Surgery Patient of the Month – July – Typhlectomy, Intussusception and Septic Abdomen

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We wanted to share with everyone a very touching story about Rosie.

Rosie, a beautiful 1 year old mix breed, was presented to West Hills Animal Hospital on referral from her primary veterinarian for continued care of persistent diarrhea and loss of appetite. Rosie was initially evaluated 2 days prior to presentation by her primary veterinarian, where blood work revealed a low white blood cell count and low protein, and fecal examination was negative. She was treated supportively with fluids and antibiotics; however clinical signs persisted, leading to referral to West Hills. Prior to this episode Rosie had been an otherwise healthy dog.

Upon arrival at West Hills, Rosie was admitted to the hospital for additional diagnostics and intensive supportive care by one of our primary care veterinarians, Dr. Lancer. Radiographs (x-rays) did not reveal an obvious cause for her signs. The following day an abdominal ultrasound of the abdomen was performed, which also did not pinpoint an exact cause of the clinical signs, but showed evidence of dilation of her intestinal tract with fluid and ileus, which is a lack of movement of material within the digestive tract. Rosie was continued on supportive care, but her signs progressed to include nausea as well as continued diarrhea, and she was very lethargic. Repeat blood work was consistent with sepsis, a systemic wide infection that was not responding to supportive care. Following consultation with Dr. Ries and Dr. Hirshenson, our board certified veterinary surgeon, Rosie’s owners elected to pursue an abdominal exploratory surgery.

In surgery, 2 small perforations were found in the cecum which is a small section of the intestinal tract that connects the small intestine to the large intestine. This, caused intestinal contents to leak into Rosie’s abdomen. The affected portion of her intestinal tract was removed. Dr. HIrshenson suspected that the perforations developed secondary to an intussusception. This is a condition where a loop of intestines slides inside another loop, causing inflammation, and in some cases, necrosis of the intestinal tract. The condition typically occurs in young dogs and in some cases can be life threatening. In Rosie’s case, the leakage of intestinal contents into the abdomen was causing a severe systemic infection, along with severe pancreatitis (inflammation of the pancreas) and secondary changes to her heart and liver.

Rosie required intensive monitoring and supportive care following surgery including two plasma transfusions, medication to help support her heart contractility and blood pressure, and a feeding tube to provide nutrition. Each day she showed slight improvement and exactly one week following admittance to the hospital (5 days following surgery) Rosie began eating small amounts on her own. Four days later (a total of 11 days in hospital) Rosie was discharged!

Over the following 2 weeks at home Rosie continued to regain strength and put on weight and rechecks of her blood work showed continued improvement. Through the hard work of the entire West Hills staff, the dedication of Rosie’s family, and of course the determination of Rosie herself, she is back at home where she belongs running through trails!