The AFAST-applied Fluid Scoring System has been modified and this is an important change for assessing the bleeding dog and cat (and other species).
The abdominal fluid score would be a “strong positive” of “1” with our recent modification of the abdominal fluid scoring system that better categorizes small versus large volume bleeder-effusions.
There is a visual way to differentiate “weak positives” scored as a “1/2” from a “strong positive” scored as a “1” as shown at the Cysto-Colic (CC) view or maximum dimensions may also be used explained below.
A maximum dimension may also be used although the visual “weak positive” scored as “1/2” versus “strong positive” scored as a “1” works well as shown above. In dogs use under and over 1 cm and cats under or over 5 mm for “weak positive” versus “strong positive”, respectively. See the composite Figure below.
The abdominal fluid score (AFS) remains a 0-4 range as previously published; however, for smaller pockets, “weak positives”, the score is a “1/2” instead of a full “1” for “strong positives.”
This is especially helpful for the dog or cat with 3 small “weak positives” that would now total 1/2 + 1/2 + 1/2 = 1 1/2 (1.5) as shown in B) rather than a true “3” shown in C). In D) you can see the patient has a 1/2 +1/2+1 for a total of abdominal fluid score (AFS) of 2 in the figures on the far right labeled C).
Key Point: Now a small volume bleeder-effusion is AFS < 3 and a large volume bleeder-effusion is ≥ 3.
Note that the Hepato-Renal Umbilical (HRU) has been replaced more accurately with the renaming as the Spleen-Intestino Umbilical view because its target-organs are the spleen and small intestine (SIU). Some of our artwork still has the old name.
Now one has a tracking tool for static AFS, worsening (increasing AFS) and resolving (AFS) abdominal effusion in both hemorrhagic and non-hemorrhagic forms of ascites. Such a tracking tool is not used in people. Veterinarians have a clear advantage in assessing and tracking all forms of ascites.
EXPECT dogs and cats (and likely other species) to resorb the blood in a cavity or space within 48-hours if bleeding has ceased (or coagulopathy has been corrected) through author experience. No studies to the author’s knowledge have published this information but it serves as a good rule of thumb.
Copyright 2018 Gregory Lisciandro, DVM, Dipl. ABVP, ACVECC and FASTVet.com
See our FASTVet Chart for the Bleeding Patient.