veterinary

1. Haemoabdomen
Hal Drummond, Pako Tlhalerwa, Katie Jamieson, Tom Sparks

2.  A 10 year old German Shepherd dog weighing
40kg requires anaesthesia for exploratory
laparotomy and possible splenectomy. The dog
is in a collapsed state. Heart rate is 180
beats/min and femoral pulses are weak.
Mucous membranes are pale but PCV is within
the normal range (33%). Abdominal
ultrasonography reveals the presence of free
abdominal fluid and a splenic mass.

3.  A 10 year old German Shepherd dog weighing
40kg requires anaesthesia for exploratory
laparotomy and possible splenectomy. The
dog is in a collapsed state. Heart rate is 180
beats/min and femoral pulses are weak.
Mucous membranes are pale but PCV is
within the normal range (33%). Abdominal
ultrasonography reveals the presence of free
abdominal fluid and a splenic mass.

4.  Age- geriatric will lower metabolism there for altering
effecting drug metabolism
 German Shepherd-potential for cardiac disease(DCM)
 Splenectomy – likely to lose a significant amount of blood
 Collapsed state
 Tachycardic (HR 180bpm) and weak femoral pulses –
hypovolaemia
 MM pale but PCV normal
 Normal PCV indicates this is an acute bleed
 Fluids  anaemic
 Presence of free abdominal fluid and splenic mass – likely
diagnosis ruptured haemangiosarcoma
 Pain

5.  Check biochemistry/haematology prior to
fluid administration to gauge organ function
 Hypovolaemic – Fluids are vital. Must replace
fluid deficit prior to surgrey. Shock rates at
90ml/kg of crystalloids for 15mins and then
reassess vital parameters. These fluids should
be continued well into the post operative
period.
 Colloids should be considered but very expensive!
 Double IV access should be obtained to speed flid
delivery.

6.  Alpha 2?
 ACP?
 Benzodiazapine?
 Opioid?

7.  Alpha 2
 ACP
 Benzodiazapine
 Midazolam – 0.2mg/kg IV
 Opioid
 Methadone – 0.2mg/kg IV

8.  The animal should be induced with propofol
(160mg/16ml)
 Alfaxalon is a suitable alternative if it available but
is more expensive
 Both induction agents should be titrated to affect
when used
 Assess eye position, reflex and jaw tone

9.  Following induction the dog should be intubated
(size 12 ET tube approx) and maintained on
isoflurane
 As this is a large breed dog, a circle or coaxial bain
should be used to deliver the anaesthetic gas to the
patient
 Want a circuit that is suitable for sustained IPPV if the
animal becomes apnoeic intra-operatively
 Setting up a ventilator would also be advised
 Augmentin IV every 90 minutes during sx
 Avoid using NSAIDS in this case as potential for
renal failure.

10.  Careful monitoring of HR, BP and RR is
essential
 Intravenous boluses of fentanyl would be
appropriate in this case to deal with noxious
stimulus
 Dose – 40 - 200μg
 q20 mins as necessary
 Augmentin IV should be continued every 90
minutes throughout the procedure

11.  ICU
 Fluids should be continued and reassessed
every half hour
 Pain should be assessed every hour according
to Glasgow Pain score and further analgesia
should be administered if required
 Monitor HR, RR, MM and pulse quality