Abdominal distension describes the symptom of enlargement or swelling of the abdomen in cats, which is triggered by a wide variety of normal and abnormal processes.
• Abdominal distension is a feature of many conditions ranging from injury, infection, tumors, and disease of specific organs such as the liver and heart
• Investigation of abdominal distension requires physical examination, diagnostic imaging, and blood work, urinalysis, and sampling of abdominal fluid or masses
• Treatment involves management of the underlying disease process but normally includes medication such as anti-inflammatories, pain relief, steroids, or antibiotics
• Some conditions require surgical management, such as injuries or tumors
• Prognosis varies significantly depending on the underlying trigger
• Many disease processes resulting in abdominal distension are serious, life-threatening conditions and require prompt investigation
Abdominal distension results from accumulation of a particular material, such as fluid, fat, or pus, or from enlargement of one of the abdominal organs such as the liver or stomach.
Abdominal distension is common in cats as their relatively weak abdominal musculature results in abdominal distension early in some disease processes.
Most triggers of abdominal distension require prompt treatment, and many are serious or emergency conditions.
An exception to this rule is in cases of pregnancy, or weight gain resulting in enlargement of the primordial pouch, which is an accumulation of fat that hangs down slightly between the hindlegs.
Abdominal distension is a common feature of many underlying conditions and is categorized depending on the material causing the distension.
Fluid accumulation is a common cause for abdominal distension. Examples include:
Blood, as from
• Traumatic injuries
• Tumor rupture
• Blood clotting disorders
• Ingestion of anticoagulant rat poison
Pus, as from abscesses, which may arise due to penetrating injuries.
Urine, as from bladder rupture.
Clear fluid in the abdomen is normally a result of low blood protein levels, often associated with
• Feline infectious peritonitis (FIP)
• Congestive heart failure
• Liver disease
• Kidney disease
• Intestinal disease
Other causes of abdominal distension include:
Organ enlargement, including
• Tumors - enlargement of any abdominal organ, particularly in cases of hemangiosarcoma and lymphoma
• Bladder, as in cases of urinary obstruction
• Liver, as in cases of hepatic lipidosis, hepatic cysts, hepatic congestion, and some forms of poisoning
• Stomach and intestine swelling may occur after a large recent meal, due to GI obstruction, or in cases of heavy intestinal parasite infection.
• Kidney enlargement is associated with hydronephrosis and polycystic kidney disease
• Uterus enlargement occurs during pregnancy and may occur during ongoing uterine infection (pyometra)
Organ displacement, such as hernias.
Gas accumulation in the GI tract or abdominal cavity. Gas in the abdominal cavity is normally associated with a rupture in the stomach or intestinal wall.
Fat accumulation as in cases of
• Obesity
• Fat deposition in the primordial pouch
In itself, abdominal distension is not a dangerous symptom, and the severity of the underlying cause varies significantly. Developing abdominal distension is expected in some cases, such as pregnancy or consuming a large meal. Other forms of abdominal distension, such as fluid accumulation resulting from FIP infection or secondary to low blood protein, often carries a grave prognosis.
Cases of abdominal distension that arise suddenly generally are associated with conditions such as traumatic injuries or infections, whereas long-term, slow distention of the abdomen is more likely related to conditions such as tumors. Whether the abdominal distention worsens over time or remains stable does not usually reflect the severity of underlying disease, however rapidly worsening abdominal distention may make it difficult to breathe due to lung compression, and warrants immediate veterinary evaluation.
Further investigation of abdominal distension involves:
• Physical examination
• Diagnostic imaging such as X-rays, CT scan, and ultrasound
• Blood work
• Urine analysis
• Fluid analysis
• Cytology
Treatment options depend on the underlying conditions but options include:
• Anti-inflammatories
• Pain relief
• Steroids
• Antibiotics
• Fluid therapy
• Management of blood pressure
• Draining the accumulated fluid
• Surgical intervention
Sometimes weight loss affecting the musculature around the hind end and spine (known as cachexia) results in the appearance of abdominal enlargement.
On the other hand, weight gain, particularly around the primordial pouch, can also appear as abdominal distension.
Associated symptoms depend on the underlying condition, but common examples include:
• Poor appetite
• Lethargy
• Abdominal pain
• Vomiting
• Diarrhea
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