title: Use of cryopoor plasma for albumin replacement and continuous antimicrobial infusion for treatment of septic peritonitis in a dog.
abstract: OBJECTIVE
  To report the successful management of a dog with septic peritonitis and septic shock secondary to enterectomy dehiscence using novel techniques for identification of intestinal dehiscence and for septic shock treatment.
  
  
  METHODS
  A 5-year-old castrated male Bernese Mountain Dog presented for lethargy 6 days following enterotomy for foreign body obstruction. Septic peritonitis was identified due to dehiscence of the enterotomy site, and resection and anastomosis were performed using a gastrointestinal anastomosis and thoracoabdominal stapling device. Postoperatively the patient experienced severe hypotension, which responded to norepinephrine constant rate infusion (CRI) after failing to improve with fluid therapy or dopamine CRI. Further treatment included antimicrobial CRI and supportive care including careful fluid therapy. Due to low effective circulating volume paired with intersititial fluid overload and large volume abdominal effusion, fluid therapy consisted of a combination of human serum albumin, canine albumin, synthetic colloids, and isotonic crystalloids. Cryopoor plasma (CPP) was used as a source of canine albumin and intravascular volume. On Day 4, food dye was given through a nasogastric tube due to suspicion of dehiscence of the anastomosis site. Dehiscence was confirmed during abdominal exploratory, and a second resection and anastomosis was performed. Abdominal partial closure with vacuum-assisted closure device was performed. Supportive care was continued with CPP CRI and imipenem CRI. Planned relaparotomy to change the vacuum-assisted closure device was performed 48 hours later, with abdominal closure 96 hours after anastomosis. The patient was discharged on Day 15. Recheck 12 months later was normal.
  
  
  CONCLUSIONS
  This case includes novel techniques such food dye via nasogastric tube to identify anastomosis dehiscence, use of CPP as a source of canine albumin, and antimicrobial CRI in a dog with septic peritonitis.
authors.affiliation: Department of Clinical Sciences, Ohio State University, Columbus, OH, 43210.
authors.forename: Meaghan K
authors.initials: MK
authors.lastname: Ropski
authors.affiliation: Department of Clinical Sciences, Ohio State University, Columbus, OH, 43210.
authors.forename: Julien
authors.initials: J
authors.lastname: Guillaumin
authors.affiliation: Department of Clinical Sciences, Ohio State University, Columbus, OH, 43210.
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Monnig
authors.affiliation: Department of Clinical Sciences, Ohio State University, Columbus, OH, 43210.
authors.forename: Katy
authors.initials: K
authors.lastname: Townsend
authors.affiliation: Department of Clinical Sciences, Ohio State University, Columbus, OH, 43210.
authors.forename: Mary A
authors.initials: MA
authors.lastname: McLoughlin
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000662:veterinary; D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000077324:Crystalloid Solutions; D003937:Diagnosis, Differential; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000662:veterinary; D004283:Dog Diseases / Q000175:diagnosis* / Q000628:therapy; D004285:Dogs; D005440:Fluid Therapy / Q000379:methods / Q000662:veterinary*; D005549:Foreign-Body Reaction / Q000601:surgery / Q000662:veterinary; D007552:Isotonic Solutions / Q000627:therapeutic use; D008297:Male; D010538:Peritonitis / Q000175:diagnosis / Q000628:therapy / Q000662:veterinary*; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy / Q000662:veterinary; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000628:therapy / Q000662:veterinary*
chemical_list: D000890:Anti-Infective Agents; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions
keywords: canine; colloids; hydroxyethyl starch; sepsis