Friday, October 31, 2014

Hemoabdomen & Hemoperitoneum: Abdominal Bleeding in Dogs

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Hemoperitoneum (also commonly called hemoabdomen) is defined as blood within the peritoneal (abdominal) cavity. The blood accumulates in the space between the inner lining of the abdominal wall and the internal abdominal organs.
Some causes include:

  • Traumatic injuries – these are most common
  • Intra-abdominal tumors or tumors within the abdomen - these can rupture, slowly bleed, or invade into a blood vessel causing blood to enter the abdominal cavity
  • Hematomas – these are organized, local collections of blood that can rupture and bleed
  • Coagulopathies – these are clotting disorders that can cause bleeding within the abdomen as well as in other sites
    Depending on the degree of blood loss, and how rapidly the blood is lost, a hemoperitoneum may be an emergency situation. 

    What to Watch For
  • Weakness
  • Collapse
  • Abdominal distension
  • Subcutaneous (under the skin) bruising
  • Increased respiratory effort
  • Pale mucus membranes (the best place to check is the gums or inner lining of the lips)

    Other signs that might indicate a more chronic (longer term or gradual) blood loss include: anorexia, lethargy, intermittent weakness, and weight loss.

    Diagnosis

    A thorough history and physical exam is critical for prompt, and accurate diagnosis. Your veterinarian may also recommend:
  • Abdominal radiographs (x-rays)
  • Abdominocentesis (inserting a needle and syringe into the abdominal cavity) to obtain a sample for diagnostic evaluation
  • Fluid analysis of the retrieved sample is required for definitive evaluation
  • Complete blood count
    Depending on your pet's condition and initial test results, additional tests that may be required. These may include:
  • Biochemical profile
  • Coagulation panel
  • Abdominal ultrasound
  • Computed tomography (CT) or magnetic resonance imaging (MRI)
    Treatment 
    The general approach to treatment varies on the clinical condition of the patient and the cause of the hemoperitoneum. Therapy generally includes:
  • Intravenous fluid therapy
  • Blood transfusions
  • Belly wrap 
  • Oxygen therapy
  • Analgesic therapy (pain medication)
  • Vitamin K administration
  • Emergency exploratory surgery

    Home Care
    A hemoperitoneum may be an emergency situation. Veterinary care should be given as soon as possible. Keep your pet calm and comfortable. Minimize stress until you can get to a veterinary hospital. Keep your pet warm. If a traumatic injury is suspected, be careful moving your pet, as fractures may be present.
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