Canine Septic Shock Treatment

The principal and most important aspects of treatment of the septic dog include drainage of the septic focus, appropriate antibiotic treatment and aggressive fluid therapy. Low-output sepsis may be nothing more than inadequately resuscitated high-output sepsis.

Drainage of the septic focus is mandatory. Drainage may entail lancing an abscess or maintaining open abdominal drainage for peritonitis. Wounds and drainage should be cultured for aerobic and anaerobic bacteria, and the dog should be started on appropriate antimicrobial therapy with a bactericidal antibiotic. Pending the results of culturer and sensitivity, antibiotic choice location may be based on Gram Stain previous experience, and location of the septic focus. Otherwise, combinations ofof ampicillin and gentamicin, or cefazolin, metronidazole and gentamicin or cefotetan provide coverage against a broad spectrum or aerobic and anaerobic bacteria. Antibiotics are continued until the temperature and white blood cell count have returned to normal.

Pulmonary damage and pulmonary hypertension also occur in septic shock; the etiology is not known. The dog is monitored for signs of pulmonary edema (increased respiratory rate, moist rales, radiography), and if pulmonary edema occurs, less aggressive fluid therapy is indicated. Positive end-expiratory pressure respiration has been recommended if respiratory distress is suspected.

Metabolic support is frequently necessary to arrest protein catabolism is septic shock. Intravenous hyperalimentation, possibly with branched-chain amino acids is recommended. Use of antiserum to the lipopolysaccharide core of endotoxin may be promising. Use of glucose-insulin-potassium mixtures may also be beneficial.