Acute collapse

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Acute collapse is a common presenting complaint in first-opinion practice and can be a source of enormous stress for inexperienced clinicians. There is a vast list of differential diagnoses, ranging in severity from conditions requiring only simple treatment (e.g. osteoarthritis in an old dog) to those where there is immediate life-threatening compromise (e.g. haemoperitoneum). This chapter looks at the immediate considerations, history, observation, physical examination and diagnostic tests.

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9.2 A 13-year-old Labrador Retriever that presented acutely collapsed. The mucous membranes were pale and the dog had a PCV of 19%. Free peritoneal fluid was found on abdominal palpation and confirmed with ultrasonography , which also showed a large splenic mass and facilitated guided abdominocentesis to yield frank blood . Surgery removed a large spleen with multiple nodules and one large ruptured mass which was found to be non-malignant on histopathology. It should be noted that ruptured splenic masses should not be assumed to be malignant haemangiosarcomas, as haematomas, splenic hyperplasia and haemangiomas are also possible. The dog made a good recovery.
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9.3 Radiograph of the cervical spine of an 8-month-old Norfolk Terrier that was presented with quadriparesis after trauma. Severe neck pain was noted, and radiography showed a fracture/luxation of C1–C2.
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9.4 Gastric dilatation, with or without volvulus, is a common presentation as a cause of acute collapse in first-opinion practice, often as an out-of-hours emergency. Abdominal radiograph from a 10-year-old Flatcoated Retriever with GDV and mesenteric torsion. The GDV is seen as the stomach distended in the cranial abdomen with radiolucent gas, divided into two sections by a central radiopaque line; this line is somewhat obscured here by the gaseous distension of the small intestinal loops, but has been marked in red to highlight it. The entire small intestine is markedly dilated with gas, owing to a concurrent mesenteric torsion. The patient was euthanased at surgery because of necrosis of the torsed small intestine, which was a far more insurmountable problem than the GDV. Abdominal radiograph from a 6-year-old small cross-breed terrier who had broken into the feed cupboard and gorged on dry food. The caudal borders of the stomach (red arrows) are seen projecting almost to the pelvic inlet. Surgical decompression of huge quantities of swollen dry dog food was required.
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