EBT - Septic Peritonitis - Worst Case?
Discussion
So my boy (Bluto, 5 years old English Bull Terrier) is at the vets VERY ill.
It seems he managed to eat some plastic and a plastic bag.
This has resulted in surgery to his stomach and remove of some of his intestine.
At the moment he hasn't eaten for nearly 7 days (the vets have him on a drip and I managed to get him to eat a small amount of boiled chicken)
The vet reckons he might have the above.
He is being filled with various drugs (the dog, not the vet)
His temp seems to be holding at a constant.
He is not his normal self, but am hoping its just that he has had major surgery.
Now, do I need to brace for the worst?
It seems he managed to eat some plastic and a plastic bag.
This has resulted in surgery to his stomach and remove of some of his intestine.
At the moment he hasn't eaten for nearly 7 days (the vets have him on a drip and I managed to get him to eat a small amount of boiled chicken)
The vet reckons he might have the above.
He is being filled with various drugs (the dog, not the vet)
His temp seems to be holding at a constant.
He is not his normal self, but am hoping its just that he has had major surgery.
Now, do I need to brace for the worst?
Come across a few cases of peritonitis, acidosis and sepsis in humans with my job.
No idea how human prognosis and morbidity compares to animals.
Peritonitis isn't too bad if it's caught early. Sepsis however is a different kettle of fish, and responsible for the demise of many in acute care hospital wards.
However, the patients who do succumb are usually the elderly, or those with poor / weak systems and immunity.
Younger patents have a much better prognosis, if they respond well to antibiotics and fluids. Your pet is pretty young at 5 years old? So I would definitely err on the side of a good outcome, given his age.
Whatever, I wish you all the best. It's an unpleasant thing to have to go through, and I hope that we get a good result.
No idea how human prognosis and morbidity compares to animals.
Peritonitis isn't too bad if it's caught early. Sepsis however is a different kettle of fish, and responsible for the demise of many in acute care hospital wards.
However, the patients who do succumb are usually the elderly, or those with poor / weak systems and immunity.
Younger patents have a much better prognosis, if they respond well to antibiotics and fluids. Your pet is pretty young at 5 years old? So I would definitely err on the side of a good outcome, given his age.
Whatever, I wish you all the best. It's an unpleasant thing to have to go through, and I hope that we get a good result.
Are they considering a feeding tube (oesophagostomy) they really need to consider one if he hasn't eaten 7 days (is that post surgery) he really really needs nutrients in his digestive system to get the guts moving and to help healing however if already damaged this may be contraindicated so not straightforward 
The cases of suspected peritonitis I've seen in dogs has usually resulted in the patient to be opened up again to assess the level of damage to tissue and to flush with copious amounts of fluid.
He could also have gut stasis, this will stop any movement of food etc, have they ultrasound scanned him. A good ultrasonographer will be able to give a lot of info (inc suspected peritonitis) and obviously much less invasive.
We are very lucky to have an absolutely brilliant ultrasonographer who we can call in and she can tell us so much about a patient, you need someone who specialises (and basically that's all they do all day.)
It's so hard too watch them when they are poorly, how is he when you visit?
Usually you'd expect a raised temperature with a peritonitis, what are his bloods saying?
The cases of suspected peritonitis I've seen in dogs has usually resulted in the patient to be opened up again to assess the level of damage to tissue and to flush with copious amounts of fluid.
He could also have gut stasis, this will stop any movement of food etc, have they ultrasound scanned him. A good ultrasonographer will be able to give a lot of info (inc suspected peritonitis) and obviously much less invasive.
We are very lucky to have an absolutely brilliant ultrasonographer who we can call in and she can tell us so much about a patient, you need someone who specialises (and basically that's all they do all day.)
It's so hard too watch them when they are poorly, how is he when you visit?
Usually you'd expect a raised temperature with a peritonitis, what are his bloods saying?
I will ask today about the feeding tube, I know he needs to eat to try to build some strength to help fight the infection.
The ultra sound is all done in house, so no idea how good they are at it.
His temp seems (as of yesterday but it might of changed over night) to remain stable, but he has low blood pressure. Am hoping thats just from the surgery and being ill.
He looks so depressed, not his usual self, and when called seems difficult for him to focus.
He can stand and shuffle around a bit.
But I won't get to see him till tonight, so if you get chance to read this, any questions I should be asking?
The ultra sound is all done in house, so no idea how good they are at it.
His temp seems (as of yesterday but it might of changed over night) to remain stable, but he has low blood pressure. Am hoping thats just from the surgery and being ill.
He looks so depressed, not his usual self, and when called seems difficult for him to focus.
He can stand and shuffle around a bit.
But I won't get to see him till tonight, so if you get chance to read this, any questions I should be asking?
It's difficult to know what to say, every case is different with this kind of surgery when foreign bodies are involved.
Do you know how much damage the plastic had caused to his stomach/ guts before they removed it. If a lot of damage this will be making recovery a lot harder/ more serious. Peritonitis (if it wasn't obvious at the time) usually hits 24-48hrs post surgery just when you think they are doing well the patient relapses and becomes very poorly again. So as you can see there are a lot of variables re each patient.
I would ask what they are planning re getting him to eat or getting food into him and how they are going to know how the suspected peritonitis progressing and how it is being monitored and confirmed rather than suspected. This is life threatening for him but the longer he fights the better, it may take a long recovery process.
In house ultrasound can be good and we do have one but we refer out for this type of case usually.
Keeping my fingers crossed, just sorry I can't add anything more positive/ helpful for you
Do you know how much damage the plastic had caused to his stomach/ guts before they removed it. If a lot of damage this will be making recovery a lot harder/ more serious. Peritonitis (if it wasn't obvious at the time) usually hits 24-48hrs post surgery just when you think they are doing well the patient relapses and becomes very poorly again. So as you can see there are a lot of variables re each patient
.I would ask what they are planning re getting him to eat or getting food into him and how they are going to know how the suspected peritonitis progressing and how it is being monitored and confirmed rather than suspected. This is life threatening for him but the longer he fights the better, it may take a long recovery process.
In house ultrasound can be good and we do have one but we refer out for this type of case usually.
Keeping my fingers crossed, just sorry I can't add anything more positive/ helpful for you
http://www.merckmanuals.com/vet/generalized_condit...
The above is a link to a well respected veterinary manual. A lot of it is too in depth (even for me) but it gives good indicators as to how diagnosis can be reached and most importantly for you right at the bottom how to treat the condition.
It's a long article because it covers several species so do check that what you read relates to the dog. Also remember an experienced vet will just have knowledge about what they suspect without necessarily going so in depth with some of the tests you may see written here!
The above is a link to a well respected veterinary manual. A lot of it is too in depth (even for me) but it gives good indicators as to how diagnosis can be reached and most importantly for you right at the bottom how to treat the condition.
It's a long article because it covers several species so do check that what you read relates to the dog. Also remember an experienced vet will just have knowledge about what they suspect without necessarily going so in depth with some of the tests you may see written here!
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