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Peritonitis in Dogs

By Otto M. Radostits, CM, DVM, MSc, DACVIM (Deceased), Professor Emeritus, Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan ; David A. Ashford, DVM, MPH, DSc, Assistant Area Director, International Services, APHIS, USDA ; Craig E. Greene, DVM, MS, Professor, Department of Small Animal Medicine, College of Veterinary Medicine, University of Georgia ; Eugene D. Janzen, DVM, MVS, Professor, Production Animal Health, Faculty of Veterinary Medicine, University of Calgary ; Bert E. Stromberg, PhD, Professor, Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota ; Max J. Appel, DMV, PhD, Professor Emeritus ; Stephen C. Barr, BVSc, MVS, PhD, DACVIM, Professor of Medicine, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University ; J. P. Dubey, MVSc, PhD, Microbiologist, Animal Parasitic Diseases Laboratory, Beltsville Agricultural Research Center, USDA ; Paul Ettestad, DVM, MS, State Public Health Veterinarian, Epidemiology and Response Division, New Mexico Department of Health ; Kenneth R. Harkin, DVM, DACVIM, Associate Professor, College of Veterinary Medicine, Kansas State University ; Delores E. Hill, PhD, Parasitologist, U.S. Department of Agriculture ; Johnny D. Hoskins, DVM, PhD, Small Animal Consultant ; Jodie Low Choy, BVSc, BVMS, IVAS Cert, Menzies School of Health Research; University Avenue Veterinary Hospital, Northern Territory, Australia ; Barton W. Rohrbach, VMD, MPH, DACVPM, Associate Professor, Department of Comparative Medicine, Veterinary Teaching Hospital, University of Tennessee ; J. Glenn Songer, PhD, Professor, Department of Veterinary Science and Microbiology, University of Arizona ; Joseph Taboada, DVM, DACVIM, Professor and Associate Dean, Office of Student and Academic Affairs, School of Veterinary Medicine, Louisiana State University ; Charles O. Thoen, DVM, PhD, Professor, Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University ; John F. Timoney, MVB, PhD, Dsc, MRCVS, Keeneland Chair of Infectious Diseases, Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky ; Ian Tizard, BVMS, PhD, DACVM, University Distinguished Professor of Immunology; Director, Richard M. Schubot Exotic Bird Health Center, Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University

Also see professional content regarding peritonitis.

Peritonitis is inflammation of the membrane that lines the abdominal cavity (peritoneum). It is a serious and often fatal condition in dogs, with mortality as high as 68%. Peritonitis may be short or longterm, localized or widespread. Most commonly it occurs due to contamination of the peritoneal cavity (for example by perforation of the abdominal cavity by a foreign object, splitting open of an abdominal wound closure, or rupture of the intestine due to the presence of a foreign object), but it also may be caused by infectious agents such as viruses or bacteria.

Fever, blood poisoning, shock, reduced blood pressure, bleeding, abdominal pain, paralytic obstruction of the intestines with reduced fecal output, and fluid accumulation may all be signs of peritonitis. Rupture of the gastrointestinal tract, with spillage of large volumes of intestinal contents, leads to short-term peritonitis. Death due to shock from the large amounts of bacterial toxins may occur suddenly.

The first priority of treatment is to stabilize the consequences of peritonitis (for example, changes in electrolytes, acid-base imbalance, fluid loss, and blood clotting abnormalities). In addition, your veterinarian will want to identify the point of origin of inflammation and correct or remove it. Antibiotics are a standard part of the treatment. Replacement fluids, electrolytes, plasma, or whole blood may be necessary to maintain heart output.

Once your pet is stabilized, surgery is done to explore the abdomen and to repair any defects. Your veterinarian will follow this with a thorough rinsing of the abdominal cavity with a saline solution, antiseptic, or antibiotics. Antibiotics are continued after surgery. Nutritional support with intravenous feeding may be needed, as many animals with peritonitis will not eat after surgery. In animals with blood poisoning and shock, fluids, electrolytes, and antibiotics are crucial elements of treatment.