Help! Gas in abdomen

Re: Help! Gas in abdomen

Utlendigur — Fri, 08 Jul 2011 20:12:13 GMT

I had an afghan hound present (on a Friday) with what looked like gastric dilation (massive tympanic abdomen and tachypnoea) - but looking much too bright and not shocked enough. Xray showed pneumoabdomen. There was a 0.5-1cm small hole in the dorsal part of the greater curvature of the stomach. No fluid leakage, no Fb and not the sort of dog who would eat anything odd. Histo of the area round the hole showed.....normal stomach with a hole in it...Dog made a full uneventful recovery. Vet none the wiser as to why it happened.

Re: Help! Gas in abdomen

Mark Hedberg — Fri, 08 Jul 2011 15:40:20 GMT

I had an idiopathic pneumoabdomen a few months ago. Ex breeding persian cat, had been flogged off to an unsuspecting pensioner for far too much money. I read a case report online that seemed to suggest a pinpoint gastric leakage as a cause. Cat had a mass on the right kidney, enlarged heart with a galloping heart rhythm. Oh, and a liter of air (!) (head nurse's face was priceless, as was mine) in the abdomen. I put it on spironolactone for the heart, atenolol for the rhythm, deflated the belly, gave convenia and told the owner to expect the worst.

The belly very slightly reinflated and then resorbed. That was 5 months ago. Very weird, but cat is stable so I'm not argueing.

Re: Help! Gas in abdomen

Ian Battersby — Fri, 08 Jul 2011 15:25:14 GMT

An unusual case the main differentials are ruptured bowel and gas producing bacteria within the peritoneal cavity.

I have seen one cat with a similar history without evidence of peritonitis that on post mortem we found a small perforated ulcer on the lesser curvature of the stomach. I presumed it was the location of the ulcer that resulted in only air not ingesta/gastric fluid passing into the peritoneal cavity hence no peritonitis.

So although idiopathic cases are rarely reported ( i haven't actually read the case reports ) i would consider this cat to have a rupture bowel until proven otherwise. As ruptured bowel is the most common differential for this condition.

Contrast studies - avoid barium and use iodine based incase you get leakage- but in my case again there was no leakage of the contrast medium because of the position of the ulcer.

All the best

Ian

Re: Help! Gas in abdomen

CatherineThomas — Fri, 08 Jul 2011 15:18:04 GMT

no, there was no detectable smell. It is a stray cat so there is the possibility of trauma but no evidence of any wounds.

As it is/was a stray the owners dont want to do too much but the plan is to xray it again tomorrow morning.

Re: Help! Gas in abdomen

Clive Ansell — Fri, 08 Jul 2011 14:30:42 GMT

Was the released air odourous? which may indicate leakage of gut contents and/or presence of gas producing bacteria?

Any history of injury or fight wounds?

Maybe worth doing rads with positive contrast in the gut to rule out leakage?

Re: Help! Gas in abdomen

Sandra Milburn — Fri, 08 Jul 2011 14:09:08 GMT

Wow, a real Friday-case! Very interesting, never seen or heard anything like this. Good luck and keep us posted :)

Re: Help! Gas in abdomen

CatherineThomas — Fri, 08 Jul 2011 14:02:39 GMT

Well we drained loads of air from the abdomen and the cat now looks rather deflated, although still dyspnoeic.

I've just spoken to Dick White and apparently there are rarely cases of idiopathic pneumoabdomen and this could be one of them so he said we shouldn't open her up. We should just monitor for recurrence and drain the air as necessary for now. He also said the diaphragm could be stretched becuase the abdomen was so full, so this could be why the dyspnoea hasn't gone immediately as it will take time for function to return.