FB ingestion, scavenger, vomiting, pain, distributive shock, recent surgery, reduced vol-
What are the clinical signs/history with septic peritonitis?
ume/increased frequency of urine ascension, stranguria/dysuria, haematuria
Acute abdomen, pain, vomiting, PUPD, organ specific signs, vomiting, anorexia, history of
What are the clinical signs/history with aseptic peritonitis?
scavenging/chronic vomiting, weight loss, age for neoplasia, jaundice
What are the clinical signs of haemoabdomen? Hypovolaemia
What are the clinical signs/history for uroabdomen? Abdo pain, reduced mentation, inappropriately low heart rate, urinary signs
Intestinal perforation, haematogenous, external penetrating injury, iatrogenic, urinary ascen-
What could cause septic peritonitis?
sion
Pancreatitis/hepatitis/cholangitis/splenitis/nephritis, neoplasia, bile, urine, blood, gastric
What could cause aseptic peritonitis?
perforation
What could cause haemoabdomen? Acute bleed, chronic bleed, neoplastic bleeds, trauma blunt or penetrating, coagulopathy
POCUS, tap free fluid, physical appearance of fluid, glucose measurement of fluid, lactate
How to diagnose peritonitis?
measurement of fluid, cytology, diagnostic peritoneal lavage, further imaging
What suggests septic fluid? Glucose 1mmol/l less than blood, lactate 2mmol/l more than blood
Stabilise patient first, surgery or abdominal drain and lavage if source non-removable, an-
How to treat peritonitis?
tibiotics if septic
What are the features of the escalate protocol for antibiotic usage in peritonitis? Start with no/single antibiotic and wait for C&S results before addition of others in
What are the features of the de-escalate protocol for antibiotic usage in peritonitis? Start with double/triple combination antibiotics and then reduce depending on C&S
How to diagnose haemoabdomen? POCUS, tap free fluid, PCV on fluid
What does it mean if the fluid and blood PCV are the same? Haemoabdomen acute
What does it mean if the PCV of the fluid is higher than the blood? Some acute bleed
What does it mean if the PCV of the fluid is lower than the blood? Chronic bleed
How to monitor haemoabdomen? Blood pressure (MAP) should be over 60, lactate should be less than 2mmol/l
How to treat a neoplastic bleed? If response to fluid bolus poor give transfusion, euthanasia
How to treat blunt trauma? Transfusion, tranexamic acid - antifibrinolytic so maintains clot stability, repeat transfusions
Transfusion, consider staged approach could pack it and close, tranexamic acid - antifibri-
How to treat penetrating trauma?
nolytic so maintains clot stability
Transfusion, clotting factors, platelet rich plasma, vitamin K if rat poison, treat underlying
How to treat a coagulopathy?
disease
What could cause uroabdomen? Cystotomy, trauma such as an RTA
How to diagnose uroabdomen? POCUS, tap free fluid and analyse, radiographic contrast studies, ECG for cardiogenic shock
What free fluid analysis would confirm uroabdomen? Creatinine > 2x blood, potassium >1.4x blood (dogs), potassium >1.9x blood (cats)
What can uroabdomen cause? Hyperkalaemia
Can cause acidosis so Hartmann's is alkalising, protect cardiac potential by giving calcium glu-
How to treat hyperkalaemia?
conate, urinary catheter and abdominal lavage, bicarbonate, glucose/insulin, beta agonists
Manipulates sodium movement loading the cell with sodium and so stimulates potassium
How can bicarbonate be used to treat hyperkalaemia?
uptake from the blood
Insulin causes glucose uptake, glucose bolus acts as agonist and pushes potassium into cell
How can glucose/insulin be used to treat hyperkalaemia?
and reduces cardiac ettects, neutral insulin leads to supplemental glucose
How do beta agonists get used to treat hyperkalaemia? Stimulate Na/K pump pushing potassium into cells in exchange for sodium, e.g. salbutamol
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What are the clinical signs/history with septic peritonitis?
ume/increased frequency of urine ascension, stranguria/dysuria, haematuria
Acute abdomen, pain, vomiting, PUPD, organ specific signs, vomiting, anorexia, history of
What are the clinical signs/history with aseptic peritonitis?
scavenging/chronic vomiting, weight loss, age for neoplasia, jaundice
What are the clinical signs of haemoabdomen? Hypovolaemia
What are the clinical signs/history for uroabdomen? Abdo pain, reduced mentation, inappropriately low heart rate, urinary signs
Intestinal perforation, haematogenous, external penetrating injury, iatrogenic, urinary ascen-
What could cause septic peritonitis?
sion
Pancreatitis/hepatitis/cholangitis/splenitis/nephritis, neoplasia, bile, urine, blood, gastric
What could cause aseptic peritonitis?
perforation
What could cause haemoabdomen? Acute bleed, chronic bleed, neoplastic bleeds, trauma blunt or penetrating, coagulopathy
POCUS, tap free fluid, physical appearance of fluid, glucose measurement of fluid, lactate
How to diagnose peritonitis?
measurement of fluid, cytology, diagnostic peritoneal lavage, further imaging
What suggests septic fluid? Glucose 1mmol/l less than blood, lactate 2mmol/l more than blood
Stabilise patient first, surgery or abdominal drain and lavage if source non-removable, an-
How to treat peritonitis?
tibiotics if septic
What are the features of the escalate protocol for antibiotic usage in peritonitis? Start with no/single antibiotic and wait for C&S results before addition of others in
What are the features of the de-escalate protocol for antibiotic usage in peritonitis? Start with double/triple combination antibiotics and then reduce depending on C&S
How to diagnose haemoabdomen? POCUS, tap free fluid, PCV on fluid
What does it mean if the fluid and blood PCV are the same? Haemoabdomen acute
What does it mean if the PCV of the fluid is higher than the blood? Some acute bleed
What does it mean if the PCV of the fluid is lower than the blood? Chronic bleed
How to monitor haemoabdomen? Blood pressure (MAP) should be over 60, lactate should be less than 2mmol/l
How to treat a neoplastic bleed? If response to fluid bolus poor give transfusion, euthanasia
How to treat blunt trauma? Transfusion, tranexamic acid - antifibrinolytic so maintains clot stability, repeat transfusions
Transfusion, consider staged approach could pack it and close, tranexamic acid - antifibri-
How to treat penetrating trauma?
nolytic so maintains clot stability
Transfusion, clotting factors, platelet rich plasma, vitamin K if rat poison, treat underlying
How to treat a coagulopathy?
disease
What could cause uroabdomen? Cystotomy, trauma such as an RTA
How to diagnose uroabdomen? POCUS, tap free fluid and analyse, radiographic contrast studies, ECG for cardiogenic shock
What free fluid analysis would confirm uroabdomen? Creatinine > 2x blood, potassium >1.4x blood (dogs), potassium >1.9x blood (cats)
What can uroabdomen cause? Hyperkalaemia
Can cause acidosis so Hartmann's is alkalising, protect cardiac potential by giving calcium glu-
How to treat hyperkalaemia?
conate, urinary catheter and abdominal lavage, bicarbonate, glucose/insulin, beta agonists
Manipulates sodium movement loading the cell with sodium and so stimulates potassium
How can bicarbonate be used to treat hyperkalaemia?
uptake from the blood
Insulin causes glucose uptake, glucose bolus acts as agonist and pushes potassium into cell
How can glucose/insulin be used to treat hyperkalaemia?
and reduces cardiac ettects, neutral insulin leads to supplemental glucose
How do beta agonists get used to treat hyperkalaemia? Stimulate Na/K pump pushing potassium into cells in exchange for sodium, e.g. salbutamol
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