Peritonitis

Peritonitis (peritoneal inflammation) – that sounds abstract, but it is one of the most serious diagnoses a dog can receive. The peritoneum is the mucous membrane that lines the entire abdominal cavity and envelops the internal organs. If it becomes inflamed – whether acutely or insidiously chronically – there is almost always an infection or injury within the abdominal cavity behind it. Anyone who comes to the vet with a dog that is lethargic, barely eats and has a hard belly sometimes experiences how quickly a diffuse suspicion can turn into an emergency. Peritonitis does not tolerate delay: untreated, it can lead to organ failure and death.

Causes of Peritonitis in Dogs

Several triggers are possible – and sometimes they interact:

1. Gastrointestinal perforations: Swallowed foreign bodies, tumours or gastric ulcers can perforate the intestinal wall. Bacteria and digestive fluids then enter the abdominal cavity directly – with devastating consequences.
2. Trauma or injuries: Car accidents, kicks or even surgical interventions can damage the abdominal wall or internal organs. Sometimes you only notice this hours later from the dog’s reaction.
3. Infections: Bacteria find their way into the abdominal cavity – either via a perforation of the gastrointestinal tract or as a complication after surgery.
4. Rupture of the gallbladder or bladder: If the gallbladder or urinary bladder ruptures, bile or urine spills into the abdominal cavity. Both trigger a severe inflammatory reaction.
5. Pancreatitis: A severe inflammation of the pancreas rarely remains confined to the organ itself – it can spread to surrounding tissue and affect the peritoneum.
6. Abscesses or tumours: If an abscess (an encapsulated collection of pus) or a tumour in the abdominal cavity bursts, fluids are released that can trigger peritonitis.

Symptoms of Peritonitis in Dogs

The symptoms vary depending on the cause and severity:

• Severe abdominal pain: Dogs often show a tucked-up abdomen, sensitivity when touching the abdomen or a hunched protective posture.
• Vomiting and diarrhoea: Common symptoms, especially if the inflammation affects the gastrointestinal tract.
• Loss of appetite and weakness: Affected dogs lose their appetite and appear lethargic.
• Fever: An elevated fever indicates infection in the body.
• Dyspnoea and rapid breathing: In severe cases, breathing difficulties can occur because the inflammation can affect the chest cavity.
• Pale gums and circulatory problems: Pale or bluish gums indicate circulatory problems due to shock.
• Swelling in the abdominal area: Visible swelling can indicate fluid accumulation (ascites) in the abdominal cavity.

Diagnosis of Peritonitis in Dogs

To reliably diagnose peritonitis, several examination steps are required – the vet proceeds systematically:

1. Clinical examination: First, the abdomen is palpated: Is it painful? Is it tense or swollen? At the same time, heart rate, respiratory rate and temperature are checked – vital signs often reveal how serious the situation already is.
2. Blood tests: Blood analysis provides important clues. Elevated white blood cells indicate inflammation or infection; if signs of sepsis (blood poisoning) are also present, this is a warning signal that requires immediate action.
3. X-rays or ultrasound: Imaging techniques make visible what remains hidden from the outside – free fluid in the abdominal cavity, air in unusual places or altered organs.
4. Abdominal tap: If there is a specific suspicion, a sample of abdominal fluid is taken and examined for bacteria, inflammatory cells or other abnormal substances. This procedure often provides the decisive confirmation.
5. Exploratory surgery: Sometimes none of this is enough. Then the vet opens the abdominal cavity directly – to find the cause and treat it in the same procedure.

Treatment of Peritonitis in Dogs

There is no one-size-fits-all solution – therapy depends on the cause, but one thing is almost always the same: The dog needs intensive care, and quickly.

1. Stabilisation and shock treatment: Many dogs are already in a state of shock upon admission. Fluids are administered via intravenous access to stabilise blood pressure and circulation – this is the first, life-saving step.
2. Antibiotics: Broad-spectrum antibiotics are used to combat the bacterial infection in the abdominal cavity.
3. Pain management: Peritonitis is extremely painful. Strong painkillers are not a luxury but necessary – also so that the dog can tolerate the rest of the treatment at all.
4. Surgical intervention: In most cases, there is no way around emergency surgery. The cause – whether perforation, abscess or ruptured organ – must be addressed directly. The abdominal cavity is thoroughly flushed and cleaned in the process.
5. Drainage and flushing: If fluid has accumulated (ascites), a drain is placed to remove it and support the healing process.
6. Intensive post-operative care: The real work begins after surgery. Fluid administration, regular blood checks and continuous monitoring of vital functions are essential in the first few days.

Prognosis for Peritonitis

The outcome depends on several factors: severity of the disease, timing of diagnosis, and speed of treatment. Dogs that receive veterinary care early have significantly better chances of recovery. If you wait too long, organ failure, sepsis, and in the worst case, death are imminent. This is not dramatization – it is the medical reality of this condition.

Prevention of Peritonitis

Peritonitis cannot always be prevented, but the risk can be specifically reduced:

1. Avoid foreign bodies consistently: Small objects – toy parts, bone splinters, corks – have no place within the dog’s reach. What the dog swallows can cause a perforation in the gastrointestinal tract.
2. Careful aftercare following operations: After every surgical procedure, the dog requires close monitoring. This ensures that infections or suture issues are detected early, before they escalate.
3. Taking gastrointestinal problems seriously: If you observe regular vomiting, loss of appetite, or signs of stomach ulcers in your dog, you should not wait. Early treatment can prevent a perforation from developing.