Clinical audit of canine acute abdomen scans
We have just completed a prospective series of 48 canine acute abdomens examined ultrasonographically over the last 6 months. The main findings:
1: 8/48 were foreign bodies plus 1/48 entrapped hernia -more obstructions than I was expecting. That is maybe the most important single finding: that we almost certainly didn’t miss any. All of those which we didn’t explore surgically eventually either recovered or reached a firm diagnosis by one means or another.
The newly published criterion of jejunal diameter > 15mm as a predictor of obstruction is really helpful although there was one dog in this series with even more dilated jejunum that eventually resolved without surgery after giving me sleepless nights.
2: We also didn’t end up opening up any dogs unnecessarily in this period. Although I believe that this is much less important than the other way round (not operating when surgery was required) it’s still no bad thing.
3: Two cases of atypical Addison’s were a bit of a revelation in that both had severe abdominal pain. Apparently in people Addison’s is associated with penetrating pain in the lower back, abdomen and legs.
4: We saw a lot of apparent gastroenteritis. Liquid colonic contents seem to be a fairly reliable predictor of a non-surgical condition.
There were some oddities like the granulomatous steatitis and the eosinophilic/granulomatous enteritis which go to show that however long your list of differentials for an acute abdomen there’s always something you haven’t factored in!.
