A 7-year-old spayed female Maltese dog was presented with recurrent gastrointestinal symptoms of ileal obstruction. Two weeks earlier, the dog underwent an initial exploratory laparotomy at a local clinic to remove an obstructive fecal mass containing hair from the ileum, temporarily relieving symptoms. Ten days later, anorexia and vomiting recurred, prompting referral to KU-VMTH. Physical examination revealed tachycardia (192bpm), 5% dehydration, and a systolic blood pressure of 145mmHg. Bloodwork indicated leukocytosis, anemia, and thrombocytosis, while serum chemistry analysis showed hypocalcemia, hypophosphatemia, and low total T₄. Imaging suggested ileal obstruction, necessitating a second laparotomy at the Konkuk University Veterinary Medical Teaching Hospital (KU-VMTH), Seoul, Republic of Korea, for confirmatory diagnosis and treatment. Postoperatively, the dog developed hypotension and hypothermia, and septic shock was suspected, which was confirmed through Enterobacter cloacae isolation from blood culture. The dog received partial parenteral nutrition (5% dextrose, amino acids and lipids), gastrointestinal protectants (pantoprazole, almagate), prokinetics (metoclopramide), antibiotics (cefotaxime, enrofloxacin, and metronidazole), and an appetite stimulator (mirtazapine). Hypothyroidism was suspected as the underlying cause of impaired intestinal motility, and levothyroxine therapy was initiated. The dog gradually stabilized and fully recovered, with normalized thyroid levels and no gastrointestinal signs one year post-surgery.

To Cite This Article: Choi HJ and Han HJ, 2025. Successful Management of Recurrent Ileal Fecaloma and Sepsis in a Dog with Primary Hypothyroidism: A Case Report. Pak Vet J. http://dx.doi.org/10.29261/pakvetj/2025.111