Hemorrhage is associated with decreased prognosis compared to all other indications for unplanned recurrent celiotomy.

Abstract

OBJECTIVE: To explore the causes and short-term outcomes of unplanned recurrent exploratory celiotomies in dogs. METHODS: Medical records from a tertiary veterinary teaching hospital (June 2014 to June 2024) were reviewed. Dogs were included if they underwent 2 exploratory celiotomies within 14 days, the second being unplanned. Data included signalment, comorbidities, surgical indications, complications, and survival to discharge. Cases were categorized by type of initial surgery and indication for secondary surgery. RESULTS: Of 50 dogs, 58% had an initial gastrointestinal (GI) surgery and 42% had an initial non-GI surgery. Leading indications for a second surgery included septic peritonitis (50%; 95% CI, 35.5% to 64.5%), incisional complications (18%; 95% CI, 8.6% to 31.4%), and hemorrhage (14%; 95% CI, 5.8% to 26.7%). Septic peritonitis was significantly more common following initial GI surgery, while hemorrhage and miscellaneous causes were more prevalent following non-GI surgery. Survival to hospital discharge was 66% (95% CI, 51.2% to 78.8%) and did not differ significantly by initial surgery type. Hemorrhage was the leading cause of death, accounting for 71.4% (95% CI, 29.0% to 96.3%) of all deaths, with significantly higher mortality than all other causes combined. After adjusting for initial surgery type, hemorrhage remained associated with decrease survival (adjusted OR, 0.13; 95% CI, 0.02 to 0.73). CONCLUSIONS: Septic peritonitis was the leading surgical complication following GI surgery; hemorrhage and miscellaneous complications were more prevalent following non-GI surgeries. Hemorrhagic complications were linked to a lower survival to hospital discharge. CLINICAL RELEVANCE: Findings supported condition-specific prognostication to guide clinical decision-making and client communication in dogs undergoing unplanned repeat celiotomy.