Colonic perforation in corticosteroid-treated dogs

Clinical findings for 5 new cases of colonic perforation in corticosteroid-treated dogs were presented and 8 other cases from the literature were reviewed. Colonic perforation was a fatal complication in all 13 dogs, 12 of which had had recent major surgery. Ten dogs were neurosurgical patients, 1 dog received medical therapy for head trauma and nonambulatory paresis, and 2 dogs were operated on for non-neurologic conditions. Dexamethasone was the most frequently used corticosteroid, and 12 dogs received a mean cumulative dose of 6.4 mg/kg over an average period of 5.1 days. Depression, anorexia, and emesis, the most frequent signs attending colonic perforation, became evident 3 to 8 days after surgery. Signs preceded death by an average of 22.3 hours. Correct antemortem diagnosis (5 dogs) and surgical intervention (3 dogs) had no effect on eventual outcome (mortality = 100%). Colonic perforation most frequently developed in the proximal descending portion and always involved the antimesenteric border. Gross fecal contamination of the peritoneal cavity and acute generalized peritonitis were evident in all but one dog. Adhesions were observed at the lesion site in 6 dogs, but prevented gross soilage in only one dog.