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==Description==

==Description==

'''Peritonitis''' is defined as the [[Inflammation - Pathology|inflammation]] of the [[Peritoneal cavity - Anatomy & Physiology|peritoneum]].  The inflammatory response involves vasodilation, [[Exudate|exudation]] of protein-rich fluid, cellular infiltration, pain and, chronically, formation of fibrous adhesion.  The disease can be classified into primary and secondary cases.

'''Peritonitis''' is defined as [[Inflammation - Pathology|inflammation]] of the [[Peritoneal cavity - Anatomy & Physiology|peritoneum]].  The inflammatory response involves vasodilation, [[Exudate|exudation]] of protein-rich fluid, cellular infiltration, pain and, chronically, formation of fibrous adhesion.  The disease can be classified into primary and secondary cases.

'''Primary peritonitis''' occurs spontaneously without any pre-existing pathological process in the abdomen.  In cats, [[Feline Infections Peritonitis (FIP)|feline infectious peritonitis]] is the most common cause of primary peritonitis.

'''Primary peritonitis''' occurs spontaneously without any pre-existing pathological process in the abdomen.  In cats, [[Feline Infections Peritonitis (FIP)|feline infectious peritonitis]] is the most common cause of primary peritonitis.

'''Secondary peritonitis''' occurs as the result of a pre-existing pathological process within the abdomen.  It be further classified into '''septic''' or '''non-septic''' peritonitis, where septic peritonitis results from direct bacterial infection of the peritoneal cavity.  Septic peritonitis is the most common form in the dog and its causes include:

'''Secondary peritonitis''' occurs as the result of a pre-existing pathological process within the abdomen.  It can be further classified into '''septic''' or '''non-septic''' peritonitis, where septic peritonitis results from direct bacterial infection of the peritoneal cavity.  Septic peritonitis is the most common form in the dog and its causes include:

*'''Perforation of the gastro-intestinal tract''' due to foreign bodies, [[Intussusception|intussuscepta]], invasive [[Neoplasia - Pathology|neoplasia]] or dehiscence of surgical wounds or biopsy sites.  Peritonitis as a result of wound dehiscence is most likely to occur 3-5 days post-operatively.   

*'''Perforation of the gastro-intestinal tract''' due to foreign bodies, [[Intussusception|intussuscepta]], invasive [[Neoplasia - Pathology|neoplasia]], deep ulceration or dehiscence of surgical wounds or biopsy sites.  Peritonitis as a result of wound dehiscence is most likely to occur 3-5 days post-operatively.   

*'''Penetration of the abdomen''' by a stick, gunshot or other foreign body.

*'''Penetration of the abdomen''' by a stick, gunshot or other foreign body.

*Rupture of an infected uterus ('''pyometra'''), biliary tract or urinary tract.

*Rupture of an infected uterus ('''pyometra'''), biliary tract or urinary tract.

'''Non-septic''' peritonitis may occur due to the leakage of bile, urine or pancreatic enzymes ('''chemical peritonitis''') or due to the presence of foreign substances such as barium or glove powder ('''physical peritonitis''').  In some cases of urinary tract or biliary tract rupture, septic peritonitis may occur if the tracts were previously infected.

'''Non-septic''' peritonitis may occur due to the leakage of bile, urine or pancreatic enzymes ('''chemical peritonitis''') or due to the presence of foreign substances such as barium or glove powder ('''physical peritonitis''').  In some cases of urinary tract or biliary tract rupture however, septic peritonitis may occur if the tracts were previously infected.

==Diagnosis==

==Diagnosis==

===Clinical Signs===

===Clinical Signs===

*Abdominal pain

*Depressed

*'''Abdominal pain''', manifesting as a reluctance to move due to inflammation of the parietal peritoneum.

*[[Stomach and Abomasum Consequences of Gastric Disease - Pathology|Vomiting]]

*'''Depression''', anorexia and lethargy and non-specific signs of infection or systemic disease.

*[[Diarrhoea|Diarrhoea]]

*[[Stomach and Abomasum Consequences of Gastric Disease - Pathology|'''Vomiting''']] and [[Diarrhoea|'''diarrhoea''']] may occur due to alterations in intestinal motility and functional ileus.

*Hypotension and [[Shock - Pathology|shock]]

*'''Hypotension''' and (septic) [[Shock - Pathology|'''shock''']] due to effusion of fluid into the peritoneum and systemic vasodilation.

*Hypothermia or hyperthermia

*'''Hypothermia''' or '''hyperthermia'''.

 

===Laboratory Tests===

===Laboratory Tests===

====Haematology====

====Haematology====

*Leucocytosis; predominantly neutrophilia ± left shift or neutropaenia

As with any severe inflammatory process, '''leucocytosis''' will occur.  Initially, this is caused by '''neutrophilia''' which may have a left shift or, if very severe, a degenerative right shift.  Severe localised inflammation may stimulate a '''leukaemoid response''' with massive mobilisation of neutrophils from the bone marrow pools.

*Haemoconcentration

 

'''Haemoconcentration''' (causing a raised packed cell volume (PCV) and total protein concentration) may occur due to loss of extracellular fluid.

 

====Biochemistry====

====Biochemistry====

*Hypoglycaemia - possible sepsis

*Hypoglycaemia - possible sepsis

*Increased lactate concentration

*Increased lactate concentration

Guarded.  Peritonitis is a multifactorial disease and the consequence is fatal in most cases.  A rapid diagnosis and treatment may improve the prognosis.

Guarded.  Peritonitis is a multifactorial disease and the consequence is fatal in most cases.  A rapid diagnosis and treatment may improve the prognosis.