Septic peritonitis in dogs is challenging with high morbidity and mortality rates. Human studies indicate early diagnosis and administration of appropriate antimicrobials can improve outcome in sepsis patients. This study investigated whether a canine abdominal sepsis protocol implemented in emergency room could improve outcomes. The protocol included a sepsis screening tool and suggested diagnostics, appropriate antimicrobials, resuscitation guidelines, and methods to improve transfer from emergency to the operating room when necessary.
Diagnosis was made if abdominal fluid contained intracellular bacteria on cytologic examination. Further grouping was based on source of infection and kidney health, each having its own recommended antimicrobial protocol: 1) community-acquired infection with no evidence of renal insufficiency (amikacin 15 mg/kg IV q24h, clindamycin 12 mg/kg IV q12h); 2) community-acquired infection with renal insufficiency (cefotaxime 22 mg/kg IV q8h, clindamycin 12 mg/kg IV q12h); or 3) hospital-acquired infections where Enterococcus spp was a concern (either antimicrobial options and ampicillin 22 mg/kg IV q8h). Forty dogs with septic peritonitis were included. Controls included records of 20 dogs that underwent surgery for septic peritonitis before implementation of the protocol. With the sepsis protocol, all patients received antimicrobials within 2 hours of diagnosis, which significantly improved time to antimicrobial administration; however, it did not significantly affect survival.