TOPIC:ASCITES

PREPARED BY:-PRABHU KUMAR M DHVK 1225Veterinary college , Hassan

AscitesAccumulation of non-inflammatory fluid in

the peritoneal cavity characterized by bilateral distension of lower abdomen and positive fluid waves.

AetiologyPrimary causes:-• Fall in osmotic pressure of blood • Obstruction of lymphatic vessels • Increased hydrostatic pressure in capillaries

may be due to cardiac insufficiency ,congestive heart failure and passive congestion

Important aetiological factors•Renal retention of sodium – Renal insufficiency and liver damage.•Hypoproteinaemia – Protein deficiency diet Lower protein synthesis in liver damage Loss of protein in heavy parasitic

infections like haemonchosis , strongylosis.

Other important aetiological factors

Portal hypertension or lymphatic stasis• In hepatic fibrosis, right side CHF,

tricuspid valve defects.• Pressure on portal vein, posterior venacava

, posterior vein and large abdominal lymph vessels by abscesses, cyst, tumours etc.,

Pathogenesis Venous stasis

Venous hypertensionRelease of fluid

Accumulation of fluid in peritoneal cavity

Hypoproteinaemia

Plasma colloidal osmotic pressure is decreased

Increase in hydrostatic pressure

Fluid escaped from circulation

Accumulated in body cavity

Liver Cirrhosis or Renal damage

Less kidney perfusion

Release of Rennin from kidney

Which act on angiotensin

Release of Aldosterone

Retention of more sodium in circulation

Ascites

Clinical findings•Abdomen circumference -increased

•Bilateral distension of lower abdomen- ‘Pear shaped appearance’

•Linea alba-distended downward•Flank region-hollowness with prominent spines

•If animal body position is altered fluid occupies most dependent part of peritoneal cavity causing bulging at that point

•Reduction in tone of abdominal muscles

•Dyspnoea, Constipation, inappetance ,concomittant anaemia, occasional tympany

•Palpation-undulating movement of fluid

•Dogs and Cats:-Distension may reach up to costal margins

and lower abdominal border may touch ground suface

Barrel shape-excessive distension

• Sheep and goat:-Umbilicus - bulged outwardsTactile percussion-fluid thrill or fluid waves

Subsequently animal shows•Weakness , sunken eyes• Increased respiration and heart rate• Lie down as they have little tendency to walk•Engorged and prominently visible blood vessels in abdominal area•Death -Primary cause or cachectic effects of generalised oedema

Necropsy findings•Large amount of fluid in body cavity•Adhesions in long standing cases•Pressure on visceral organs also seen

Diagnosis •History:- hypoproteinaemia•Clinical signs:- liver cirrhosis•Radiological examination:-Hazy Opaque abdominal cavity- ground glass

appearanceAbdominal organs may not be visible due to

presence of fluid having high specific gravity

•Ultrasonography :-Ascitic fluid may be identified

•Abdominal paracentesis :-Collect fluid by puncturing on midline by 14-

15 gauze needle

Fluid-clear, watery, straw colored or turbid containing fibrin, RBCs and WBCs.

Protein content below 3.5 g/dl and Specific gravity less than 1.016

If milky- presence of lecithinIf turbid -presence of large no. Of cellsGreenish yellow-presence of bile due to as a

result of extravasation.Reddish- presence of erythrocytesInflammatory- If >500 total nucleated cells/ml of fluid in

small animalsIf >9000cells/ml in large animalsPresence of macrophagesIn haemorrhages- PCV15-20% And Fluid clots due to presence of high prootein

Differential diagnosis•Hepatomegaly•Splenomegaly•Uterine neoplasm•Urethra obstruction with enlarged bladder -

rectal palpation•Gastric torsion and intestinal obstruction• Fat deposition In al these cases abdominal enlargement

is there but fluid thrills are not felt and no shape alteration.

•Peritonitis- tenderness , high temp , paralytic ileus, escape of exudate in abdominal paracentesis

Treatment •In hypoproteinaemia associated with parasitic

infectionBroad spectrum antihelminticProtein rich diet-High biological value Sodium free/low conc• For fluid excretionDiuretic therapyFrusemide-0.5-2 ml small animals, 5-10ml in large animals, I/M, once daily for 2-4 days

•Removal of excessive abdominal fluid-in abdominal discomfort/ respiratory distress

puncture between umbilicus and pubis close to linea alba by 14-15 gauze needle.

never drain completely- shock0.5-2ml adrenaline-cardiac /respiratory failure

• Antibiotics

Doing Thank You Dance