Abdominal computed tomography and exploratory laparotomy have high agreement in dogs with surgical disease

Julia J. Sevy DVM , Robin White DVM, MSc, DACVR , Shannon M. Pyle BS , and Adrien Aertsens DVM, MRCVS, DECVS

Background: Surgical abdominal disease in dogs can be diagnosed by various imaging modalities, such as radiography, ultrasonography, and computed tomography (CT). CT is considered the gold standard for human patients with acute abdominal pain, but its agreement with exploratory laparotomy in dogs is unknown.

Study: The objective of this study was to compare the results of abdominal CT with exploratory laparotomy in 100 dogs with surgical disease. The authors hypothesized that CT is a sensitive screening tool for presurgical diagnoses of abdominal conditions and that subsequent exploratory laparotomy would yield similar conclusions and diagnoses without significantly impacting the surgical plan.

Methods: The authors retrospectively reviewed the medical records of dogs that had undergone a preoperative abdominal CT scan read by a board-certified radiologist followed by an exploratory laparotomy at one academic institution. CT and surgical reports were compared for agreement, defined as no intraoperative change in the diagnosis, surgical plan, or prognosis compared with the original CT findings. The authors also analyzed the association between agreement and the predictors of body condition score, time interval between CT and surgery, and disease process (oncologic vs nononcologic).

Results: The overall agreement between abdominal CT scan and exploratory laparotomy in all cases was 97%. There was no evidence that proportion agreement differed on the basis of the predictors. Surgical findings disagreed with CT scan conclusions in 3 cases, involving a traumatic diaphragmatic hernia and prepubic tendon rupture, a gastric polyp, and a pancreatic islet cell tumor with splenic and hepatic nodules.

Limitations: The study had some limitations, such as a biased patient population, confounding by surgeon knowledge of the CT findings prior to surgery, variability in surgeon and radiologist experience, and a large range of time between CT scan and surgical intervention.

Conclusions: The study found high agreement between abdominal CT and surgical findings in dogs, suggesting that performing a smaller approach to a specific organ of interest instead of a full abdominal exploration is acceptable in dogs with surgical disease and a preoperative CT scan. Further studies are needed to support and strengthen this conclusion.

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