Introduction

Surgical biopsy of the small intestine has a 12% prevalence of fatal enteric wound dehiscence (EWD), but no studies have specifically assessed EWD in neoplasic conditions.

Methods

Complete medical records were identified for cats and dogs undergoing small intestinal surgery at the institute between 2004 and 2011. Animals with EWD were compared with the surviving population to identify risk factors for fatality.

Results

Forty-four dogs and 31 cats underwent enteric surgery and 11 dogs and 8 cats had histopathological confirmation of neoplasia; the remainder had non-neoplastic conditions.

The prevalences of EWD for neoplastic and non-neoplastic surgical populations were 5/18 (27.8%) and 5/57 (8.8%) (P = 0.053): 3/10 (30%) and 4/34 (11.7%) in dogs (P = 0.32) and 2/8 (25%) and 1/23 (4.3%) in cats (P = 0.16).

Eight out of eleven (72.7%) dogs undergoing surgery for neoplastic conditions were euthanised before14 days postoperatively, compared with 8/33 (24.2%) undergoing surgery for non-neoplastic conditions (P = 0.009). For cats, the corresponding figures were 1/8 (12.5%) animals euthanased for neoplasia and 1/30 (3%) cats euthanased for non-neoplastic conditions (P = 0.38). The prevalence of death/euthanasia postoperatively was not related to the prevalence of EWD.

Among animals for which signalment and laboratory data were available, EWD was statistically significantly associated with lower total protein (41.86 ± 21.3 vs. 63.4 ± 13.5 g/l, p = 0.02) and a longer surgical duration (137 ± 67.3 vs. 83.9 ± 38.8 minutes, p = 0.04) compared with those without EWD.

Otherwise, no statistically significant differences were identified in any of the parameters examined for the development of fatal EWD following surgery for neoplasia, including: species (p = 0.27), age (8.29 ± 2.16 years in animals suffering from dehiscence vs. 8.29 ± 3.29 years in animals with no dehiscence, p = 0.98), weight (15.4 ± 8.38 vs. 12.23 ± 10.8 kg, p = 0.56), duration of disease before surgery (7 ± 9.5 vs. 3.15 ± 2.18 months, p = 0.17), excisional margins (3 vs. 2 histopathological reports of dirty margins, p = 0.56), preoperative albumin (23 ± 6.2 vs. 26.3 ± 6.2 g/l, p = 0.36), preoperative urea (5.9 ± 2.8 vs. 6.1 ± 6.8 mmol/l, p = 0.46), preoperative neutrophil count (16.69 ± 13.9 vs. 13.0 ± 7.4 x 10⁹/l, p = 0.49) or development of intraoperative hypotension (2 vs. 6 cases, p = 0.66).

Tumours reported included carcinoma (n = 10), lymphoma (n = 3) adenocarcinoma (n = 3), leiomyosarcoma (n = 2), adenoma (n = 1). There was no correlation between tumour type and EWD.

Conclusion

Surgery for neoplasia carries an increased risk of EWD compared with non-neoplastic surgery. EWD is more likely with elevated surgical duration, possibly reflecting surgical complexity, and low preoperative total protein. A significant number of dogs are euthanased or died within 14 days of surgery for neoplasia, even where EWD does not occur.