A perforated bowel in dogs is a serious condition that can have potentially life threatening consequences. If you suspect your dog has a perforated bowel, please see your vet immediately. A perforated bowel in dogs can be caused by ingesting sharp items such as bones, pieces of toys or plastic, sticks and parts of beer cans or it can happen as a result of external traumatic injury such as being hit by car and other penetrating injuries. Immediate veterinary treatment is important to prevent serious complications.
Causes of Perforated Bowel
There are several potential causes for a perforated bowel in dogs. As mentioned, the bowel may perforated because of ingesting items that are sharp or because of some type of traumatic injury (penetrating stick, bite wounds, stab wounds, gunshot) leading to penetrating injuries in the abdomen.
At times, a perforated bowel may result from a surgical complication, a deep ulcer (often due to giving aspirin, non-steroidal anti-inflammatory drugs, and steroids,) ingestion of a caustic substance, a tumor that weakens the bowel, or an intestinal blockage in dogs that goes untreated.
If there is something stuck in a dog's bowel, without surgery to remove the stuck item, the obstruction may lead to septic peritonitis which can lead to death, explains veterinarian Dr. Gary.
Risk for Peritonitis
When a dog develops a perforated bowel, there are risks for the development of peritionitis. Peritonitis is the inflammation of the peritoneum, the layer of tissue lining the abdomen and all the enclosed organs.
This complication may happen when the perforated bowel results in leakage of the bowel's contents into the peritoneum. Peritonitis can occur as a result of bacteria, bile, stomach acid, partially digested food or stool, leaking and causing inflammation. Left untreated, peritonitis may progress to septic peritonitis, a life-threatening infection in the bloodstream.
Symptoms of Perforation
In dogs who have ingested foreign items, owners must be watchful for signs of a potential obstruction which can progress to perforation of the intestinal tract.
These initial signs include loss of appetite, vomiting, diarrhea or constipation, explains veterinarian Dr. Peter.
Dogs who have ingested sharp items and are at risk for perforation, and its associated peritonitis, will generally develop worrisome signs such as loss of appetite, lethargy, severe abdominal pain, collection of fluids in the dog's abdomen (dog ascites) reluctance to move, assuming a “praying position,"abdominal tenderness, trouble breathing, fever, increased breathing rate or trouble breathing, and signs of shock such as increased heart rate, slow capillary refill time, poor pulse, pale gums and low body temperature.
If the dog underwent recent intestinal surgery, a worrisome symptom is the presence of fluids leaking from the surgical wound (wounddehiscence).
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Diagnosing the Perforation
When a dog presents for a potential perforation, the vet may perform several diagnostic tests. The vet may choose to do X-rays or an ultrasound so to examine the bowel and determine whether there is an actual perforation or potential risk for it.
The x-rays or ultrasound are best done by an experienced radiologist so to determine whether there is presence of free air in the abdomen, a sign that is strongly indicative of a perforation with possible gastrointestinal leakage.
Barium studies are not a good choice if there are risks for a perforation as the barium may leak out of the perforated bowel which is difficult to remove and risks increasing the dog's mortality rate, explains Coby Richter, a board-certified veterinary surgeon.
"If I examined your dog and was concerned that a bone had perforated the stomach.. I would take x-rays of her belly to look for "free gas" in her abdomen. If I saw this, I would very quickly start her on antibiotics and take her to surgery." ~Dr. Fiona, veterinarian
Every Second Counts
If you suspect your dog has a perforated bowel, consider that every second counts. Consider that if you are really dealing with a perforation, every hour you wait lowers the chances for survival, warns veterinarian Dr. Marie.
For this reason, in the case of a suspected foreign body, it is best to not take any chances and have surgery done right away. The vet will perform surgery to find the source of the perforation and repair it surgically.
Dogs with a blockage and potential for a perforated bowel can go downhill quickly so best to take action quickly.
Surgery in presence of a perforation and peritonitis is not without complications ( intestines may need re-sected and a 3 to 7 day stay in the hospital may be required), and therefore, if feasible, it's important to prevent things from progressing to such state.
"Perforations are not automatically a fatal condition, but do require aggressive treatment...This issue can be treated successfully in many cases -- I'd say there's probably about a 80-90% success rate IF there's no cancer present. If cancer is present, then unfortunately the prognosis is much worse."~Dr. Drew
- Gastrointestinal Causes of Peritonitis, Jacqui Niles, BVetMed, Cert SAS, DACVS Metropolitan Veterinary Associates, Valley Forge, PA
- Dove Lewis: Septic Peritonitis in Dogs and Cats