VCP 411: Medicine Section

METHOD OF ABDOMINAL PALPATION IN SMALL ANIMALS

• Palpation of abdomen is most satisfactory information in dogs and cats. The examination should be done while the animal is standing on a table with a non-slippery surface, muscular tone is increased and is difficult to overcome if the animal is of uncertain footing.
• If the animal is too large, examination is made on the floor by clinician sitting on a stool behind and slightly one side.
• During palpation, the fingers are firmly extended together and placed on each side of abdomen, the thumb of each hand pointing upwards.
• Gentle pressure is applied and then gradually increased until the tone of the muscle is relaxed and the underlying organs can be identified.

Method of abdominal palpation in large animals

• Horse – provides only a little information because of the intensification of the tone of the abdominal musculature.
• Cattle – Whole hand or fist should be placed firmly in contact with abdomen and held in place until a degree of muscular relaxation occurs. A firm punch is applied for detecting superficial pain. Both sides should be palpated. Palpation for motility of rumen, consistency, amount of ruminal content, large intra abdominal tumors, parts of fetus, liver enlargement right side costal 13^th rib may be palpated behind the right costal arch e.g., acute hepatitis. Firm upward pressure in the hypogastric region –xiphoid cartilage where the diaphragm is attached – cause pain in traumatic reticulitis, moves sideways or kicks or groans.

Method of palpation of the different species

• Ear: The ears is palpated by fingers. The pinnae are pressed between the fingers to check for consistency, tenderness. Normal ear is elastic, little cooler than the rest of the body surface.
• Inflammation – increased warmthness, tenderness with reddening of the skin.
  • Sarcoptes, Psoroptes – affected part is thick and firm.
  • Haematoma – fluctuating.
  • Ear tip necrosis – crumpled and leathery skin.
  • Otitis externa – squelching sound.
  • Cold ears – inadequate peripheral circulation.
• Oesophagus: palpable by placing one hand on either side of neck and feeling along the jugular groove, starting at the pharynx. Normally the esophagus cannot be felt-swelling within the lumen-foreign body, tumor, swelling in the wall-injury, abscess, swelling in the immediate surroundings – edema, emphysema, cellulites, tumour.
• Cardiac area: It is done with fingers tips by laying the left hand flat against the chest inside the left elbow at the 4^th or if necessary the 3^rd and 5^th intercostals space. The right hand of the investigator rests on the withers. Feel for the presence of apex beat, tremor of the chest wall, tender in the chest wall.
• Spleen: Palpation of the healthy spleen is impossible whether externally or from the rectum because of the intra thoracic location. In painful diseases of the spleen palpation will elicit grunting or defensive movements. When spleen is enlarged palpation might be possible by using a claw like grip at the dorso caudal edge of the angle between the last rib and the transverse process of the lumbar vertebrae.
• Abomasum: The lateral surface of the abomasums is related to the abdominal wall on the right side ventral to 7^th-10^th ribs. Palpation by means of firm pressure with the closed fist in calf. Palpation is possible because of low intra abdominal pressure than in old cattle, in which the tension of the abdominal wall is so great. Animals with extensive abomasitis or ulceration show signs of pain when the projection field of abomasums is palpated. Sand in the abomasums may produce a crepitating sound like compression of snow ball in the region of xiphoid. Deep palpation with both the fist aimed vigorously towards the animals back may provoke a rebound of an abomasums hardened by accumulation of sand, impaction severe displacement (left or right) semi spherical tense swelling can be felt in the forward part of the flank.
• Rumen / stomach: Palpation of the rumen contraction is done with the flat of the left hand in the left flank. Consistency is tested by pressing with the fingertips.
  • Rumen containing roughage – normally feels moderately soft or doughy in the middle part. Cattle consumed large quantities of cereal grain, straw-very firm, Dehydrated animal –almost firm. Grain fed animal – soft and porridge like. Atonic rumen filled with excess gas-tense, resilent and tympanitic.
  • Fluctuating – fluid in the lower part.
    • Tense – at the height of contraction
    • Taut – abnormally filling with gas or foamy food mass.
    • Firmer – over loading of the rumen with solid food or soil barely yielding consistency.
• Liver: In all domestic animals – when normal is situated in the concavity of the diaphragm and it does not extend beyond the costal arch even on the right side for its border to be readily palpable. Gross enlargement of the liver (Hepatomegaly) causes the right or ventral border to project beyond the costal arch or xiphoid cartilage and the edge is usually uniformly thickened and rounded, in contradiction to the sharp edge of the normal liver.
• Udder: Both hands should be employed. Each quarter is felt in the milked out state for consistency and tenderness. Healthy glandular parenchyma and interstitial tissue – fine grained in young cows, coarse grained in older cow.
• Teat: Usually palpated using the fingers. Holding teat in between fingers. In case of obstruction pass any probe or teat siphon and perform indirect palpation.
• Limbs: palpated with palms. Palpate for haematoma, cellulites, abscess, fracture, exostoses, and arthritis.
• Lymph glands: Done by sliding method of palpation. Palpate for size, consistency, pain, lobulation, abscess and adenitis.
• Muscles: palpated wtiht eh palm of the hand or fingers, always compare the feel of the muscle with its counterpart on the other side.