post-op gastrotomy case

Re: post-op gastrotomy case

Michael Woodhouse — Mon, 28 Feb 2011 22:53:58 GMT

[quote user="Hannah Chilton"]cue more metacam bashing; that's what happened last time I mentioned I gave metacam on line[/quote]

Brilliant stuff meloxicam in the cat. Has made a lot of miserable cats happy.

Re: post-op gastrotomy case

HMC — Mon, 28 Feb 2011 13:31:28 GMT

[quote user="Mark Holmes"]My feeling is that it is an abdominal wound issue. Unlikely that it would be BAR with peritonitis. Handling of the stomach could cause a pancreatitis.[/quote]

agree

Re: post-op gastrotomy case

HMC — Mon, 28 Feb 2011 13:30:27 GMT

[quote user="Gerry Henry"]Did you pack the abdo with swabs?[/quote]

It wasn't me doing the op.

The cat is doing well with syulox, baytril and metacam (cue more metacam bashing; that's what happened last time I mentioned I gave metacam on line). I guess the metacam could be obscuring any problems, but the pyrexia has now gone and the cat is comfortable on abd palpation and back to his normal self and the abdomen is not distended (just marked muscle layer swelling).

Thanks for all the tips but he didn't get to the stage of needing further tests.

Re: post-op gastrotomy case

Gerry Henry — Mon, 28 Feb 2011 11:33:41 GMT

Did you pack the abdo with swabs? Were they all present and correct? A swab in an infected (we have to assume some leakage) environment is very bad news; if the imaging/bloods are equivocal and you're still worried, go back in, you won't lose marks for being zealous. For what its worth I always give post op a/biotics if I've opened bowel.

Re: post-op gastrotomy case

Andrew Kent — Fri, 25 Feb 2011 22:47:52 GMT

Agree scan abdo and tap any fluid. Run lactate, glucose and perform cytology on fluid will give you an idea of what is going on.

Andy

Re: post-op gastrotomy case

Bob Russell — Fri, 25 Feb 2011 17:30:12 GMT

Basic haematology might be a good idea before spending vast amounts of money. Elevated wbcs possible infection. Very low wbc's all busy in the abdomen fighting an overwhelming peritonitis?

Re: post-op gastrotomy case

nikki — Thu, 24 Feb 2011 00:13:33 GMT

i wouldn't open it up yet, but i would do an ultrasound and if any free fluid present then tap it.

Re: post-op gastrotomy case

Mark Holmes — Wed, 23 Feb 2011 18:54:51 GMT

My feeling is that it is an abdominal wound issue. Unlikely that it would be BAR with peritonitis. Handling of the stomach could cause a pancreatitis.

Re: post-op gastrotomy case

bob lehner — Wed, 23 Feb 2011 17:52:28 GMT

Would suggest an abdo tap and ultrasound (or X-ray if u/s not available). Should give some clues.

Re: post-op gastrotomy case

HMC — Wed, 23 Feb 2011 17:51:30 GMT

I would have given post-op abs too. The gastrotomy was to remove tin foil so I assume that all was removed.

Re: post-op gastrotomy case

Hannah Wynne Richards — Wed, 23 Feb 2011 17:42:51 GMT

Why was the gastrotomy performed in the 1st place I wouldn't open upat this stage unless I thought I may have missed something 1st time I'm also old-fashioned enough that I would have given continuing antibiotics at the time of the operation (what a confession these days !!!!!!!!!!!!!!!!!!!) My thoughts would be peritonitis possibly responsive to the right antibiotic, possibly sterile from contamination by gastric fluids-you have to balance advantage of lavage against disadvantage of further surgery

Wynne