Retrospective evaluation of gastrointestinal foreign bodies and presurgical predictors for enterectomy versus enterotomy in dogs (2013-2016): 82 cases.

Abstract

OBJECTIVE: To evaluate preoperative diagnostics in dogs with gastrointestinal foreign body (GIFB) obstruction and to identify clinical variables associated with the performance of simple enterotomy (EO) versus enterectomy (EC). DESIGN: Retrospective case control study from October 2013 to January 2016. SETTING: Veterinary Teaching Hospital. ANIMALS: Eighty-two client-owned dogs diagnosed at the time of surgery with GIFB obstruction. MEASUREMENTS AND MAIN RESULTS: Data were collected from medical records regarding history, initial physical examination, clinicopathologic testing, diagnostic imaging, and surgical reports. Based on univariate analysis, dogs that required EC were ill (P&#xa0;<&#xa0;0.0001) and anorexic (P&#xa0;=&#xa0;0.0007) for a longer duration; had a higher vomiting severity score (P&#xa0;=&#xa0;0.005); and had worse perfusion parameters (mucous membrane color [P&#xa0;=&#xa0;0.028] and quality [P&#xa0;=&#xa0;0.032], poorer pulse quality [P&#xa0;=&#xa0;0.0015], relatively lower blood pressure [P&#xa0;=&#xa0;0.0328], greater heart rates [P&#xa0;=&#xa0;0.0011]). Dogs undergoing EC were more likely to have altered peritoneal detail on radiographs (P&#xa0;=&#xa0;0.0014; odds ratio [OR]&#xa0;=&#xa0;25.5; 95% confidence interval [CI]: 2.4, 275.7) and echogenic peritoneal effusion on ultrasound (P&#xa0;=&#xa0;0.0101; OR&#xa0;=&#xa0;12.5; 95% CI: 1.3, 120.9), compared to the EO group. Heart rate (adjusted P&#xa0;=&#xa0;0.028; OR&#xa0;=&#xa0;1.07; 95% CI:&#xa0;1.0, 1.1) and vomiting severity score (adjusted P&#xa0;=&#xa0;0.028; OR&#xa0;=&#xa0;5.6; 95% CI:&#xa0;1.2, 26.1) maintained significance after multiple logistic regression. CONCLUSIONS: Multiple factors in the preoperative clinical evaluation were different between dogs undergoing EO versus EC for GIFB obstruction. However, many of these variables become insignificant with multiple logistic regression. The presence of an increased heart rate or increased vomiting severity score at presentation was independently associated with undergoing enterectomy. Prospective studies with greater number of animals are warranted to validate these results.