• 1.

    Allen DASDSchertel ER. Prevalence of small intestinal dehiscence and associated clinical factors: a retrospective study of 121 dogs. J Am Anim Hosp Assoc 1992; 28: 7076.

    • Search Google Scholar
    • Export Citation
  • 2.

    Ralphs SCJessen CRLipowitz AJ. Risk factors for leakage following intestinal anastomosis in dogs and cats: 115 cases (1991–2000). J Am Vet Med Assoc 2003; 223: 7377.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Shales CJWarren JAnderson DM, et al. Complications following full-thickness small intestinal biopsy in 66 dogs: a retrospective study. J Small Anim Pract 2005; 46: 317321.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Wylie KBHosgood G. Mortality and morbidity of small and large intestinal surgery in dogs and cats: 74 cases (1980–1982). J Am Anim Hosp Assoc 1994; 30: 469474.

    • Search Google Scholar
    • Export Citation
  • 5.

    Staatz AJMonnet ESeim HB III. Open peritoneal drainage versus primary closure for the treatment of septic peritonitis in dogs and cats: 42 cases (1993–1999). Vet Surg 2002; 31: 174180.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Lanz OIEllison GWBellah JR, et al. Surgical treatment of septic peritonitis without abdominal drainage in 28 dogs. J Am Anim Hosp Assoc 2001; 37: 8792.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Bentley AMOtto CMShofer FS. Comparison of dogs with septic peritonitis: 1988–1993 versus 1999–2003. J Vet Emerg Crit Care 2007; 17: 391398.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Harvey HJ. Complications of small intestinal biopsy in hypoalbuminemic dogs. Vet Surg 1990; 19: 289292.

  • 9.

    King LG. Postoperative complications and prognostic indicators in dogs and cats with septic peritonitis: 23 cases (1989–1992). J Am Vet Med Assoc 1994; 204: 407414.

    • Search Google Scholar
    • Export Citation
  • 10.

    Gibbs JCull WHenderson W, et al. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg 1999; 134: 3642.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Ahrendt GMTantry USBarbul A. Intra-abdominal sepsis impairs colonic reparative collagen synthesis. Am J Surg 1996; 171: 102108.

  • 12.

    Ahrendt GMGardner KBarbul A. Loss of colonic structural collagen impairs healing during intra-abdominal sepsis. Arch Surg 1994; 129: 11791183.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Khalili TMNavarro RAMiddleton Y, et al. Early postoperative enteral feeding increases anastomotic strength in a peritonitis model. Am J Surg 2001; 182: 621624.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Buck MHouglum KChojkier M. Tumor necrosis factor-alpha inhibits collagen alpha1 (I) gene expression and wound healing in a murine model of cachexia. Am J Pathol 1996; 149: 195204.

    • Search Google Scholar
    • Export Citation
  • 15.

    Hastbacka JHynninen MKolho E, et al. Collagenase 2/matrix metalloproteinase 8 in critically ill patients with secondary peritonitis. Shock 2007; 27: 145150.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Goldwasser PFeldman J. Association of serum albumin and mortality risk. J Clin Epidemiol 1997; 50: 693703.

  • 17.

    Lohsiriwat VChinswangwatanakul VLohsiriwat S, et al. Hypoalbuminemia is a predictor of delayed postoperative bowel function and poor surgical outcomes in right-sided colon cancer patients. Asia Pac J Clin Nutr 2007; 16: 213217.

    • Search Google Scholar
    • Export Citation
  • 18.

    Lohsiriwat VLohsiriwat DBoonnuch W, et al. Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery. World J Gastroenterol 2008; 14: 12481251.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Rich MWKeller AJSchechtman KB, et al. Increased complications and prolonged hospital stay in elderly cardiac surgical patients with low serum albumin. Am J Cardiol 1989; 63: 714718.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Buzby GPMullen JLMatthews DC, et al. Prognostic nutritional index in gastrointestinal surgery. Am J Surg 1980; 139: 160167.

  • 21.

    Detsky ASBaker JPO'Rourke K, et al. Predicting nutrition-associated complications for patients undergoing gastrointestinal surgery. JPEN J Parenter Enteral Nutr 1987; 11: 440446.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Powanda MCMoyer ED. Plasma proteins and wound healing. Surg Gynecol Obstet 1981; 153: 749755.

  • 23.

    King LGWohl JSManning AM, et al. Evaluation of the survival prediction index as a model of risk stratification for clinical research in dogs admitted to intensive care units at four locations. Am J Vet Res 2001; 62: 948954.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Weisman DLSmeak DDBirchard SJ, et al. Comparison of a continuous suture pattern with a simple interrupted pattern for enteric closure in dogs and cats: 83 cases (1991–1997). J Am Vet Med Assoc 1999; 214: 15071510.

    • Search Google Scholar
    • Export Citation
  • 25.

    Papazoglou LGMann FAWagner-Mann C, et al. Long-term survival of dogs after cholecystoenterostomy: a retrospective study of 15 cases (1981–2005). J Am Anim Hosp Assoc 2008; 44: 6774.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Identification of risk factors for septic peritonitis and failure to survive following gastrointestinal surgery in dogs

Janet A. GrimesDepartment of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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Chad W. SchmiedtDepartment of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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Karen K. CornellDepartment of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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Mary Ann G. RadlinksyDepartment of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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Abstract

Objective—To identify risk factors for failure to survive and development of septic peritonitis following full-thickness gastrointestinal incision in dogs.

Design—Retrospective cohort study.

Animals—Dogs that underwent gastrointestinal surgery from 1998 through 2007 at the University of Georgia Veterinary Teaching Hospital.

Procedures—Medical records of dogs undergoing a full-thickness gastrointestinal incision were reviewed, and information regarding dog history, clinicopathologic findings, surgery characteristics, and outcome was collected.

Results—Records for 197 dogs (225 surgeries) were evaluated. In 35 (16%) surgeries, the dogs died prior to hospital discharge. After 28 (12%) surgeries, dogs developed septic peritonitis. For 45 (20%) surgeries, dogs had preoperative septic peritonitis; of those, approximately a third resulted in continued septic peritonitis (17/45; 38%) or death (15/45; 33%). Of the 180 surgeries performed in dogs lacking preoperative septic peritonitis, 11 (6%) resulted in development of septic peritonitis and 20 (11 %) resulted in death. When all surgeries were considered, common risk factors for development of septic peritonitis included preoperative septic peritonitis, low preoperative serum albumin and plasma protein concentrations, and intraoperative hypotension. Presence of a foreign body was a protective factor.

Conclusions and Clinical Relevance—Multiple factors were associated with failure to survive and development of septic peritonitis after gastrointestinal surgery in dogs. Aggressive perioperative attempts to increase protein concentrations and intraoperative surgical strategies to decrease the chance of a poor outcome may be indicated in dogs with risk factors identified in this study.

Abstract

Objective—To identify risk factors for failure to survive and development of septic peritonitis following full-thickness gastrointestinal incision in dogs.

Design—Retrospective cohort study.

Animals—Dogs that underwent gastrointestinal surgery from 1998 through 2007 at the University of Georgia Veterinary Teaching Hospital.

Procedures—Medical records of dogs undergoing a full-thickness gastrointestinal incision were reviewed, and information regarding dog history, clinicopathologic findings, surgery characteristics, and outcome was collected.

Results—Records for 197 dogs (225 surgeries) were evaluated. In 35 (16%) surgeries, the dogs died prior to hospital discharge. After 28 (12%) surgeries, dogs developed septic peritonitis. For 45 (20%) surgeries, dogs had preoperative septic peritonitis; of those, approximately a third resulted in continued septic peritonitis (17/45; 38%) or death (15/45; 33%). Of the 180 surgeries performed in dogs lacking preoperative septic peritonitis, 11 (6%) resulted in development of septic peritonitis and 20 (11 %) resulted in death. When all surgeries were considered, common risk factors for development of septic peritonitis included preoperative septic peritonitis, low preoperative serum albumin and plasma protein concentrations, and intraoperative hypotension. Presence of a foreign body was a protective factor.

Conclusions and Clinical Relevance—Multiple factors were associated with failure to survive and development of septic peritonitis after gastrointestinal surgery in dogs. Aggressive perioperative attempts to increase protein concentrations and intraoperative surgical strategies to decrease the chance of a poor outcome may be indicated in dogs with risk factors identified in this study.

Contributor Notes

Address correspondence to Dr. Schmiedt (cws@uga.edu).