🔍 Key Findings

• Peritoneal effusion cytology remains the most rapid and reliable diagnostic for SP; detection of intracellular bacteria is highly specific (100%) and sensitive in dogs and cats.
• Blood-effusion glucose difference >20 mg/dL has 100% sensitivity and specificity for SP in both dogs and cats, but point-of-care glucometers may falsely elevate effusion glucose.
• Preoperative stapled intestinal anastomoses have lower dehiscence rates than handsewn in dogs with SP in some studies, especially in unstable patients.
• Fluorescent angiography may outperform visual/palpatory assessment in determining intestinal viability during surgery.
• Omentalization and serosal patching offer reinforcement for intestinal repairs in SP; experimental studies show improved healing, though clinical data are limited.
• Open abdomen with VAC therapy offers comparable survival to closed methods, with potential benefits including improved peritoneal healing and drainage.
• Closed suction drains show survival rates ranging from 52–100% in dogs and cats with SP; concerns exist about nosocomial infections, but survival was not consistently affected.
• Lavage with saline is standard (200–300 mL/kg), but risks include mesothelial irritation and cytokine spread; buffered solutions like LRS or Plasmalyte may be superior.