Research Update: Effects of extensive small bowel resection in dogs and cats

Small-animal practitioners commonly evaluate patients because of foreign body ingestion, and subsequent small bowel resection is a common treatment. Extensive (≥ 50%) removal of the small intestine can produce small bowel syndrome, a condition characterized by malabsorption, weight loss, and fluid and electrolyte imbalances. Thus, extensive small intestinal resection is uncommon in small-animal practice, possibly because dogs and cats with lesions that require extensive resection are euthanized because of a perceived poor prognosis.

In this retrospective case series, the medical records of 13 dogs and seven cats that underwent extensive resection of the small intestine were reviewed to identify the patients' outcomes and the factors associated with these outcomes. The dogs were significantly older (median = 4 years) than the cats (median = 1 year). All of the patients had vomiting as the initial clinical sign. In all of the cats and eight of the dogs, intestinal resection was performed because of a foreign body.

Mean (± SD) percentage of intestine resected was 81% (± 8%) in cats and 61% (± 12%) in dogs. The median hospital stay was three days for the cats and four days for the dogs, and partial or total parenteral nutrition was administered to four dogs and one cat. Three dogs died or were euthanized without being discharged from the hospital because of surgery site dehiscence and septic peritonitis (two dogs) or respiratory distress syndrome (one dog). Two cats were lost to follow-up after surgery.

Follow-up information was available for 10 dogs and five cats. The median survival time was 995 days for dogs and 774 days for cats. Owners reported good outcomes in eight dogs and four cats. Two dogs and one cat had poor outcomes; they were euthanized because of diarrhea and weight loss, diarrhea and dyschezia, and diarrhea and dehydration. The authors concluded that in these cases no association existed between outcome and age, underlying cause, or amount of intestinal resection. Although complications occurred after surgery, most patients were discharged and had good outcomes.

COMMENTARY

Although this study involved only 20 cases, this article provides evidence that animals can survive and have an acceptable quality of life after extensive small bowel removal. Furthermore, good outcomes were not based on prolonged hospitalization (≥ four days) and intensive care that might be considered unrealistic in some general practices. Note that in this study a portion of the ileum or ileocolic valve was removed in only four cases, and the outcome was not clearly delineated—resecting these structures has been previously associated with a poor prognosis.

Gorman SC, Freeman LM, Mitchell SL, et al. Extensive small bowel resection in dogs and cats: 20 cases (1998-2004). J Am Vet Med Assoc 2006;228:403-407.

The information in "Research Updates" was provided by Veterinary Medicine Editorial Advisory Board member Joseph Harari, MS, DVM, DACVS, Veterinary Surgical Specialists, 21 E. Mission Ave., Spokane, WA 99202.

Joseph Harari, MS, DVM, DACVS