Abdominal Palpation Technique Principles
📌 Abdominal palpation requires significant practice; initial attempts often feel like "mush" until repeated practice allows for better structure identification.
🐶 Optimize positioning for animal comfort and effectiveness, acknowledging that the ideal technique may be non-ergonomic for the veterinarian.
📏 Most abdominal structures are oriented in the sagittal plane (cranial to caudal), making the optimal approach to start dorsally and pull ventrally.

Recommended Palpation Method (Dorsal to Ventral)
📌 Position hands along the lateral aspect of the abdomen with fingers pointing straight towards the ceiling, often aligning with the natural costal arch.
✋ Keep fingers flat; curling fingers inward or poking causes pain; proper technique should not hurt the patient.
⏱️ Press gently for three to four breaths to allow abdominal muscles to fatigue, which is necessary before attempting to feel structures.

Identifying Structures via Sliding and Manipulation
👉 Once muscles fatigue, use the slide technique while maintaining tension with wrist muscles, allowing fingers to be flexible and give way to structures.
🐾 To differentiate feces (colon) from an intussusception, press gently; feces will leave a dent that stays, while an intussusception feels more rubbery and bounces back.
🖐️ Utilize all 10 fingers separately for manipulation, even while maintaining overall compression using forearm muscles.

Palpating Specific Organs
📍 In the caudal abdomen, the urinary bladder is identifiable by being compressible, tethered caudally (snapping back when pulled cranially), and changing shape when compressed toward the pelvic inlet.
🦴 To check for retroperitoneal/sublumbar lymph node enlargement or tumors, slide caudally and watch for an abrupt swelling rather than the normal gradual flare of abdominal muscles onto the pelvic bone.
🥩 For the liver (hepatomegaly), slide cranially to caudally off the rib cage; an extra ridge felt after the costal arch suggests an enlarged liver.

Alternative Techniques and Exceptions
❌ Palpating quickly or poking with fingertips is uncomfortable and requires re-fatiguing the muscles after every press; slow sliding is superior.
📉 Palpating from the bottom up might be necessary in cases of significant ascites (fluid buildup) to wait for structures to fall between the fingers.
🐈 For cats, the same technique is used on a table, but they often relax faster; palpating dorsally can help feel the kidneys, though the standard dorsal-to-ventral method is preferred for assessing kidney contour irregularity.

Key Points & Insights
➡️ Practice is essential to move past the initial feeling of "mush" and accurately identify abdominal structures.
➡️ Comfort is key for the animal; slow pressure application over 3–4 breaths fatigues muscles, allowing for easier palpation without causing pain.
➡️ The recommended technique involves having fingers pointed up toward the ceiling and employing a sliding motion rather than repeated poking to maintain patient comfort and efficacy.
➡️ Differentiate normal structures like the bladder (compressible, tethered) from potential abnormalities by manipulating them gently during the slide.

📸 Video summarized with SummaryTube.com on Oct 14, 2025, 12:24 UTC