Abdominal Exploratory in Cats
Dr. Cathy Reese
If your pet was hit by a car or has experienced other major trauma, your veterinarian may need to provide initial emergency stabilization therapy in the form of intravenous fluids and oxygen. If your pet has been sick or vomiting for an extended period of time, he may also require stabilization in the form of intravenous fluid therapy. Liver. The liver is inspected for color, shape, size, and the presence of tumors or abscesses. A biopsy is taken if anything looks abnormal and the abscess or tumor is removed if possible.
Exploratory abdominal surgery involves a large incision in the skin and muscle of the abdomen. If there is fluid present in the abdominal cavity, a sample may be collected for analysis and bacterial or fungal culture. Your veterinarian will examine every organ in the abdomen:
Gall bladder. The gall bladder is inspected for abnormalities or obstruction. If a stone is suspected, the gall bladder is opened, the stone removed and the bile duct flushed. If the gall bladder is infected or cancerous, it may need to be removed. If the flow of bile is obstructed by a stone or tumor, and the obstruction cannot be relieved, the flow of bile may need to be rerouted by attaching the gall bladder directly to the intestine.
Pancreas. The pancreas is inspected for consistency and the presence of abscesses or tumors. A biopsy is taken and abscesses are drained or partially removed if necessary.
Spleen. The spleen is inspected for tumors, abscesses, rupture or torsion, which is twisting of the blood vessels that cuts off the blood supply to the spleen, and is removed or biopsied if necessary.
Kidneys. The kidneys are examined for shape and size. Small kidneys may indicate kidney failure. The kidneys can be biopsied, or one can be removed if necessary. The ureters (tubes which carry urine from the kidneys to the bladder) are inspected for stones, tumors, or signs of an obstruction.
Urinary bladder. The bladder is inspected for stones, tumors or injury, especially if the animal has been hit by a car or suffered other major trauma. Part of the bladder can be removed, although care must be taken to avoid injury to the connection of the ureters to the bladder. The inside of the bladder is often cultured for bacterial infection.
Adrenal glands. These producers of hormones, such as cortisol and epinephrine (adrenaline), are inspected for size and shape. Tumors can develop in these glands, which would require their removal.
Lymph nodes. Lymph nodes are present throughout the body and can become enlarged secondary to inflammation, infection, or cancer. The nodes in the abdomen are inspected for size, shape, and consistency, and removed or biopsied if indicated.
Stomach. The stomach is palpated (felt) for tumors or ingested foreign objects, which can often be removed, depending on their location and invasiveness. The stomach can also twist on its axis, causing the flow of gas and ingested material to be obstructed. The stomach can dilate and press on major blood vessels that return blood to the heart, causing the patient to go into shock. This syndrome is called gastric dilatation/volvulus (also called bloat, due to the patient's bloated) and is most commonly seen in large to giant breed dogs, especially those with deep chests. It is a surgical emergency and needs veterinary attention right away. During emergency exploratory surgery, the stomach is untwisted and evaluated to see if any of the stomach tissue has died due to loss of blood flow. If possible, the necrotic (dead) part of the stomach is removed, and then the stomach is attached to the body wall with stitches to prevent it from twisting again in the future. If there is severe necrosis of the stomach and too much needs to be removed, the dog may not survive. Some of these dogs are euthanized or put to sleep during surgery due to a poor prognosis.
Intestine (small and large). The intestines are examined inch by inch for tumors, foreign bodies, rupture, or twisting of their blood supply causing death of the intestine. Some foreign bodies can be removed by making an opening in the intestine, removing the object, and then closing the intestine with stitches. Other times, the object will have been present for a long time, causing too much pressure on the intestine, resulting in necrosis (death) of part of the intestine. Or, it may have caused an obstruction of the flow of food that resulted in rupture or perforation of the bowel. In these cases, some of the intestine may need to be removed. Some tumors of the intestine may also need to be removed in a similar way. There is a limit to how much bowel can be safely removed from a patient before the digestive process becomes adversely affected. If too much needs to be removed, then the patient's prognosis may be very poor and euthanasia may be the only option.
Reproductive organs. The uterus and ovaries can become infected or can develop tumors. In either of these cases, an ovariohysterectomy is necessary. The organs may be biopsied or submitted for bacterial culture.
In males, one or both testicles may be affected. Males that do not have both testicles descended into the scrotum are called cryptorchid, and cryptorchid testicles can develop into tumors if not removed, so they are removed during exploratory abdominal surgery.