Intestinal dehiscence and mortality in cats undergoing gastrointestinal surgery

Abstract

Objectives The aim of this study was to determine the incidence of and risk factors for both gastrointestinal (GI) incisional dehiscence and mortality in a large cohort of cats undergoing GI surgery. We hypothesized that cats with preoperative septic peritonitis (PSP), systemic inflammatory response syndrome (SIRS) or sepsis would have higher GI dehiscence and mortality rates than unaffected cats. Methods A medical records search identified cats with surgically created, full-thickness incisions into their stomach, small intestines or large intestines. Preoperative data, including signalment, clinical signs, comorbidities, surgical history, current medications, presenting physical examination findings, complete blood counts and serum biochemistry values, were collected. It was determined whether or not cats had PSP, SIRS or sepsis at admission. Intraoperative data, final diagnosis and postoperative variables such as vital parameters, bloodwork and (if applicable) the development of GI dehiscence or mortality were noted. Postoperative follow-up of at least 10 days was obtained in survivors. Results In total, 126 cats were included. One cat developed GI dehiscence following complete resection of a jejunal adenocarcinoma. Twenty-three cats (18.2%) died within 10 days of surgery. Cats with PSP ( P = 0.0462) or that developed hypothermia 25–72 h postoperatively ( P = 0.0055) had higher odds of mortality in multivariate analysis. Cats with PSP had 6.7-times higher odds of mortality than cats not diagnosed with PSP. Conclusions and relevance In cats receiving GI surgery, the incidence of GI incisional dehiscence was <1%. Cats with PSP had a higher likelihood of mortality. SIRS was a common finding in cats with septic peritonitis, but was not associated with mortality. Postoperative mortality during the home recovery period might be significant in cats. Future studies evaluating postoperative mortality in cats should consider extending the research period beyond the date of discharge.

Clinical outcomes of the use of unidirectional barbed sutures in gastrointestinal surgery for dogs and cats: A retrospective study

“…Age and sex distributions in the population of this study are similar to other populations of retrospective studies involving dogs 3,6,10,32,33 . Our cat population is younger than the population described by Hiebert et al 34 In our study all cats had obstruction related to a foreign body. In contrast, Hiebert et al 34 had a population with a wider range of indications for gastrointestinal surgery.…”

“…Our cat population is younger than the population described by Hiebert et al 34 In our study all cats had obstruction related to a foreign body. In contrast, Hiebert et al 34 had a population with a wider range of indications for gastrointestinal surgery. In similarity to other retrospective studies on gastrointestinal surgery in dogs, the most common indication for gastrointestinal surgery in our population was an obstruction due to a foreign body 7,11,12,33,35 …”

Performance time and leak pressure of hand‐sewn and skin staple intestinal anastomoses and enterotomies in cadaveric cats

“…12 The current literature about surgical techniques to address FBO in cats is significantly lacking compared to literature in dogs. While it is possible that results of canine studies may be extrapolated and applied to cats, species variations in tissue size, healing, and instrumentto-tissue compatibility may exist as differences in human and canine gastrointestinal tissue 11 and differences in rates of feline and canine dehiscence 13 have already been suggested. The purpose of this study was to perform a prospective feline cadaveric study comparing hand-sewn and skin staple SI anastomosis and enterotomy closures to determine if these techniques may be considered in this species.…”