Septic peritonitis in cats: antibiotics and source control
7-year-old cat operated on 3 days ago for an intestinal foreign body. It presents depressed, with abdominal pain, hypothermia, bradycardia and a systolic pressure of 75 mmHg. Abdominocentesis shows degenerate neutrophils with intracellular bacteria: enterotomy dehiscence.
What is the most appropriate plan?
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A. Antibiotics and fluids for 24–48 hours, and operate only when completely stable and normotensive
While the intestinal leak remains open, contamination continues and the patient will rarely fully stabilise. Delaying source control worsens survival.
B. Medical treatment with culture-guided antibiotics and percutaneous abdominal drainage, without surgery
Percutaneous drainage does not close the perforation. In septic peritonitis from an intestinal leak, definitive treatment is surgical.
C. Take her to theatre immediately, without prior fluids or antibiotics, so as not to lose time
Anaesthetising a hypotensive, hypothermic, bradycardic cat without resuscitation greatly increases the risk of arrest. A brief, targeted resuscitation is needed first.
D. Take culture samples, start broad-spectrum intravenous antibiotics within the first hour, resuscitate with fluids and warming, and operate as soon as she is reasonably stabilised
Correct. The priorities in sepsis are resuscitation, early antibiotics (every hour of delay worsens survival) and source control within a few hours. If hypotension does not respond to fluids, a vasopressor is added and surgery still goes ahead.
lightbulb Key takeaway
Take cultures before antibiotics, but do not wait for the results: start broad-spectrum and de-escalate later according to sensitivity. In cats, sepsis often presents with bradycardia, hypothermia and hypotension, and feline SIRS criteria account for this. Enterotomy dehiscence typically appears 3–5 days after surgery.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.