Tag Archives: Septic Abdomen

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!

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!