Difference between revisions of "Peritonitis - Cats and Dogs"
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==Description== | ==Description== | ||
Peritonitis is defined as the inflammation of the peritoneum. Peritonitis can be septic or non-septic. Septic peritonitis results from free bacteria in the peritoneal cavity, caused by perforating injuries to the gastrointestnal tract due to foreign bodies, necrosis secondary to obstruction or intussusception. Non-septic, also known as chemical peritonitis, may be the result of leakage of bile, urine or pancreatic enzymes. However, non-septic peritonitis can cause septic peritonitis, for example cases where septic urine is present. | Peritonitis is defined as the inflammation of the peritoneum. Peritonitis can be septic or non-septic. Septic peritonitis results from free bacteria in the peritoneal cavity, caused by perforating injuries to the gastrointestnal tract due to foreign bodies, necrosis secondary to obstruction or intussusception. Non-septic, also known as chemical peritonitis, may be the result of leakage of bile, urine or pancreatic enzymes. However, non-septic peritonitis can cause septic peritonitis, for example cases where septic urine is present. | ||
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==Diagnosis== | ==Diagnosis== | ||
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===Laboratory Tests=== | ===Laboratory Tests=== | ||
====Haematology==== | ====Haematology==== | ||
| − | + | *Significant leucocytosis or leucopaenia | |
====Biochemistry==== | ====Biochemistry==== | ||
| − | |||
*Hypoglycaemia | *Hypoglycaemia | ||
*Increased lactate concentration | *Increased lactate concentration | ||
| − | |||
| − | |||
| − | |||
| − | |||
| − | |||
| − | |||
===Diagnostic Imaging=== | ===Diagnostic Imaging=== | ||
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| + | ===Histopathology=== | ||
| + | *Abdominal fluid collected for laboartory analysis via abdominocentesis. The fluid should be stained for intracellular bacteria and assessed for: | ||
| + | **amylase and lipase for pancreatitis | ||
| + | **bile for biliary leak | ||
| + | **creatinine for urine | ||
| + | **glucose (2.8 mmol/l) and lactate (>5.5 mmol/l) for sepsis | ||
| + | |||
| + | ==Treatment== | ||
| + | It is vital to identify cases which require emergency surgical intervention. Any of the following is a major indication: | ||
| + | *positive for intracellular bacteria. | ||
| + | *free gas visible in the abdominal radiograph. | ||
| + | *presence of penetrating injuries in the abdomen. | ||
| − | === | + | ===Fluid therapy=== |
| + | *Aggressive fluid therapy with crystalloid and colloid should be given on initial presentation to improve haemodynamic parameter. | ||
| + | *Fluid therapy is also very important in the postoperative period. | ||
| + | ===Analgesia=== | ||
| + | *Opiods should be given. | ||
| − | == | + | ===Antimicrobial=== |
| − | * | + | *Broad spectrum antibiotics should be given, preferably following culture and sensitivity test. |
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Revision as of 15:37, 18 August 2009
 |
This article is still under construction. |
Signalment
Description
Peritonitis is defined as the inflammation of the peritoneum. Peritonitis can be septic or non-septic. Septic peritonitis results from free bacteria in the peritoneal cavity, caused by perforating injuries to the gastrointestnal tract due to foreign bodies, necrosis secondary to obstruction or intussusception. Non-septic, also known as chemical peritonitis, may be the result of leakage of bile, urine or pancreatic enzymes. However, non-septic peritonitis can cause septic peritonitis, for example cases where septic urine is present.
Diagnosis
Clinical Signs
- Depressed
- Tachycardia
- Tachypnoea
- Pale, cyanotic or muddly mucous membranes
- Hypothermia or hyperthermia
- Abdominal pain
Laboratory Tests
Haematology
- Significant leucocytosis or leucopaenia
Biochemistry
- Hypoglycaemia
- Increased lactate concentration
Diagnostic Imaging
Radiography
- Abdominal radiography may reveal free gas in the abdomen. This is highly suggestive of peritonitis
- Thoracic radiograph should be assessed for signs of metastatic disease.
Histopathology
- Abdominal fluid collected for laboartory analysis via abdominocentesis. The fluid should be stained for intracellular bacteria and assessed for:
- amylase and lipase for pancreatitis
- bile for biliary leak
- creatinine for urine
- glucose (2.8 mmol/l) and lactate (>5.5 mmol/l) for sepsis
Treatment
It is vital to identify cases which require emergency surgical intervention. Any of the following is a major indication:
- positive for intracellular bacteria.
- free gas visible in the abdominal radiograph.
- presence of penetrating injuries in the abdomen.
Fluid therapy
- Aggressive fluid therapy with crystalloid and colloid should be given on initial presentation to improve haemodynamic parameter.
- Fluid therapy is also very important in the postoperative period.
Analgesia
- Opiods should be given.
Antimicrobial
- Broad spectrum antibiotics should be given, preferably following culture and sensitivity test.
Prognosis
References
- Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company.
- Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition) BSAVA
- Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier.