Clinical findings and outcomes of 153 dogs surgically treated for intestinal intussusceptions

Abstract

ObjectiveTo describe perioperative characteristics and outcomes of dogs surgically treated for intestinal intussusception.Study designMulti‐institutional, retrospective study.AnimalsOne hundred fifty‐three client‐owned dogs with intestinal intussusception.MethodsDogs were included when they had undergone surgical treatment of a confirmed intestinal intussusception. Medical records were reviewed for demographics and clinical data, including surgical complications (graded 1‐4). Follow‐up was obtained via telephone interview with owners and referring veterinarians.ResultsDogs had a median age of 10 months (range, 2‐156), and the most common location for intussusception was ileocolic (66/153 [43%]). Most cases had no identifiable cause (104/155 [67%]). Intestinal resection and anastomosis (IRA) was performed in 129 of 153 (84%) dogs; enteroplication was performed in 28 of 153 (18%) dogs, including 13 with and 15 without IRA. Intraoperative complications occurred in 10 of 153 (7%) dogs, all involving intestinal damage during attempted manual reduction. The median duration of follow‐up after discharge was 334 days (interquartile range, 15‐990; range, 1‐3302). Postoperative complications occurred in 53 of 153 (35%) dogs, including 22 of 153 (14%) with severe (grade 3 or 4) events. Diarrhea, regurgitation, and septic peritonitis were the most common postoperative complications; intussusception recurred in four of 153 (3%) dogs, all within 72 hours postoperatively. Fourteen‐day postoperative mortality rate was 6%.ConclusionSurgical treatment of intestinal intussusception was curative in most dogs, even when an underlying cause was not identified. Surgical complications were common, including a 14% risk of life‐threatening short‐term complications.Clinical significanceSurgical treatment of intestinal intussusception offers an excellent prognosis, but the potential life‐threatening complications should be considered.

Noninvasive hydrostatic reduction of an ileocecocolic intussusception in a puppy

“…12 In both small animals and children, the site most commonly involved is the ileocecal area. 2,3 Successful USGHR initially was performed in human medicine with the objective of providing an alternative to hydrostatic reduction using barium enema and fluoroscopy. 7 This technique is used widely in pediatric medicine and is associated with decreased duration of hospitalization and decreased mortality.…”

“…Enteroplication may be performed to prevent future recurrences. 3 Only a few studies have explored nonsurgical management of intussusception in small animals. In 27 experimentally-induced ileocolic intussusception dogs, laparoscopic-assisted pneumatic reduction by insufflation of carbon dioxide through the rectum was successful in 26/27 (96%) of cases and 1 perforation occurred.…”

“…Compared to surgical management, USGHR does not allow assessment of the bowel integrity and possible tissue necrosis. In the case of suspected intestinal tissue necrosis, surgical management is recommended and intestinal resection and anastomosis should be performed if deemed necessary 3 . For this reason, USGHR carries a risk of bowel perforation if a large volume of saline is instilled under pressure.…”

“…A tentative diagnosis can be made clinically by palpation of an abdominal mass but definitive diagnosis usually requires ultrasound examination with identification of a characteristic target‐like structure involving the intestines 4 . Spontaneous reduction has been described, but surgical correction is commonly required 3,5 …”

“…In dogs, the etiology usually is unknown, but foreign bodies, intestinal parasites, gastroenteritis, neoplasia, previous abdominal surgery or any condition affecting intestinal motility are potential triggering factors 1 . Ileocolic intussusception is the most common type in small animals 2,3 . A tentative diagnosis can be made clinically by palpation of an abdominal mass but definitive diagnosis usually requires ultrasound examination with identification of a characteristic target‐like structure involving the intestines 4 .…”