Anaphylaxis-related hemoperitoneum in 11 dogs

To describe the unique complication of hemoperitoneum associated with anaphylaxis.

Retrospective case series from September 2012 to August 2017.

Two private emergency and specialty referral hospitals.

Eleven client-owned dogs diagnosed with anaphylaxis and hemoperitoneum upon presentation or referral.

None.

Inclusion criteria included clinical signs consistent with anaphylaxis (hypotension, tachycardia, vomiting, diarrhea, weakness, collapse, with or without the presence of dermal signs) due to witnessed or unwitnessed presumed bee sting, an elevated alanine aminotransferase (ALT), performance of abdominal FAST (AFAST) examination with an abdominal fluid score, the sonographic presence of gallbladder wall edema, and hemoperitoneum. All dogs (n=11) were managed medically without surgical intervention. 91% (n=10) of dogs survived to discharge.

Hemoperitoneum development can be seen with anaphylactic reactions, though the exact mechanism remains to be fully understood. Medical therapy is warranted and can be successful in these patients; surgery is not indicated to address hemoperitoneum.