acute peritonitis and death

[amiron]

My perfectly healthy 1y10m dog died within less than 24 hours. On Wednesday morning she had some infection. The signs were not so severe (no high fever and no malicious findings on the blood text except for high count of white blood cells). The doctor gave some painkillers and antibiotics through injection and liquid transfusion and prescribed further antibiotics (doxycycline 100mg) in capsules. However, the dog refused to eat and so she could not get the capsules. On Thursday morning we took her again to the vet. This time she had high fever. He gave her the doxycycline through injection and started to severe liquid transfusion but her brain died only minutes after the pulse and the blood pressure were found to be OK. Autopsy revealed that the death was caused by peritonitis, but there is not a clue what was the precursor of the peritonitis. It might have originated from Pancreatitits, but the blood examinations do not support this hypothesis. There is also no sign of physical trauma or accident that could have impaired the abdomen membrane.

It is now, unfortunately, all post-mortem, but do you have any idea what could prevented this gloomy result?

Thanks,
Amir

[Traci]

I'm so sorry for your loss, my heart goes out to you

Without more information, it would be impossible to guess. Where exactly was the peritonitis, was their fluid, and if so, where was it contained (abdomen, intestine, heart, etc)? Did your vet send samples to a pathologist or did he simply make a guess on preliminary findings? What were the original symptoms that prompted the initial vet visit? (vomiting, diarrhea, lethargy, etc). What was the pain medicine prescribed, and for what purpose?

[amiron]

The vet made the autopsy at his clinic. He discovered that both the Pancreas and the internal abdomen were digested to the extent that they were rotten. The cause of this demolition was a germ that in ordinary condition is restricted to the intestines. The vet could not tell how this germ had gotten out.
I initially brought the dog to the clinic because it did not want to eat or go out and looked depressed
Under different circumstances, I would have asked for a second opinion, but since the disease took less than 24 hours - most of which without high fever or lethal signs and half of which during the night - I simply did not have enough time.
It won't save my dog, but I would like to know what went so wrong.


Amir

[Traci]

Only a guess, but it sounds like ischemic pancreas or bowel or intestine, in which there may have been an abcess or leak that allowed septic bacteria to escape and cause DIC (disseminated intravascular coagulation). I would guess a more scrutinizing examination on the organs would lead your vet to the exact cause (i.e., tear or rupture), but ultimately, a pathologist could tell your vet more with special staining techniques, examination of fluids, etc, and cultures for bacterial causes.

Since your dog was so young, it wouldn't seem likely that this was an inheritable disease, but may have been an acute onset from a rupture that ultimately caused septicemia. I wouldn't be able to guess at what could cause such an acute onset, only a pathologist could determine that. Simpler rule outs might be toxins, rancid foods, raw meat or bone fragments, bacteria from rancid foods, etc, but most of these should have been ruled out upon the necropsy.

I can understand your need for closure, but please be prepared that there may not be a full explaination without a pathologist's examination and opinion. As tragic as your loss is, it doesn't sound like there was anything you could have done to prevent it. What you did do was recognize an emergency, you acted and responded and did the very best you could do for your baby, I'm sure she knew that.....

(((HUGS))) to you in this difficult time...

[k9Karen]

I can't offer anything about the cause beyond what Traci has said, but I wanted to express my heart-felt condolences on your loss. It's always hard to lose someone we love. Everyone on this board understands the pain of losing a furry friend all too well. Please don't blame yourself or the vet. This progressed way too fast for anything to have made a difference. It is unfortunate, but sometimes, there really is nothing we can do, and you did everything you knew to do and you did it right.

Take care

[amiron]

Thanks for all your condolences. They mean a lot.

What I still ask myself is what was the precursor. The autopsy ruled out external factors (poisoning, bad food and so forth) for the attack, but it did not tell what was responsible for the infection.
The bottom line of the report was that both the Pancreas and the internal abdomen were too ruined and too rotten to tell. What does it leave me with besides enormous grief?

Amir

[k9Karen]

I wish I could answer your question. I really don't know if anyone can. That's what makes things like this so hard. Not knowing is often worse than knowing. There are any number of guesses, but, if your vet couldn't determing the cause from the necropsy, it is unlikely that you will ever know. Anything that caused a 'leak' of intestinal bacteria into the abdomen could be the problem - something he ate, a blockage or intestinal torsion, a congenital or hereditary disorder, etc. There are probabley at least a dozen or more possibilities. Were any tissues sent for analysis to a pathologist? Even that may not give you an exact answer. The pathologist can determine the type of damage, but may not be able to determine the starting point.

It will take time to get over this. Let yourself grieve. I understand the terrible pain, and knowing why will not take it away. Only time can do that for you. It is hard to believe it now, but, in time, this will not be as bad as it is today. Take care

[Traci]

Amir, without a full pathology, as Karen notes, you may never know the true cause. The pathologist could utilize special tests that your vet isn't equipped with and may be able to offer some explaination your vet couldn't find.

I do not think you could have prevented this. Unless you intentionally fed your dog contaminated meat, bones, etc, the source of infection could have been from nearly anything. It could have been a weakened muscle or tissues somewhere that you may never have been able to detect, it could have been a silent infection once that turned severe, unbeknownst to you. It could be numerous things that even had you known, there still may have been no effective treatment for it in time.

If you question yourself, you will drive yourself crazy with unexplainable what-if's. Sometimes things happen beyond our control or depth of knowledge and understanding. What is better is to accept that you did everything you could do in your power for your baby, and allow yourself to grieve and remember the cherished times you had together. She knew how much you loved and cared about her.

In time, perhaps you can take in another puppy or dog, it's obvious you have much to give another in need.

(((HUGS)))

[Magnum's Mom]

I am sorry you lost your sweet girl so tragically. Our dogs love and trust us unconditionally and we feel 100% reponsible for their well being. Unfortunately, they can't tell us where they are hurting and cover up their pain and weakness to please us. When we figure out that something is wrong, we take our furbabies to the vet. Again, they can't tell the vet what is hurting and they cover up their pain and weakness. The vet doesn't have X-ray vision. It's been my experience that, no matter how many diagnostic tests we have done, the results are sometimes "inconclusive." When all our efforts at finding a diagnosis and treatment fail and we lose a precious furbaby, we are left with a whole in our heart as big as the world. We are devastated by the loss and not knowing what went wrong.

At some point we have to give up on knowing why and deal with loss. You miss your sweet girl and she is never coming back to you in her earthly form. She will live in your heart forever and the sweet memories will always be with you.

Best wishes.