Abdomen
The normal abdomen has some palpable structures, but remember that there are several layers of tissue between your hands and the structure. When normal, the palpable organs will not be well defined in most cases. Focus on anatomic location of where abdominal organs are during this laboratory, and begin to develop a sense of a normal abdominal palpation. When you encounter an abnormality on abdominal palpation in the future, it will be in stark contrast to the relatively unexciting abdominal palpation of the normal dog (and cat).
Abdominal palpation technique:
Technique: Initially, the muscles of the abdominal wall should be palpated to check for masses and for any hernias in the body wall. It is important to check for umbilical hernias in pediatric patients.
To palpate the abdomen, begin by very gently pressing your fingertips into the cranial aspect of the abdominal wall (one hand on either side). Move your hands in a dorsal-to-ventral method, and then ventral-to-dorsal. Begin with very light pressure, then if the animal is relaxing, gradually add more pressure to enable palpation of organs. Perform this palpation technique as you gradually move to the mid- and caudal abdomen. In cats and some small dogs, a one-handed technique can be performed. Here is an example of palpation technique:
The animal may arch its back when the abdomen is palpated. Rule out back pain prior to abdominal palpation: exert pressure over each lumbar vertebra in a serial manner.
Abdominal palpation anatomy:
The video shows a diagram outlining the structures we can palpate in an abdomen:
Palpable abdominal organs in the normal dog and cat include:
| Organ | Location / technique | Description |
| Spleen (mostly in larger dogs) | Lies to the left side of the abdomen, along ventral wall | Palpated for increase in size and for nodules or masses.
If the tip of the spleen is folded over, it may be mistaken for a mass. Can be difficult to palpate (or not palpable) in smaller dogs and cats |
| Small Intestines | Mid-abdomen, when moving hands dorsally to ventrally | Loops of small intestine can be felt as they slip through the fingers.
Evaluated for thickness, rigidity and irregular masses |
| Large Intestine | Distal large intestine is in dorsal abdomen, along midline | Can be palpated especially when filled with feces |
| Urinary Bladder | Caudal abdomen; compress the caudal abdomen when palpating and move hand(s) cranial to caudal | Filled bladders can be easily palpated in the caudal abdomen. Partially filled or empty bladders are not easily palpated
The bladder feels like a fluid filled vesicle that slips between the fingers/hands. |
| Kidneys | Dorsal, cranial abdomen | Kidney surface is normally smooth; right and left should be the same size.
Canine kidneys are fixed in the retroperitoneal space. The right kidney is more cranial than the left, and therefore only the caudal end may be palpated (or may not be palpable). The left kidney is more caudal and can be palpated in some dogs. Feline kidneys are more mobile than those of the canine. Each kidney can be gently grasped and palpated entirely. |
| Uterus – only palpable if enlarged and filled (pregnant, pyometra) | Caudal abdomen, dorsal to bladder | If there is a pregnancy or pyometra, the uterus can be palpated as an enlarged organ dorsal to the urinary bladder. |
| Liver – only palpable if enlarged | Most cranial abdominal organ; cannot be entirely palpated as the edges should not extend past the costal margin. | With diffuse enlargement, the liver can be palpated extending caudally past the costal margins.
For solitary masses, only those lobes affected will be extending caudally and can be palpated. |
Note that individual variation in patients (and learning stage of the person palpating) will mean that “palpable” organs are sometimes not appreciated in some patients. Diseases of some “non-palpable” organs can cause them to be appreciated in abnormal patients (e.g., liver mass).
A distended abdomen could be due to organ enlargement, mass/tumor, fluid distention, excess fat, or pregnancy. To detect ascites (free fluid in the abdomen), test for the wave sign by placing one hand on either side of the abdomen, then ballot the abdomen (gently tap) with one hand and feel for a fluid wave on the other side with the other hand. This test is not sensitive, however, meaning it will detect only large amounts of fluid present.
