Presentation, diagnosis, and management of gossypibomas in veterinary specialty hospitals: A multi-institutional study of 21 cases

Abstract

Objective: To report the incidence, management, and outcomes of gossypibomas encountered in veterinary specialty hospitals.

Study design: Multi-institutional, retrospective study.

Animals: A total of 21 client-owned animals (18 dogs, 3 cats).

Methods: A spreadsheet was generated and distributed to veterinary specialty institutions for case recruitment and evaluation of animals with histopathologic diagnosis of a gossypiboma.

Results: A total of 15 of 21 animals were female, and 11/15 females had ovariohysterectomies resulting in their gossypiboma. Median time to representation after initial surgery was 13.5 days (IQR: 4-90). Duration of clinical signs prior to representation was a median time of 5 days (IQR: 1.5-11), and the clinical signs included pyrexia (10), abdominal discomfort (8), lethargy (7), and anorexia (7). The secondary surgery was performed on an urgent basis in 10/21 animals. Animals were hospitalized for a median time of 5 days (IQR: 1.5-11) postoperatively. Postoperative complications occurred in 4/21 animals and included sepsis (1), urinary and fecal incontinence (1), persistent anorexia (1), and aspiration pneumonia (1). A total of 19 of 21 animals survived to discharge.

Conclusion: Majority of animals had intraabdominal gossypibomas and frequently presented for non-specific clinical signs. Surgical treatment was commonly performed within 1 month prior to re-presentation. Surgical management yielded a good long-term prognosis but may need to be performed urgently. Postoperative complications may be associated with the gossypiboma or the additional surgical intervention required for removal.

Clinical significance: Gossypibomas are preventable postoperative complications that can result in high morbidity and mortality but carry a favorable long-term prognosis following surgical excision.