Retrospective evaluation of recurrent secondary septic peritonitis in dogs (2000–2011): 41 cases

Abstract

Objective To describe the clinical characteristics of recurrent septic peritonitis in dogs. Design Multicenter retrospective observational study. Animals Client‐owned dogs with recurrent septic peritonitis. Setting Three university emergency and referral hospitals. Interventions None. Measurements and Main Results Medical records from 3 veterinary university teaching hospitals were reviewed and data were collected using a standardized data collection sheet for all cases of septic peritonitis during the study period (2000–2011). Forty one dogs met the inclusion criteria for recurrent peritonitis. All dogs underwent relaparotomy. The original cause of septic peritonitis in these cases included previous surgery for gastrointestinal foreign body removal (n = 26), gastrointestinal neoplasia (n = 3), gastric or duodenal ulceration (n = 3), bilary tract leakage (n = 2), and single instance for each of the following: penetrating foreign body, hernia strangulation, intussusception, mesenteric volvulus, infection of the laparotomy incision, prostatic abscess, and trauma. Eighteen animals survived to discharge. There was no difference detected between survivors and nonsurvivors with recurrent peritonitis in terms of inciting cause, serum albumin concentration, surgical management, or provision of appropriate initial antimicrobials. The survival rate for dogs having recurrent peritonitis was 43.9% (18/41 dogs). Conclusions This retrospective study did not identify any significant prognostic indicators for dogs with recurrent peritonitis and that the mortality rate for dogs having more than one surgery for septic peritonitis is similar to that reported for a single surgery for septic peritonitis.

Identification of risk factors for recurrent secondary septic peritonitis following initial surgical treatment of secondary septic peritonitis in dogs

“…In both this study and the study by Barfield et al, 9 the majority of dogs that had recurrence of peritonitis had a GI source of sepsis, 87% and 90%, respectively. This finding is not likely simply due to the fact the GI tract is the most common source of SSP in dogs, 2‐4 since dogs with sepsis of GI origin were 4.4 times as likely to develop RSSP as dogs with sepsis originating from another organ system in this study.…”

“…Recurrence of SSP is an important complication following surgery for SSP in dogs. In this study, the rate of recurrence was 10%, while another recent report suggests that the rate could be as high as 28% 9 . Recurrence of SSP requires relaparotomy, and in both this study (8/15 [53%]) and the study by Barfield et al (9/29 [31%]), 9 many owners elected euthanasia without further treatment once recurrence was identified.…”

“…Of those 7 dogs, 3 (42.9%) survived. Barfield et al 9 reported a survival rate of 43.9% (18/41) in a cohort of dogs undergoing relaparotomy for RSSP. Unfortunately, the small number of dogs in our study undergoing relaparotomy for RSSP precludes a statistically meaningful comparison with the survival rate reported by Barfield et al 9 or with the survival rate of the NoRSSP group in this study (84.3%).…”

“…Barfield et al 9 reported a survival rate of 43.9% (18/41) in a cohort of dogs undergoing relaparotomy for RSSP. Unfortunately, the small number of dogs in our study undergoing relaparotomy for RSSP precludes a statistically meaningful comparison with the survival rate reported by Barfield et al 9 or with the survival rate of the NoRSSP group in this study (84.3%). In comparing the survival rates of the RSSP and NoRSSP groups, it is also worth noting that the survival rate of the NoRSSP group in this study was calculated after the exclusion of cases of intraoperative euthanasia.…”

“…Both studies identified preoperative SSP and preoperative hypoalbuminemia as risk factors for GI dehiscence. A recent study by Barfield et al specifically examined a population of dogs treated surgically for recurrent SSP 9 . Survival among this group of dogs was 43.9% (18/41).…”