title: Surgical intervention in the management of severe acute pancreatitis in cats: 8 cases (2003-2007).
abstract: OBJECTIVE
  To evaluate clinical characteristics and outcomes of cats undergoing surgical intervention in the course of treatment for severe acute pancreatitis.
  
  
  METHODS
  Retrospective observational study from 2003 to 2007 with a median follow-up period of 2.2 years (range 11 d-5.4 y) postoperatively.
  
  
  METHODS
  Private referral veterinary center.
  
  
  METHODS
  Eight cats.
  
  
  METHODS
  None.
  
  
  RESULTS
  Quantitative data included preoperative physical and clinicopathologic values. Qualitative parameters included preoperative ultrasonographic interpretation, perioperative and intraoperative feeding tube placement, presence of free abdominal fluid, intraoperative closed suction abdominal drain placement, postoperative complications, microbiological culture, and histopathology. Common presenting clinical signs included lethargy, anorexia, and vomiting. Leukocytosis and hyponatremia were present in 5 of 8 cats. Hypokalemia, increased total bilirubin, and hyperglycemia were present in 6 of 8 cats. Elevated alanine aminotransferase and aspartate transferase were present in all cats. Surgery for extrahepatic biliary obstruction was performed in 6 cats, pancreatic abscess in 3 cats, and pancreatic necrosis in 1 cat. Six of the 8 cats survived. Five of the 6 cats that underwent surgery for extrahepatic biliary obstruction and 1 cat that underwent pancreatic necrosectomy survived. All 5 of the cats with extrahepatic biliary obstruction secondary to pancreatitis survived. The 2 nonsurvivors included a cat with a pancreatic abscess and a cat with severe pancreatitis and extrahepatic biliary obstruction secondary to a mass at the gastroduodenal junction. Postoperative complications included progression of diabetes mellitus, septic peritonitis, local gastrostomy tube stoma inflammation, local gastrostomy tube stoma infection, and mild dermal suture reaction.
  
  
  CONCLUSIONS
  Cats with severe acute pancreatitis and concomitant extrahepatic biliary obstruction, pancreatic necrosis, or pancreatic abscesses may benefit from surgical intervention. Cats with extrahepatic biliary obstruction secondary to severe acute pancreatitis may have a good prognosis.
authors: Advanced Critical Care, Culver City, CA 90232, USA. tolinatina@yahoo.com
authors: Tolina T
authors: TT
authors: Son
authors: Lisa
authors: L
authors: Thompson
authors: Sergi
authors: S
authors: Serrano
authors: Ravi
authors: R
authors: Seshadri
mesh_terms: D000038:Abscess / Q000150:complications / Q000601:surgery / Q000662:veterinary; D000818:Animals; D002371:Cat Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002415:Cats; D001651:Cholestasis, Extrahepatic / Q000453:epidemiology / Q000209:etiology / Q000601:surgery / Q000662:veterinary*; D005260:Female; D008297:Male; D009336:Necrosis / Q000150:complications / Q000601:surgery / Q000662:veterinary; D010195:Pancreatitis / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000601:surgery / Q000662:veterinary*; D011183:Postoperative Complications / Q000662:veterinary; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome