Evaluation of peripheral blood and abdominal fluid variables as predictors of intestinal surgical site failure in dogs with septic peritonitis following celiotomy and the placement of closed-suction abdominal drains

Abstract

OBJECTIVE To evaluate peripheral blood and abdominal fluid variables as predictors of intestinal surgical site failure in dogs with septic peritonitis following celiotomy and closed-suction abdominal drain (CSAD) placement. DESIGN Prospective study. ANIMALS 26 dogs with septic peritonitis that underwent celiotomy and CSAD placement. PROCEDURES Abdominal fluid and blood samples were collected prior to surgery and daily thereafter until CSAD removal. Abdominal fluid was collected through the CSAD. Analysis of all samples included pH, PCO2, PO2, PCV, WBC count, and total solids, glucose, lactate, and electrolyte concentrations. Abdominal fluid samples also underwent cytologic evaluation and bacterial culture, and the volume of fluid removed through the drain was recorded daily. The blood-to-fluid glucose and lactate differences, fluid-to-blood lactate ratio and blood-to-fluid WBC and neutrophil ratios were determined daily. Dogs were categorized into 2 groups on the basis of whether they had an uneventful recovery (UR) or developed postoperative septic peritonitis (POSP). RESULTS 23 dogs had a UR and 3 developed POSP. On the third day after surgery, the abdominal fluid WBC count was significantly lower and the blood-to-fluid WBC and neutrophil ratios were significantly higher for dogs in the POSP group, compared with those for dogs in the UR group. None of the other blood and abdominal fluid variables assessed differed significantly between the 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE Results failed to identify any objective predictive indicators for POSP in dogs with CSADs. Use of blood-to-fluid WBC and neutrophil ratios as predictive indicators for POSP requires further investigation.

Retrospective evaluation of the use of small‐bore wire‐guided catheters for the management of peritoneal effusion in cats and dogs

“…In this study, 3 catheters were placed to manage fluid accumulation in dogs with peritonitis. This practice is described in people [10][11][12] and in veterinary medicine for postoperative care in animals, 1,30,31 but a benefit to their use cannot be inferred from this study. The peritoneal catheters in these cases seemed to be used to retrieve existing inflammatory or infective fluids where that was deemed beneficial by the attending clinicians.…”

Delayed hypersensitivity reaction to human serum albumin in a dog surgically managed for septic peritonitis

“…Hypoalbuminaemia and hypoproteinaemia are two of the most consistent postoperative findings in dogs that have had surgery for septic peritonitis due to gastrointestinal perforation 4 5 8 15 17 18. Peritonitis and hypoalbuminaemia are risk factors for developing anastomotic leakage, and higher postoperative albumin and total protein levels are associated with increased survival rates 5 8 13 17 18. The use of closed suction drains in the treatment of septic peritonitis has been shown to decrease the mortality rates in dogs by 12–30 per cent 17–19.…”

“…Peritonitis and hypoalbuminaemia are risk factors for developing anastomotic leakage, and higher postoperative albumin and total protein levels are associated with increased survival rates 5 8 13 17 18. The use of closed suction drains in the treatment of septic peritonitis has been shown to decrease the mortality rates in dogs by 12–30 per cent 17–19. However, Dayer and others16 were unable to demonstrate a difference in survival of dogs that had a closed suction drain placed compared with primary closure of the abdomen.…”

Aetiology, clinical parameters and outcome in 113 dogs surgically treated for septic peritonitis (2004–2020)

“…However, additional diagnostic tests have been suggested to aid the diagnosis of SP; many of which rely on the difference between serum and peritoneal fluid parameters. Potential biomarkers include pH, glucose, bicarbonate, lactate, 5 white blood cell (WBC) and neutrophil counts 6 . Recently, novel biomarkers such as chemokine ligand‐2, interleukin‐6 and interleukin‐18 have been suggested to aid in the diagnosis of SP 7 .…”