Enterectomy and short bowel syndrome

Re: Enterectomy and short bowel syndrome

Sean Henney — Tue, 04 Nov 2014 22:21:16 GMT

'Personally I use chlorhexidine and don't wear gloves and I just don't get wound infections.'

That was your comment in the thread about surgical scrubs-now it's become a rare occurrence. Perhaps one only remembers the really outstanding cases-not the daily grind?

Re: Enterectomy and short bowel syndrome

Martin Atkinson — Tue, 04 Nov 2014 18:33:57 GMT

[quote user="Malcolm Ness"] I believe that the most common reason for animal interference is infection.[/quote]So I presume that as, with very few exceptions, the only patients of mine which get a wound infection are those that get their E collars off (or the owner took them off), the reason they got them off was so they could lick at their already infected wound? Interesting proposition.

Re: Enterectomy and short bowel syndrome

Malcolm Ness — Tue, 04 Nov 2014 18:00:01 GMT

[quote user="Martin Atkinson"]That is somewhat different to those secondary to animal interference as you well know.[/quote]

On the contrary, I believe that the most common reason for animal interference is infection.

Re: Enterectomy and short bowel syndrome

Martin Atkinson — Tue, 04 Nov 2014 16:32:04 GMT

[quote user="Malcolm Ness"]

[quote user="Martin Atkinson"]till a risk of wound infection.[/quote]

You never have surgical infections, so how do you know?

[/quote]Naughty Malcolm. Lets define it shall we?: I very rarely get wound infections secondary to surgery which I would hope would be in common with any competent surgeon. That is somewhat different to those secondary to animal interference as you well know. But I'll spare you asking: how do I know which are which?!

Re: Enterectomy and short bowel syndrome

Malcolm Ness — Tue, 04 Nov 2014 16:19:59 GMT

[quote user="Martin Atkinson"]till a risk of wound infection.[/quote]

You never have surgical infections, so how do you know?

Re: Enterectomy and short bowel syndrome

Malcolm Ness — Tue, 04 Nov 2014 16:19:38 GMT

[quote user="Martin Atkinson"]till a risk of wound infection.[/quote]

You never have surgical infections, so how do you know?

Re: Enterectomy and short bowel syndrome

Evelyn Barbour-Hill — Tue, 04 Nov 2014 15:49:57 GMT

[quote user="Martin Atkinson"]Evelyn, you only need one dog to do what the Yorkie in my earlier post did to realise that even if 99.99% of your patients don't interfere with their stitches it 'aint worth taking the chance![/quote]

Well, if you do sums i think it would work out that it is worth "taking the chance" .

I haven't put a lampshade on a dog for 31 years.

Re: Enterectomy and short bowel syndrome

Martin Atkinson — Tue, 04 Nov 2014 13:49:37 GMT

[quote user="Robin Grimmer"]intra-dermals?[/quote]Still a risk of wound infection. Plus, I'm competing with the stack 'em high and sell 'em cheap boys down the road and do a lot of charity spays and they won't stretch to a reel of Vicryl Rapide I'm afraid.

Re: Enterectomy and short bowel syndrome

Robin Grimmer — Tue, 04 Nov 2014 11:37:42 GMT

[quote user="Martin Atkinson"]

Evelyn, you only need one dog to do what the Yorkie in my earlier post did to realise that even if 99.99% of your patients don't interfere with their stitches it 'aint worth taking the chance![quote user="Evelyn Barbour-Hill"]

[quote user="Martin Atkinson"] send everything home with a Buster collar..[/quote]

Are you trying to wind me up?

[/quote]

intra-dermals?

Re: Enterectomy and short bowel syndrome

Martin Atkinson — Tue, 04 Nov 2014 10:00:26 GMT

[quote user="Martin Atkinson"] send everything home with a Buster collar..[/quote]

Are you trying to wind me up?

[/quote]

Re: Enterectomy and short bowel syndrome

Evelyn Barbour-Hill — Tue, 04 Nov 2014 01:18:08 GMT

[quote user="Martin Atkinson"] send everything home with a Buster collar..[/quote]

Are you trying to wind me up?

Re: Enterectomy and short bowel syndrome

Martin Atkinson — Mon, 03 Nov 2014 16:28:51 GMT

Wasn't meant as a pun - honest!

Once bitten twice shy though (no not a pun either) although its a good reason to send everything home with a Buster collar..

Re: Enterectomy and short bowel syndrome

Evelyn Barbour-Hill — Mon, 03 Nov 2014 15:48:32 GMT

[quote user="Martin Atkinson"]ate its own intestines[/quote]

[quote user="Martin Atkinson"] suck it and see situation[/quote]

Re: Enterectomy and short bowel syndrome

Martin Atkinson — Mon, 03 Nov 2014 13:01:53 GMT

I took twelve inches of jejunum out of a Yorkshire Terrier that herniated its guts when it chewed its sutures out after a bitch spay and ate its own intestines!! Did very well.

This is surely a suck it and see situation. If you have to do the surgery then at least the dog has a chance which it would not have done if you left it.

Re: Enterectomy and short bowel syndrome

Alastair Franklin — Mon, 03 Nov 2014 04:15:58 GMT

Unfortunately there is no magical figure - depends on multiple factors, such as how much, what part of the intestine, possibly the age of the patient and also time permitted for adaptation. The figure of 80% comes from a paper from the 1950s - in puppies, 80% led to acceptable growth, however 90% led to high rates of morbidity and mortality. I don't recall if it has been explicitly reported in dogs, but in humans there are greater effects if you resect the duodenum / proximal jejunum.

I think given the age, some degree of SBS is possible, however you may be pleasantly surprised , especially given it was jejunum only, and the intestine would have had a chance to recover (to a degree) from the early episode. I'd be more concerned about a lab not eating 36hrs post-op - how is he doing?

Re: Enterectomy and short bowel syndrome

No Name — Sat, 01 Nov 2014 12:54:34 GMT

In lectures not long ago I was told that short bowel syndrome occurs after >80% of the SI is removed so it seems like there is quite a large reserve capacity. Hope that helps? Not sure how many meters of SI are in an average sided lab though....