Peritoneal Lavage in Dogs

Peritoneal lavage is a diagnostic, surgical procedure performed to establish whether there is any free floating fluid (usually blood) in the abdominal cavity. A peritoneal lavage is used relatively early on, as it is primarily a diagnostic tool. The procedure will be performed by a vet or a specialist. Despite it being a highly accurate test for evaluating intraperitoneal hemorrhage, or ruptured hollow viscus, it is not performed frequently as abdominal sonography is increasingly being used.

Before the procedure, the dog will have been taken to the vet following visible pain, discomfort or other symptoms. The vet will then give the dog a physical examination, followed by possible tests, including blood work. Once the decision for a peritoneal lavage has been made, the procedure will take place promptly, often within days. The procedure itself will go as follows:

• The dog will be intravenously anesthetised.
• A vertical incision of the skin will be made one third of the distance from the umbilicus to the pubic symphysis. 
• The linea alba is then divided.
• The peritoneum is picked up to prevent bowel perforation.
• The peritoneum is then entered.
• A catheter will be inserted towards the pelvis and an attempt at aspiration of material using a syringe will be made.
• If no blood is aspirated, warm saline is infused. 
• After a few minutes this is drained and then sent for analysis.

Peritoneal lavage is extremely effective in attaining its goal of allowing a thorough and accurate evaluation of a hemorrhage. Due to the diagnostic nature of this procedure, plus the emphasis on safety, long-term implications are unlikely. Despite minimal risks of complications, it is extremely unlikely a dog will suffer from any permanent effects, as the procedure is used mainly for diagnostic purposes. 

There are alternatives to having a peritoneal lavage. Abdominal sonography is increasingly being used instead. This is due to the non-invasive nature of sonography. A peritoneal lavage is an invasive procedure, that comes with greater associated risks than a sonography. But, a sonography cannot provide as accurate results, as it does not allows direct access to the problem area. As  sonography is not as informative, it increases the chance of the vet missing vital information.

As a peritoneal lavage is a serious, invasive procedure, the dog will require some time before it recovers. It may need to stay in the veterinary hospital overnight, possibly for more than one night. When the dog returns home it will need time to recover in a quiet, safe space, away from other pets. The vet will likely give the dog a special diet to reduce stress on the abdomen. 

The dog will need to go back to the vet to review the results of the procedure. This is likely to happen soon after the procedure, within a week or so. How long until the dog will be fully healed depends on the condition of the dog, and what further treatment is required. It could be anywhere from a few weeks to several months. No ongoing maintenance will be required as a result of the peritoneal lavage itself. 

There are a number of costs associated with a peritoneal lavage. 

• There is the initial cost of the visit to the vets which will cost between $75 and $150. 
• The anesthetic will cost between $100 and $150.
• The procedure itself will cost between $100 and $200. 
• If the dog needs to stay in overnight, additional fees of at least $50 a night should also be expected. 
• If antibiotics or medication are needed, a further $30 to $50 a week will be required, depending on the size of the dog. 
• Follow-up visits will cost between $75 to $150 per visit. 

All of these costs will depend on the experience of the vet, and the individual case. Prices also vary depending on the location of the veterinary hospital. 

There are minimal risks associated with the procedure, just 0.8%-1.7% suffer from complications. Those complications are all short term issues, such as injury to the iliac vessels, inadequate fluid return, and bladder punctures. However, when the chances of these are around 1%, the benefits that the procedure offer far outweigh the risks. A peritoneal lavage can give a detailed and accurate diagnosis of the abdominal problem, which then allows for the most effective treatment to be administered. While there is the chance of the dog suffering from peritonitis and bleeding again in the future, it will not be as a result of the procedure itself.

When it comes to preventing peritonitis, there is little that can be done by the owner. However, one measure owners can take is to keep a watchful eye on the dog and to reduce the chance of the dog eating any sharp objects. This entails keeping children’s toys tidied away when the dog is in the same area. It also means keeping sharp kitchen utensils out of reach from the dog. This is also a measure that will reduce the chances of children or adults injuring themselves on any sharp objects.

With peritonitis and all abdominal issues, owners can ensure the dog is regularly checked at the vets and that any signs of discomfort and pain are dealt with promptly. The most effective way to prevent all illnesses is to get them diagnosed as early as possible, giving treatment the best possible chance of success. All of these measures will help, but will have a limited effect in preventing abdominal issues entirely.

Abdominal bleeding is also difficult to prevent as it frequently occurs as a result of injury or trauma. However, take your dog to the vet and enquire about diet changes. Some vets will recommend a diet alteration that will put less strain on the abdomen and may help to some degree prevent recurrent abdominal bleeds and illnesses.