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Acute Abdomen 21

• Recurrence may occur in some cases despite
clinically apparent resolution and appropriate
VetBooks.ir • Relapse may occur if the duration of treat- Diseases and Disorders
therapy.
ment is inadequate or if appropriate treat-
ment is delayed or interrupted. Incomplete
surgical excision may contribute to indolent
infections.

PEARLS & CONSIDERATIONS
Comments
Culture and histopathologic analysis of tissue
are gold standard diagnostic tests, but simple
cytologic examination is a practical and high-
A B yield test. Often, filamentous organisms may
ACTINOMYCOSIS A, Ulcerative draining wound spreading across the muzzle of a 3-year-old Belgian Malinois be cytologically apparent when culture or biopsy
with cervico-facial actinomycosis. B, Aspirates from a maxillary mass on the dog in panel A (50× magnification, is inconclusive.
Wright-Giemsa stain). Note the branching filamentous bacteria surrounded by inflammatory cells.
Technician Tips
Standard barrier precautions, such as a protec-
• Nocardia spp. are usually sensitive to sulfon- is indicated. Long-term sulfonamide treatment tive gown and gloves, should be worn while
amides (e.g., trimethoprim-sulfa 30-45 mg/ may increase the risk of these complications. handling animals with draining lesions to
kg PO q 12h). Successful treatment of protect against zoonosis and to prevent con-
nocardiosis has been reported with many PROGNOSIS & OUTCOME tamination of the skin.
antibiotics, including ampicillin, amikacin
and erythromycin. • Actinomyces infections have a more favorable SUGGESTED READING
prognosis compared to Nocardia infections. Sykes J: Actinomycosis and nocardiosis. In Greene
Possible Complications • Localized infections may respond well to CE, editor: Infectious diseases of the dog and cat,
When using sulfonamide antibiotics, monitoring treatment. Disseminated disease carries a ed 4, St. Louis, 2012, Elsevier Saunders, pp
of adverse effects such as anemia, leukopenia, poor prognosis. 484-495.
keratoconjunctivitis sicca (dry eye), cutaneous • Individual patient factors, such as immuno- AUTHOR: Kirk Ryan, DVM, DACVIM
drug eruptions, hepatopathy, and polyarthritis suppression, may impact prognosis. EDITOR: Joseph Taboada, DVM, DACVIM

Acute Abdomen Client Education
Sheet

BASIC INFORMATION CONTAGION AND ZOONOSIS • History of incomplete or absent vaccinations
Certain infectious causes (e.g., canine parvo- (e.g., for canine parvovirus)
Definition virus) can be highly contagious.
A sudden onset of abdominal pain PHYSICAL EXAM FINDINGS
ASSOCIATED DISORDERS • Signs of abdominal pain
Epidemiology Depends on severity and nature of underlying ○ Tense abdomen, praying position,
SPECIES, AGE, SEX disorder. May include hypovolemia, hemor- vocalizing
Dogs more commonly affected than cats rhage, dehydration, sepsis, or hypoalbumin- ○ Limited accuracy: stoic patients may hide
emia. Systemic complications may prove signs of pain; fearful patients may tense
GENETICS, BREED PREDISPOSITION life-threatening. the abdomen even in absence of pain.
Gastric dilation/volvulus (GDV) typically affects Clinical Presentation • Collapse/weakness
large-breed, deep-chested dogs. Pancreatitis is • Perfusion abnormalities (e.g., tachycardia,
common in middle-aged, small- to medium- HISTORY, CHIEF COMPLAINT poor pulse quality, pale or hyperemic mucous
sized dogs. • Evidence of abdominal pain membranes)
• Collapse • Dehydration may coexist with hypovolemia
RISK FACTORS • Vomiting, including hemoptysis (e.g., dry mucous membranes, skin tenting,
• Dietary indiscretion may result in pancreatitis • Diarrhea: small or large bowel (p. 1215) enophthalmos)
or gastrointestinal (GI) foreign body. • GI bleeding: melena (duodenal/jejunal) or
• Previous abdominal surgery for intestinal hematochezia (colonic/rectal) Etiology and Pathophysiology
foreign body or other conditions can increase • Weight loss Causes can be categorized according to organ
the chance of subsequent obstruction • Anorexia system and treatment approach:
through intestinal injury or adhesions. • History of dietary indiscretion • GI
• Infectious disease that can cause GI hyper- • History of medications that affect GI mucosal ○ Surgical: obstruction (e.g., foreign body,
motility (e.g., canine parvovirus) may pre- integrity (e.g., nonsteroidal antiinflammatory intussusception, neoplasia); GDV; per-
dispose to intussusception. drugs [NSAIDs]) foration (e.g., ruptured gastric/duodenal

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