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Insight into Septic Peritonitis

Clinician's Brief (Capsule)

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Septic peritonitis, a common cause of abdominal distress associated with high mortality rates in dogs and cats, is often secondary to GI perforation and requires immediate medical and surgical treatment. This retrospective study reported risk factors and outcomes in 55 animals (44 dogs, 11 cats) treated surgically to identify prognostic factors for future treatment. The overall mortality rate was 63.6%, similar to previously published ranges. Patients with a history of antiinflammatory drug administration were likely to have a perforation at the level of the pylorus, although pyloric perforation did not significantly impact survival to discharge. Age, closed-suction drainage, recent previous abdominal surgery, and location of perforation did not impact short-term outcomes.

Commentary

Septic peritonitis remains a challenging surgical and medical condition requiring emergent, intensive, and costly care. Despite advances in critical care interventions, prognosis is always guarded as mortality rates approach 80%. Emergency surgery is indicated after patient stabilization to treat the source of sepsis—often the GI tract. This study supports the previously documented association between antiinflammatory administration and pyloric perforation; however, this association did not impact survival. Interestingly, outcome was not affected by any other risk factors evaluated (eg, previous GI surgery, abdominal drain use), although future prospective investigations are required to corroborate these findings.—Jason Bleedorn, DVM, DACVS

Source

Septic peritonitis from pyloric and non-pyloric gastrointestinal perforation: Prognostic factors in 44 dogs and 11 cats. Dayer T, Howard J, Spreng D. J SMALL ANIM PRACT 54:625-629, 2013.

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