Perioperative management of septic peritonitis in small animals: A review

Septic peritonitis (SP) is a complex, life-threatening disease, driven by peritoneal inflammation and microbial contamination, requiring timely and dynamic perioperative management.

The aim of this review was to synthesize current knowledge on the perioperative management of SP in dogs and cats.

Evidence-based strategies for initial stabilization include fluid resuscitation with balanced crystalloids, asopressors, and antimicrobial therapy targeting polymicrobial infections. Anesthetic management should prioritize hemodynamic stability and a multimodal approach to analgesia. Postoperative management should include early enteral nutrition (which is associated with increased survival) and monitoring and treatment of coagulation derangements. Patients should be closely monitored for recurrent SP after surgery, which is associated with high mortality. Evidence for risk factors of dehiscence such as hypoalbuminemia and interoperative hypotension is inconsistently found in studies. Other potential complications include hospital acquired infection and intra-abdominal hypertension.

There is significant variation in the treatment approach for small animals with SP, likely due to gaps in evidence. Reported survival rates vary widely between studies due to diverse and inconsistent study populations, highlighting the need for further research to optimize care in veterinary patients.