Assessing major influences on decision-making and outcome for dogs presenting emergently with nontraumatic hemoabdomen

Abstract

Abstract OBJECTIVE To evaluate factors contributing to owner decision-making, satisfaction, and perception of quality of life (QOL) with treatment of dogs with nontraumatic hemoabdomen (NTH). ANIMALS 132 client-owned dogs. PROCEDURES An electronic survey was administered to owners of 436 dogs that presented emergently with NTH to a single institution between January 2015 and May 2022. Following survey response, retrospective data collection was performed. RESULTS Owners reported QOL as the most important factor influencing their decision-making (92%), followed by risk of cancer (57%) or time remaining with their pet (56%). QOL scores were significantly higher with surgery versus those with palliative care (P = .007). Median survival time (MST) was 213 days with surgery and 39 days with palliative care (P = .049). Survival benefit of surgery was lost when considering only dogs with malignant histopathology (MST, 81 days; P = .305). Owners were more likely to be satisfied when they chose surgery over either euthanasia or palliative care (P = .039). Thirty-four owners (26%) second-guessed or were unsure of their decision. CLINICAL RELEVANCE Surgery resulted in the longest MST with greater perceived QOL and owner satisfaction compared with both palliative care and euthanasia and should therefore be considered highly. The importance of malignancy and survival time on owners’ decisions, along with the negative impact of metastasis on survival, underscores the importance of timely preoperative staging. The rate of second-guessing highlights the need for standardization of NTH discussions including treatment options and potential outcomes in order to effectively and efficiently guide treatment of patients with this common presentation.