Sonographic Assessment Of Intestinal Layering As A Predictor For The Necessity Of Enterectomy In Dogs And Cats

The objective of this retrospective study was to evaluate the positive and negative predictive values (PPV and NPV) of sonographic evidence of intestinal wall layering damage as a predictor for the operative necessity to perform enterectomy in dogs and cats with obstructive intestinal foreign bodies. Forty seven dogs and 5 cats with sonographic evidence of obstructive intestinal foreign bodies were used in this study. Sonographic reports of patients diagnosed with intestinal foreign body and treated surgically, between the years 2013-2018 were reviewed. Subjects were divided into two groups based on the integrity of their intestinal wall layering: Group I were subjects with sonographic loss of intestinal layering (LWL) and Group II were subjects with intact intestinal layering (IWL). Records were reviewed and the surgical procedure was classified as "Enterectomy" or "Enterotomy". Sensitivity, specificity, PPV and NPV of the sonographic evidence of loss of intestinal wall layering were calculated as a predictor for the enterectomy or enterotomy procedure. Enterectomies were performed in 36% (8/35) of the IWL and 89% (15/17) of the LWL cases. The sensitivity and specificity of the sonographic evidence of loss of intestinal wall layering as a predictor of enterectomy were 66% and 94% respectively. PPV calculated to be 89% and NPV 78%. Septic peritonitis was evident in 55% of LWL and 6% of IWL surgeries. It was concluded that sonographic evidence of loss of intestinal wall layering in dogs and cats with intestinal foreign bodies may serve as predictor suggestive for the need to select enterectomy versus enterotomy at the site of the intestine with questionable viability of the intestinal wall. The prevalence of septic peritonitis in cases with sonographic evidence of loss of intestinal wall layering was relatively high. A surgeon experienced with enterectomy techniques will help provide the best prognosis to the patient.