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2.e4 Abdominal Distention

○ If hemorrhagic effusion recognized, Advanced or Confirmatory Testing PROGNOSIS & OUTCOME
coagulation tests may be appropriate. Depends on results of examination and initial Varies, depending on the underlying cause
VetBooks.ir • Abdominal imaging to determine organ TREATMENT PEARLS & CONSIDERATIONS
diagnostic tests
If palpable abdominal mass, consider
involvement
○ Radiographs useful for determining
organ size, to recognize air-filled hollow Treatment Overview Comments
viscus Varies, depending on the underlying cause • Acute onset of abdominal distention often
○ Ultrasound useful to assess internal signals an emergent issue (e.g., gastric dila-
architecture of organs (e.g., cysts, solid Acute General Treatment tion/volvulus, caudal vena caval syndrome,
infiltrates) Severe abdominal distention due to accumula- portal vein thrombosis, hemoabdomen)
• Three-view thoracic radiographs to identify tion of fluid can compromise respiration and • Pet owners may not realize that an intact
metastasis contribute to discomfort. Abdominal drainage female has been bred, leading them to present
• Fine-needle aspiration (FNA) of mass(es) may be indicated not only for diagnostic but a pregnant female for evaluation of abdomi-
with cytology may provide diagnosis. also therapeutic purposes. nal distention.
○ Platelet count ± PT/PTT before FNA to • The presence of abdominal distention does
assess risk of bleeding Possible Complications not necessarily carry a poor prognosis as it
○ Ultrasound guidance helpful during • Severe abdominal distention may cause may be benign in nature.
sample collection respiratory compromise. • Although abdominal distention may cause
○ Lymphoma typically recognized by FNA • Aspirate or biopsy may result in respiratory effort due to pressure on the
cytology hemorrhage. diaphragm, additional or alternative reasons
○ Fungal granuloma (e.g., histoplasmosis, for respiratory effort may be present. For
aspergillosis) often recognized by FNA Recommended Monitoring example, bicavitary effusion, metastatic lung
cytology For animals with tachypnea, respiratory rate disease, or pulmonary thromboembolism
○ Sarcomas may not exfoliate well. and effort should be monitored. often complicate disorders causing abdominal
distention.
Prevention
• Routine heartworm prevention (heartworm
disease)
• Calorically appropriate diet (obesity)
Technician Tips
Monitoring a patient’s respiratory rate and effort
during abdominocentesis can provide guidance
about the amount of fluid to be removed to
provide comfort for the patient.
Client Education
In disease states, cachexia can occur with
abdominal distention. Not all animals with
abdominal enlargement are “overweight.”
SUGGESTED READING
Walter J: Abdominal enlargement. In Ettinger SJ,
Feldman EC, editors: Textbook of veterinary
internal medicine, ed 8, St. Louis, 2017, Elsevier,
pp 78–80.
RELATED CLIENT EDUCATION
SHEET
Consent to Perform Abdominocentesis
AUTHOR: Aida I. Vientós-Plotts, DVM
A B EDITOR: Leah A. Cohn, DVM, PhD, DACVIM

ABDOMINAL DISTENTION A, Dorsal view of a young English bulldog with marked ascites caused by
right-sided congestive heart failure due to severe pulmonic stenosis. The abdominal distention hides the dog’s
weight loss and may be mistaken by the owner as an increase in lean body mass. This degree of abdominal
distention was associated with poor appetite, lethargy, and dyspnea. B, Same dog 2 hours later, when large-volume
abdominal drainage was complete. The dog was breathing normally, was more active, and appeared markedly
more comfortable. The extent of cardiac cachexia is revealed.

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