Surgery Patient of the Month- November- Septic Abdomen

Thor

Thor, a very handsome 2 year old Rhodesian Ridgeback, presented to West Hills with a several day history of lack of appetite and lethargy. His owners reported that he had vomited three times over the two days prior to presentation. Thor was previously very healthy with no major medical problems.

Dr. Jared Coren evaluated Thor and determined that other than a fever, Thor had no changes on his exam. He recommended preliminary bloodwork and radiographs (x-rays) of his abdomen to help delineate the cause of Thor’s clinical signs.

Bloodwork revealed an elevation in Thor’s white blood cell count and other changes consistent with a systemic bacterial infection, called sepsis.  On evaluation of the x-rays, a possible mass effect was seen in the mid-abdomen, but it was unclear as to where the mass was arising from.  Given these findings, Dr. Coren consulted with our board certified surgeon, Dr. Marc Hirshenson, who agreed that the next best step for Thor would be an abdominal exploratory surgery.

Thor was taken to surgery, where a mass the size of a softball was found arising from the omentum. The omentum is a collection of fat, blood vessels and lymphatics and is known as the “abdomen’s natural bandaid.”

Thor's Lesion post-operativelyThor’s Lesion post-operatively

On further evaluation, it was clear that the “mass” was an abscess, or walled off localized infection. Purulent material was arising from the abscess and leaking into the abdominal cavity. The abscess was dissected away from any vital organs and was able to be removed in its entirety.  A closed suction drain was placed prior to closure to ensure that all residual bacteria and fluid could be evacuated during Thor’s recovery.

Intra-abdominal abscess formation is rare in dogs and cats, and it was unclear as to why Thor developed this condition. Possible causes include a penetrating foreign body from the intestinal tract or an underlying cancerous process that becomes infected.  To rule out this possibility, the tissue was submitted for biopsy.

Thor spent the next four days in hospital recovering with intensive supportive care. Each day he

Thor Post Op

gained more strength and began eating again. He required a lot of monitoring and care in hospital, but by the time he went home, he was energetic and comfortable.

A pathologist reviewed the mass and confirmed the presence of an abscess. While no underlying cause could be determined, no cancer was found in the sample. Surgery was considered curative.

Thor continues to do well at home and has not looked back since his rare experience!