Retrospective evaluation of vacuum-assisted peritoneal drainage for the treatment of septic peritonitis in dogs and cats: 8 cases (2003-2010)

Objective - To describe the use of vacuum-assisted peritoneal drainage (VAPD) in dogs and cats with septic peritonitis. Design - Retrospective descriptive study. Setting - University Veterinary Teaching Hospital. Animals - Six dogs and 2 cats with septic peritonitis. Interventions - Application of VAPD after abdominal exploration. Measurements - Pre- and post-operative physical and clinicopathologic data, surgical findings, treatment, VAPD fluid production, outcome, and survival are reported. Main results - Eight nonconsecutive cases of septic peritonitis, consisting of 6 dogs and 2 cats, were treated surgically and had VAPD applied post-operatively. The mean duration of clinical signs prior to surgical intervention was 4 +/- 3 days. VAPD therapy was applied for a mean of 2 +/- 1.1 days and collected a median of 27 mL/kg/d of abdominal effusate. The median time in hospital was 5 days and abdominal closure was completed in 5 of the 8 patients. All specimens collected at surgery cultured positive for bacteria, most commonly Enterococcus spp. The peritoneum of 4 animals was cultured at the time of abdominal closure; 1 was negative and 3 were positive for Escherichia coli, Enterococcus spp. or gram-positive cocci. Cultures before and after surgery differed in 2 patients. Hypoproteinemia was present in all patients postoperatively. Three patients were considered survivors, all of which were dogs. Five patients died or were euthanized due to cardiopulmonary arrest (n = 3), pyothorax (n = 1), and acute, severe, septic peritonitis (n = 1). Conclusions - VAPD is available for maintaining abdominal drainage for the treatment of septic peritonitis after surgical intervention; however, similar to open abdominal drainage and closed suction drainage, nosocomial infection and hypoproteinemia remain challenges in the treatment of septic peritonitis.