Peritonitis

Question 1

What are some indicators on blood/peritoneal fluids that is consistent with septic peritonitis?

Answer 1

Glucose: paired blood/ peritoneal fluid difference >1.1mmol/L
Lactate: peritoneal fluid >2mmoL/L than blood

Question 2

What are some indicators on blood/peritoneal fluids that is consistent with uroperitoneum?

Answer 2

• > 2x increase in creatinine in the peritoneal fluid compared to serum
• > 1.4x (dogs) or 1.9x (cats) increase in potassium in the peritoneal fluid compared to serum

Question 3

What are some indicators on blood/peritoneal fluids that is consistent with bile peritonitis?

Answer 3

• > 2x bile concertation in the peritoneal fluid compared to serum
• cytology will also how bile pigment or crystals

Question 4

What are some common biochemistry abnormalities noted for peritonitis?

Answer 4

• metabolic acidosis
• hyperlactatemia
• hypocalcemia
• hyperkalemia (uroperitoneum)
• hypoalbuminemia
• hyperglycemia followed by hypoglycemia

Question 5

What is a negative prognostic feature in both dogs and cats?

Answer 5

lactate
- elevated lactate on arrival
- persistent lactate after treatment
- poor lactate clearance

Question 6

Elevated ALT and GGT is a prognostic factor in which species?

Answer 6

dogs

Question 7

What are the two main categories of causes of peritonitis?

Answer 7

Primary - extra-abdominal source
Secondary - intra-abdominal source

Question 8

What’s the initial treatment goals for peritonitis?

Answer 8

Stabilization
- IV Fluids: shock dose. Colloids may be needed
- blood products: albumin
- fix blood pressure: vasopressors- norepinephrine preferred

Question 9

What’s the overall prognosis for septic peritonitis in dogs?

Answer 9

Generally speaking, survival 47-85%
septic bile = 27-45%
non-septic bile = 87-100%

Question 10

What’s the prognosis for cats with uroperitoenum?

Answer 10

62%