emergency, or as a delayed surgical case requiring the patient to be stabilised before undergoing surgery. Fluid replacement in the form of a drip is generally advocated in all cases of acute abdomen as it aids in supporting the heart and blood pressure. Medical management entails the use of appropriate drugs to relieve the patient from pain, treat infections, and addressing other possible symptoms such as stopping vomiting and diarrhoea. Surgery is reserved for cases that require surgical intervention for survival.

Conclusion

Acute abdomen is a medical and/or surgical emergency in which time is of the essence. Early intervention improves the chances of the pet’s survival. Unfortunately, due to the broad possible causes of presenting signs, proper management of each case relies heavily on a thorough diagnostic workup. Good pet owner cooperation with the veterinary teams at the hospital is of paramount importance, and dare I say, could be the difference between life and death.

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