• 1.

    Ellison GW. Complications of gastrointestinal surgery in companion animals. Vet Clin North Am Small Anim Pract 2011;41:915934.

  • 2.

    Ralphs SC, Jessen CR, Lipowitz 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.

    Smith AL, Wilson AP, Hardie RJ, et al.. Perioperative complications after full-thickness gastrointestinal surgery in cats with alimentary lymphoma. Vet Surg 2011;40:849852.

    • Search Google Scholar
    • Export Citation
  • 4.

    Swinbourne F, Jeffery N, Tivers MS, et al.. The incidence of surgical site dehiscence following full-thickness gastrointestinal biopsy in dogs and cats and associated risk factors. J Small Anim Pract 2017;58:495503.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Wylie KB, Hosgood GH. Mortality and morbidity of small and large intestinal surgery in dogs and cats: 74 cases (1980–1992). J Am Anim Hosp Assoc 1994;30:469474.

    • Search Google Scholar
    • Export Citation
  • 6.

    Yoon HY, Mann FA. Bilateral pubic and ischial osteotomy for surgical management of caudal colonic and rectal masses in six dogs and a cat. J Am Vet Med Assoc 2008;232:10161020.

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

    Rosin E, Walshaw R, Mehlhaff C, et al.. Subtotal colectomy for treatment of chronic constipation associated with idiopathic megacolon in cats: 38 cases (1979–1985). J Am Vet Med Assoc 1988;193:850853.

    • Search Google Scholar
    • Export Citation
  • 8.

    Rosin E. Megacolon in cats: the role of colectomy. Vet Clin North Am Small Anim Pract 1993;23:587594.

  • 9.

    Radlinsky MG. Surgery of the digestive system. In: Fossum TW, ed. Small animal surgery. 4th ed. St Louis: Mosby Elsevier, 2012;386583.

    • Search Google Scholar
    • Export Citation
  • 10.

    Arteaga TA, McKnight J, Bergman PJ. A review of 18 cases of feline colonic adenocarcinoma treated with subtotal colectomies and adjuvant carboplatin. J Am Anim Hosp Assoc 2012;48:399404.

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

    White RN. Surgical management of constipation. J Feline Med Surg 2002;4:129138.

  • 12.

    McGrotty Y, Knottenbelt C. Significance of plasma protein abnormalities in dogs and cats. In Pract 2002;24:512517.

  • 13.

    Parsons KJ, Owen LJ, Lee K, et al.. A retrospective study of surgically treated cases of septic peritonitis in the cat (2000–2007). J Small Anim Pract 2009;50:518524.

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

    Klaser DA, Reine NJ, Hohenhaus AE. Red blood cell transfusions in cats: 126 cases (1999). J Am Vet Med Assoc 2005;226:920–923.

  • 15.

    Klainbart S, Agi L, Bdolah-Abram T, et al.. Clinical, laboratory, and hemostatic findings in cats with naturally occurring sepsis. J Am Vet Med Assoc 2017;251:10251034.

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

    Declue AE, Delgado C, Chang CH, et al.. Clinical and immunologic assessment of sepsis and the systemic inflammatory response syndrome in cats. J Am Vet Med Assoc 2011;238:890897.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Nivy R, Itkin Y, Bdolah-Abram T, et al.. Neutrophil counts and morphology in cats: a retrospective case-control study of 517 cases. Isr J Vet Med 2013;68:149157.

    • Search Google Scholar
    • Export Citation
  • 18.

    McIntyre RL, Hopper K, Epstein SE. Assessment of cardiopulmonary resuscitation in 121 dogs and 30 cats at a university teaching hospital (2009–2012). J Vet Emerg Crit Care (San Antonio) 2014;24:693704.

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

    Waldrop JE, Rozanskin EA, Swanke ED, et al.. Causes of cardiopulmonary arrest, resuscitation management, and functional outcome in dogs and cats surviving cardiopulmonary arrest. J Vet Emerg Crit Care (San Antonio) 2004;14:2229.

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

    Costello MF, Drobatz KJ, Aronson LR, et al.. Underlying cause, pathophysiologic abnormalities, and response to treatment in cats with septic peritonitis: 51 cases (1990–2001). J Am Vet Med Assoc 2004;225:897902.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Brady CA, Otto CM, Van Winkle TJ, et al.. Severe sepsis in cats: 29 cases (1986–1998). J Am Vet Med Assoc 2000;217:531535.

  • 22.

    Elliott DA. Nutritional management of chronic renal disease in dogs and cats. Vet Clin North Am Small Anim Pract 2006;36:13771384.

  • 23.

    King JN, Tasker S, Gunn-Moore DA, et al.. Prognostic factors in cats with chronic kidney disease. J Vet Intern Med 2007;21:906916.

  • 24.

    Troìa R, Mascalzoni G, Calipa S, et al.. Multiorgan dysfunction syndrome in feline sepsis: prevalence and prognostic implication. J Feline Med Surg 2019;21:559565.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Hayes G, Mathews K, Doig G, et al.. The feline acute patient physiologic and laboratory evaluation (Feline APPLE) score: a severity of illness stratification system for hospitalized cats. J Vet Intern Med 2011;25:2638.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Garcia Stickney DN, Thieman Mankin KM. The impact of postdischarge surveillance on surgical site infection diagnosis. Vet Surg 2018;47:6673.

  • 27.

    Dickinson AE, Summers JF, Wignal J, et al.. Impact of appropriate empirical antimicrobial therapy on outcome of dogs with septic peritonitis. J Vet Emerg Crit Care (San Antonio) 2015;25:152159.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Keir I, Dickinson AE. The role of antimicrobials in the treatment of sepsis and critical illness-related bacterial infections: examination of the evidence. J Vet Emerg Crit Care (San Antonio) 2015;25:5562.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Evaluation of short-term risk factors associated with dehiscence and death following full-thickness incisions of the large intestine in cats: 84 cases (1993–2015)

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  • 1 From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996 (Lux, Roberts); Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602 (Grimes); Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24061 (Benitez); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616 (Culp, Ben-Aderet); and Martingale Consulting LLC, Media, PA 19063 (Brown). Dr. Roberts’ present address is the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108. Dr. Benitez's present address is Dogwood Veterinary Surgical Care PLLC, Cornelius, NC 28031.

Abstract

OBJECTIVE

To evaluate short-term risk factors associated with dehiscence and death in cats undergoing full-thickness large intestinal incisions.

ANIMALS

84 client-owned cats that had undergone full-thickness large intestinal incisions and for which information regarding outcome through postoperative day 7 was available.

PROCEDURES

Medical records from 4 veterinary teaching hospitals were reviewed. For cats that met the inclusion criteria, signalment, history, laboratory test results, surgical and medical procedures, perioperative complications, and outcome were analyzed. A Fisher exact or Wilcoxon rank sum test was used to identify individual variables associated with dehiscence of intestinal incisions or patient nonsurvival to hospital discharge or both.

RESULTS

84 cats met the inclusion criteria. The overall dehiscence and survival to hospital discharge rates were 8.3% (7/84 cats) and 94% (79/84 cats), respectively. Factors associated with dehiscence and nonsurvival to hospital discharge included presence of band neutrophils, performance of partial colectomy with colonic resection and anastomosis, administration of blood products, postoperative cardiopulmonary arrest, and incisional inflammation or infection. Factors associated with nonsurvival to hospital discharge only included low serum globulin concentration, repair of colonic trauma or dehiscence, and postoperative colonic dehiscence. Factors associated with dehiscence only included hypoalbuminemia, renal dysfunction, administration of blood products or > 2 classes of antimicrobials, and intra-abdominal fecal contamination.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that intestinal dehiscence and mortality rates associated with large intestinal incisions in cats may be higher than previously proposed, although the risk of either outcome was still low. Factors suggestive of systemic illness were associated with colonic dehiscence or death, and focused prospective studies of risk factors are warranted. (J Am Vet Med Assoc 2021;259:162–171)

Abstract

OBJECTIVE

To evaluate short-term risk factors associated with dehiscence and death in cats undergoing full-thickness large intestinal incisions.

ANIMALS

84 client-owned cats that had undergone full-thickness large intestinal incisions and for which information regarding outcome through postoperative day 7 was available.

PROCEDURES

Medical records from 4 veterinary teaching hospitals were reviewed. For cats that met the inclusion criteria, signalment, history, laboratory test results, surgical and medical procedures, perioperative complications, and outcome were analyzed. A Fisher exact or Wilcoxon rank sum test was used to identify individual variables associated with dehiscence of intestinal incisions or patient nonsurvival to hospital discharge or both.

RESULTS

84 cats met the inclusion criteria. The overall dehiscence and survival to hospital discharge rates were 8.3% (7/84 cats) and 94% (79/84 cats), respectively. Factors associated with dehiscence and nonsurvival to hospital discharge included presence of band neutrophils, performance of partial colectomy with colonic resection and anastomosis, administration of blood products, postoperative cardiopulmonary arrest, and incisional inflammation or infection. Factors associated with nonsurvival to hospital discharge only included low serum globulin concentration, repair of colonic trauma or dehiscence, and postoperative colonic dehiscence. Factors associated with dehiscence only included hypoalbuminemia, renal dysfunction, administration of blood products or > 2 classes of antimicrobials, and intra-abdominal fecal contamination.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that intestinal dehiscence and mortality rates associated with large intestinal incisions in cats may be higher than previously proposed, although the risk of either outcome was still low. Factors suggestive of systemic illness were associated with colonic dehiscence or death, and focused prospective studies of risk factors are warranted. (J Am Vet Med Assoc 2021;259:162–171)

Contributor Notes

Address correspondence to Dr. Lux (clux@utk.edu).