Article

Gastrointestinal foreign bodies in dogs and cats: A retrospective study of 208 cases

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Abstract

To establish predilection sites of obstruction and to investigate clinical factors associated with a poor outcome. A retrospective study of 208 consecutive cases over a 48-month period from first-opinion practice. Overall, 91 per cent of cases recovered with higher survival rates from discrete foreign bodies (94 per cent in dogs and 100 per cent in cats) as opposed to linear foreign bodies (80 per cent in dogs and 63 per cent in cats). English bull terriers, springer spaniels, Staffordshire bull terriers, Border collies and Jack Russell terriers were over-represented. In dogs, 63 per cent of obstructions occurred in the jejunum but foreign objects were encountered at all points along the gastrointestinal tract. A longer duration of clinical signs, the presence of a linear foreign body and multiple intestinal procedures were associated with significantly increased mortality. Neither the degree of obstruction (partial or complete) nor the location of the foreign body was shown to have a significant influence on survival. Prompt presentation, diagnosis and surgical intervention improve the outcome of gastrointestinal obstruction by foreign bodies. At surgery, the minimal number of intestinal procedures should be performed to restore the integrity of the alimentary tract.

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... In cases that the foreign bodies are small and have no sharp part, no symptoms can be observed. However, complications such as peritonitis, abscess, and septicemia can occur in the case of gastric ruptures associated with foreign bodies (1,4,8,9,10). ...
... Endoscopic methods are frequently used to remove gastric foreign bodies. However, in cases that foreign bodies have sharp surfaces, gastrotomy operations are preferred to avoid the risk of damage to the stomach and esophagus (8,10,12). Gastrotomy operations have significant advantages over enterotomy operations. For example, the vascularization of the stomach is greater than that of the intestines, resulting in a shorter recovery time. ...
... Foreign bodies with a cutting and penetrating s u r f a c e c a n c a u s e p e r f o ra t i o n s i n t h e gastrointestinal tract. In cases with perforation, fatal complications such as peritonitis, intraabdominal abscess and generalized septicemia may occur (1,5,8,10). In this study, it was found that the foreign body encountered in the stomach of the cat did not cause perforation in the digestive system, although it had a sharp surface. ...
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Article
In this study, information was given about the diagnosis and treatment of a 2-month-old female cat that was admitted to the clinic with the complaint of swallowing a foreign body (earring). The medical history of the case indicated that the cat had a good appetite and defecated normally. Abdominal palpation showed a distended stomach. No clinical findings other than the distended stomach were noted during clinical examination. Radiographic examination revealed a foreign body with hyperechoic contrast in the stomach. Due to the presence of a penetrating foreign body, it was decided to urgently perform an operation. For the operation, the cat was anesthetized with xylazine and ketamine. The foreign body (earring) in the stomach was removed from the body by gastrotomy. Special diet and parenteral antibiotics were applied to the patient in the postoperative period. During the interviews with the owner on the 15th postoperative day, it was learned that the cat continued its normal life.
... Thus, the intestines get compressed due to LFB and causes plication. As a result, perforation may occur in the intestines (Aronson et al., 2000;Hayes, 2009). ...
... It has been reported that LFB obstructions are more common in cats than in dogs, and the object causing the obstruction is mostly thread or thread-needle (Bebchuk, 2002;Evans et al., 1994;Felts et al., 1984;Hayes, 2009). The most common clinical manifestations are vomiting, anorexia, and depression for both species (Bebchuk, 2002;Evans et al., 1994). ...
... These rates were observed in the cats with the duration of clinical findings between 1-10 days. However, the mortality rate was reported to be quite high in cases with symptoms over 14 days (Hayes, 2009). Clinical findings lasting up to 30 days have been observed in some cases. ...
... In emergency practice, gastrointestinal foreign body (FB) ingestion is common in dogs. Foreign bodies can pass through the gastrointestinal tract without showing clinical signs, or they can cause damage and have a clinical impact, as in cases with partial or complete obstruction [1]. In human practice, the time of ingestion of FBs is known in most cases, and only 10-20% of ingested FBs require medical treatment [2], while others pass through the digestive system without any medical interventions. ...
... The nature of the FB, the degree of obstruction (complete or partial), and the presence of perforation have an influence on clinical presentation and treatment. The common clinical signs associated with gastrointestinal FB ingestion are vomiting, abdominal pain, anorexia, absence of defecation, and diarrhoea [1,3,4]. Vomiting is the most represented clinical sign in upper gastrointestinal obstruction, with a median duration of two or three days after ingestion before presentation [1,5]. ...
... The common clinical signs associated with gastrointestinal FB ingestion are vomiting, abdominal pain, anorexia, absence of defecation, and diarrhoea [1,3,4]. Vomiting is the most represented clinical sign in upper gastrointestinal obstruction, with a median duration of two or three days after ingestion before presentation [1,5]. Chronic vomiting may lead to hypovolemic shock that should be stabilised to improve the general condition before anaesthesia and to reduce gastrointestinal damage from poor intestinal perfusion. ...
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Article
In emergency veterinary practice, gastrointestinal foreign body (GFB) removal is a common procedure that is performed with different techniques, such as endoscopy or surgery. The aims of this retrospective, multicentre, clinical study were to report the common locations and types of objects recovered and to investigate clinical factors and outcomes in dogs after surgical or endoscopic treatment for GFB removal. Records of dogs with a GFB diagnosis referred to the Teaching Veterinary Hospital or treated in three different veterinary hospitals from September 2017 to September 2019 were examined. The data obtained from each case included breed, age, clinical signs at presentation, duration of clinical signs, type and location of the GFB, treatment, length of hospitalisation and outcome. Seventy-two dogs were enrolled in the study. There were 42 males (58%) and 30 females (42%). The median age was 36 months (range: 3 months to 8 years). Endoscopic retrieval was performed in 56% of GFBs (located in the stomach or duodenum), whereas 44% of dogs underwent surgery. The type of FB detected varied greatly: kid toy (14%), metallic object/coin (13%), cloth (13%), sock (8%), ball (8%), plastic material (8%), peach stone (7%), fishhook (6%), sewing needle (4%), hair tie (4%), pacifier (3%), plant materials (3%) and others (9%). Moreover, the FBs were classified as sharp (13%, n = 9), pointed (33%, n = 24), blunt (26%, n = 19), or linear (28%, n = 20). In this study, 68% of FBs were localised in the stomach, 25% in the intestinal tract (50% duodenum, 28% jejunum, and 22% ileum), and 7% in both the stomach and small intestine. The type of GFB was not significantly associated with age, site or breed. There was a significant association between the type of GFB and sex: if the dog was male, there was a 38% probability of ingesting linear GFBs. The dog survival rate was 100% in cases treated by gastric endoscopic or surgical removal, 94% in cases treated with enterotomy and 33% in cases in which enterectomy was necessary. Enterectomy and multiple surgical sites were associated with a poor outcome. The presence of vomiting for more than 24 h was significantly associated with death.
... 5 Studies in dogs investigating FBs located distal to the cardia showed contradictory results with some reporting that most of the obstructions occurred in the stomach 7 and others with predominant occurrence in the jejunum. 8,9 Of the FBs identified distal to the cardia in dogs, 70% caused complete obstruction. 8 It is possible that FB obstruction of the stomach and small intestine in pigs are more frequent because FBs that pass through the small diameter of the small intestine are then able to freely move distally without causing clinical signs of obstruction. ...
... 8,9 Of the FBs identified distal to the cardia in dogs, 70% caused complete obstruction. 8 It is possible that FB obstruction of the stomach and small intestine in pigs are more frequent because FBs that pass through the small diameter of the small intestine are then able to freely move distally without causing clinical signs of obstruction. ...
... 7,8 Dogs with linear FBs had more severe clinical signs and an increased duration of hospitalization than their counterparts with non-linear FBs. 8,10 In our study, hospitalization period and survival rates appeared to be similar for pigs with linear and non-linear FBs. However, the small number of pigs included in this study did not allow statistical analysis to determine differences between groups. ...
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Article
Background: Pigs have an indiscriminate eating behavior placing them at high risk of developing foreign body (FB) obstructions. Objectives: Describe the clinical and diagnostic features, treatments, and outcome of pet pigs diagnosed with gastrointestinal (GI) FBs. Medical and surgical treatments, pig outcomes, and post-mortem findings were also investigated. Animals: Seventeen pet pigs. Methods: A multicenter retrospective study was conducted. Gastrointestinal FBs were defined as swallowed objects that became lodged within the gastrointestinal tract distal to the cardia identified during exploratory laparotomy. Results: Common clinical signs were anorexia/hyporexia, tachypnea, vomiting, dehydration, tachycardia, and ileus. Diagnostic imaging identified the presence of a FB in 4 cases. Upon celiotomy, the FBs were in the stomach and small intestine in 17 cases and large colon in 2 cases. Types of FB included fruit pit, diaper, and metallic objects. Of the 17 pigs, 15 (88%) were discharged from the hospital and 2 (12%) were euthanized. Conclusion and clinical importance: Clinical signs of GI FB were similar to those reported in obstipated pigs. Diagnostic imaging has limitations for detection of FB. Surgical removal of FBs in pigs carried a good prognosis.
... Gastrointestinal foreign bodies (GFB) may cause complete or partial obstruction in the digestive system. Complete obstruction leads to very severe clinical symptoms and a faster deterioration of general condition, whereas partial obstruction results in chronic digestive problems and malabsorption [7]. Further, obstructions due to FB in the gastrointestinal system may lead to gastric dilatation or volvulus [10]. ...
... The most common place of obstruction is the jejunum, and the most effective treatment is enterotomy [10]. Conservative or surgical intervention can be used as the treatment method, depending on the localization of the FB and the problem it creates [7]. ...
... Fossum reported that exposure to FB generally occurs in dogs when they are puppies [5]. However, Caixeta et al. reported the age of dogs ingesting FB as 5.8 ± 4.5, Hobday et al. as 4.27 ± 3.51, Hayes as 2.5 ± 3.0, and 1.8 ± 1.8 y in cats [3,7,8]. Thus, the age range of 1.6 ± 1.43 in cats and 4.08 ± 3.98 y in dogs identified in the present study is consistent with that reported in other studies [3,7,8] and differs from that reported by Fossum [3,5,7,8]. ...
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Article
Gastrointestinal foreign bodies (GFB) in cats and dogs are among the life-threatening surgical diseases that require invasive surgery. This study aimed to evaluate the cases of GFB in 32 cats and dogs diagnosed and treated in Hatay Mustafa Kemal University Veterinary Health Practice and Research Hospital. Information regarding the type, breed, age, sex, clinical symptoms, characteristics of foreign bodies (FB), localization, prognosis, type of treatment administered, and conditions determined in postoperative controls was collected. The cases were aged between 1 and 7 years and adult animals were also included. The rate of FB incident was the same in male and female cats, whereas male dogs had a higher rate of FB incident. Strings/ropes and metallic objects were the most common foreign objects found in animals. Early diagnosis and treatment were important in preventing complications in the cases, FB was usually found in the stomach, and vomiting was the most common clinical symptom. Further, surgical intervention (gastrostomy/enterotomy) was the most common treatment method with a rate of 53.13 % for treating FB in the gastrointestinal system that yielded successful results. Thus, to avoid complications and for a good prognosis, owners must be conscious and seek for diagnosis and treatment as soon as they notice the incidence of swallowing a FB, so as to ensure early diagnosis and treatment.
... In dogs and cats, intestinal FB are some of the most common causes of obstruction ( Papazoglou et al., 2003 ) and can result in life-threatening complications caused by hypovolemia, toxemia, intestinal necrosis, perforation, or peritonitis ( Hayes, 2009 ;Pratt et al., 2014 ), especially when the FB are not spherical, i.e., linear or angular ( Hobday et al., 2014 ). The care usually consists in the removal of the FB by endoscopy or surgery and monitoring for possible complications ( Lindquist and Lobetti, 2017 ). ...
... Importantly, the causes underlying the FB ingestion are barely investigated or mentioned ( Papazoglou et al., 2003 ;Hayes, 2009 ;Pratt et al., 2014 ;Hobday et al., 2014 ). A recent study indicates that "there are no reports of an apparent underlying reason for the ingestion of the FB" ( Lindquist and Lobetti, 2017 ). ...
... In our study, the Bernese Mountain breed was overrepresented:, which is contradictory with previous results from the literature ( Hayes, 2009 ). Indeed, their behavioral profile differed from that of other dogs, with more repeated FB ingestion and no clear behavioral explanation. ...
Article
Foreign body (FB) ingestion in dogs can threaten the animal's life and often result in an emergency surgery. The causes of pica (ingestion of non-nutritive substance) remain unexplored, although behavioral conditions including hyperactivity, impulsivity, obsessive-compulsive oral/ingestive disorders, anxiety or attachment related troubles have been implicated. Such behavioral causes of pica were investigated with two grids: Lit's owner-based questionnaire, which measures inattention and hyperactivity-impulsivity, and Beata's clinical 4A grid which investigates aggression, anxiety, attachment, and autocontrols of dogs. These grids were fulfilled for 42 FB ingesting dogs and 42 pair-matched control dogs. The main results show that FB ingestion is rarely related to digestive pain (12% of cases) but is primarily of a behavioural nature (88% of cases). Total Scores from both grids are significantly different between FB and control group (Lit scores: Wilcoxon signed-rank test, W = 665.5; P = 0.007; 4A: Wilcoxon signed-rank test, W = 41; P<0.001). Regular shredding of objects is mainly related to a hyperactivity-impulsivity disorder (Lit total score: Mann-Whitney test, U = 99; P = 0.02; 4A Autocontrols Scores: Mann-Whitney test, U = 35; P< 0.001), whereas its absence in FB ingestion suggests anxiety or attachment disorder. Behavioral pathology should be assessed not only for dogs ingesting non-edible objects, but also for those shredding objects. This exacerbated oral exploration is a sufficient sign for veterinarians to consider a behavioral investigation.
... Foreign body intestinal obstruction is a common clinical occurrence in the veterinary routine [4,5,9,12]. Amongst the different causes of such obstructions, the accidental ingestion of objects for human use has been frequently reported [2]. ...
... The most common signs observed in affected animals are vomiting, apathy, and abdominal pain [4,5]. The severity of the condition depends on the type of obstruction, whether simple or strangled (more severe). ...
... The diagnosis is based on clinical evaluation and imaging tests [3,5], although in emergency cases, exploratory laparotomy is a recommended method [1,4]. Intestinal obstructions should always be considered as a clinical emergency [7,12], the treatment of which is surgical [10]. ...
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Article
Background: Intestinal obstruction by a foreign body is a common occurrence in domestic animals, needing the attention of veterinarians and owners, given that a serious complication of this condition is intestinal rupture, with consequent peritonitis. Perforating objects are the ones most often associated with rupture, but any object that obstructs the intestinal tract, if not removed properly, can lead to intestinal rupture, generating a poor prognosis. This article reports a case of intestinal rupture caused by a non-perforating foreign body in a dog. Case: A 1-year-old Chow-Chow dog was taken by its owner to the Portal Pet private clinic, with a history of foreign body ingestion and emesis. The owner reported that he took the animal to veterinary care in another establishment on the day he noticed vomiting, with no other abnormality being detected. An injectable medication was administered, but the owner did not know what it was, and the dog was discharged. After 15 days, the owner sought care at the clinic initially mentioned, due to the persistence of emesis, in addition to the onset of diarrhea and apparent apathy. On physical examination , the dog was apathetic, with pale mucosa and pain on abdominal palpation. A firm structure was felt, located in the epigastric region, compatible with a foreign body. The dog was referred for hospitalization and an abdominal ultrasound was requested, in addition to blood samples for hematological and serum biochemical tests (urea, creatinine, alanine aminotransferase, and alkaline phosphatase). Serology for parvovirus was also performed. The blood count revealed leukopenia (4,800 thousand/mm 3) and biochemical analysis showed an increase in alkaline phosphatase (895.5 U/l). The results for parvovirus were negative. Ultrasonography confirmed the presence of a foreign body. The animal was referred for exploratory laparotomy, in which the foreign body was found in the abdominal cavity as a result of intestinal rupture, and peritonitis was observed. The foreign body was removed, the abdominal cavity washed, intestinal raffia made, and an abdominal drain inserted. The foreign body was identified as a silicone makeup sponge. Three days later, the drain was removed. The patient had good post-surgical clinical evolution and was discharged. The prescription given was as follows: omeprazole 1 mg/kg (VO, every 24 h in the morning, for 2 weeks); dipyrone 25 mg/kg (VO, TID, for 4 days); cephalexin 25 mg/kg (VO, BID, for 10 days); mineral vitamin supplement based on probiotics and prebiotics 1 tablet/10 kg (VO, every 24 h, for 10 days); vermifuge based on milbemycin oxime and praziquantel 5-25 mg (VO, in a single dose, with repetition after 15 days); enrofloxacin 50 mg 10 mg/kg (VO, every 24 h, for 7 days); immunoglobulin based on blood plasma, vitamins and minerals 1 tablet/10 kg (VO, BID, until new recommendations); and metronidazole 40 mg/mL oral solution at a dose of 25 mg/kg (VO, BID, for 7 days). As topical treatment, an antiseptic spray based on laurel, diethylene glycol ether, sodium sulfate, and povidine iodine was prescribed for surgical wound cleansing, until the suture removal, and the use of a surgical collar was requested. A reassessment was scheduled after 10 days, during which the suture was removed. At this point the dog had fully recovered. Discussion: Intestinal obstruction by a foreign body is a common cause of veterinary emergencies. As observed in the reported case, rupture of the intestinal wall and peritonitis can result. Although the prognosis of the affected animals is guarded, diagnosis prior to the worsening of septicemia as well as immediate surgical intervention were essential for recovery.
... Bones are the most commonly reported gastrointestinal FBs, although snacks, balls, toys, hooks, pieces of wood and needles have also been reported [1,6,7,16,21]. Although rare, possible complications associated with endoscopic removal of FBs include perforation, hemorrhage, malfunctions in moving the FB making it more difficult to remove, breathing problems related to esophageal perforation with possible tracheal involvement, and the formation of stenosis when there is damage to the esophageal mucosa [20]. ...
... As these forceps does not need to be inserted through the endoscope's working channel, they can have a larger diameter, be more robust and have greater amplitude of object grasping, which could increase the likelihood of successful endoscopic removal of an esophageal FB. Gastrointestinal FBs are a common diagnosis among dogs that are brought in for emergency veterinary care and yet pose a challenge [7]. Most (78%) of the FBs in the present study were located in the stomach, unlike previous studies that refer to the esophagus [6] or the small intestine [8] of dogs as being the most common site where FBs are lodged. ...
... However, some studies have shown that gastrointestinal FBs mostly affected large breeds such as Labrador retriever (13.6%), Golden retriever (5.3%) [8], Staffordshire terrier (30%) and English bull terrier (7%) [7]. It is important to highlight the high prevalence of Shih tzu (18%) and Yorkshire (6%) in the present study, agreeing with the prevalences found in previous studies in which Shih tzu represented between 11 and 18% and Yorkshire 9% [12,21]. ...
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Article
Background: Dogs and cats with acute signs of choking, retching, cough, vomiting, regurgitation, hypersalivation, dysphagia and odynophagia should have the presence of a gastrointestinal foreign body (FB) as part of their differential diagnosis, where it is a frequent condition in the care of small animals. Most objects lodged in the esophagus, stomach, and proximal duodenum can be removed by upper digestive endoscopy, a curative, little invasive procedure. The objective of our study was to evaluate the physical aspects and location of esophageal and gastric FBs observed in 88 dogs and the age and breed of the affected animals and to determine the success rate and eventual complications associated with the procedure as well.Materials, Methods & Results: Eighty-eight cases of dogs, males and females of varying ages and breeds, submitted to upper digestive endoscopy were selected because of suspicion of esophageal or gastric FBs. The endoscopic procedure aimed at confirming the diagnosis, whether or not followed by endoscopic removal of these objects. Prior to endoscopy, the animals had laboratory tests (blood count and serum biochemistry) and subsequently to the anesthetic protocols of choice for each case. Data including breed, age, type of constituent material and anatomical location of the FB, endoscopic procedure success rate and complications were recorded and descriptively evaluated. Of the 88 dogs evaluated, 60% (n = 53) were male and 40% (n = 35) female. According to the breed of the animals, 55% (n = 49) were small-breed dogs, 29% (n = 25) large-breed dogs, and 8% (n = 7) medium-breed dogs, and 8% were of mixed breed dogs, which could assume various sizes. Shih Tzus accounted for 18% (n = 16) of the animals, Lhasa apsos 8% (n = 7) and mixed breed 8% (n = 7), where these were the most frequently affected breeds. Regarding age, animals 1 to 5 years old represented 66% (n = 58) of the patients, and those 6 to 10 years old accounted for 20% (n = 18), while 11% of the dogs were over 10 years old (n = 10). Two animals (3%) had no information about their ages. Pieces of cloth were the most frequently found FBs, representing 20%(n = 20), followed by animal bones (19%) and fruit pits (10%). As for location, 78% (n = 69) of the FBs were located in the stomach and 22% (n = 19) in the esophagus. The success rate of endoscopic FB removal in this study was 83% (n = 73). In 76% (n = 67) of the animals, there were no complications due to the presence of FB in the upper gastrointestinal tract. The most frequent complications were esophageal ulcerations (n = 7) and the inability to move the FB (n = 5) and adherences. (n = 4).Discussion: The results showed that small-breed dogs, especially Shih Tzus and Yorkshires, represented a larger number of cases, probably due to their popularity in Brazil, where the study was conducted. Males were more prevalent than females, and the most affected age was between 1 and 5 years, with emphasis on younger animals. There were more gastric FB cases compared to esophageal FB cases, which was related to the interval between the ingestion of the object and veterinary care. Although not the most prevalent FB, the high rate of mango pits can be explained by the vast number of mango trees in the Federal District. There were few complications compared to the success of cases, indicating that endoscopy is the procedure of choice for the diagnosis and removal of FBs from the gastrointestinal tract.
... Complications may include intestinal perforation, tissue necrosis, peritonitis, toxaemia and death. GI obstruction in dogs and cats is often caused by the anatomical predisposition in the intestinal structure of small animals and their constant presence in a human environment, one conducive to the swallowing of inappropriate and inedible objects (1,2,7,8,19). ...
... Apart from obstruction, the list of differential diagnoses included local inflammations and general metabolic, infectious and neoplastic diseases. The dominance of vomiting, diarrhoea and constipation in the course of obstruction in the dogs and cats observed in the studies is consistent with previous observations (1,7,8,12,13). However, on the basis of deep palpation, it is rare to find pain and indication of the area of obstruction, which was only possible in individual cases. ...
... Foreign bodies were found in 12 animals: 4 in the stomach (33.3%) and 8 in the intestines (66.7%). The anatomical distribution of foreign bodies observed coincides with the observations of other authors (1,3,7,12,13). After a study on a large group of animals, Hayes, similarly to other authors, stated that 63% of all foreign bodies in dogs are located in the jejunum. ...
Article
GI obstruction often leads to intractable vomiting, the consequences of which can be life-threatening. For diagnosing, an ileus clinical examination with abdominal radiographs or ultrasonographs are chosen routinely. The purpose of the study was to determine the incidence of GI obstruction among animals with gastrointestinal symptoms and to define ultrasonographic accuracy in detecting these GI obstructions. 38 animals (31 dogs and 7 cats) were included in the study. At the first consultation they presented gastrointestinal symptoms. A clinical examination with palpation of the abdomen was made. An ultrasound examination was made by an experienced radiologist. 17 of the 38 animals were diagnosed with obstructive ileus. In 15 of these 17 the ileus was confirmed, and in the remaining 2 only functional obstruction and enteritis was found. For the other 21 of the 38 animals the ileus was excluded. The animals with GI obstruction accounted for 39.5% of all animals with GI symptoms. The ultrasound examination was effective in 88.2% of cases. Intestinal obstruction is common in patients with gastrointestinal symptoms. Vomiting, diarrhoea and constipation are the main symptoms. Abdomen pain is rare. Ultrasound is a valuable and safe method for detecting GI obstructions. In only 2 animals was ileus misdiagnosed.
... In a case series of gastric and esophageal foreign bodies in 102 dogs, only 2 G-bFBs were evaluated, 1 and in a retrospective evaluation of gastrointestinal foreign body surgeries, only 5 bones were identified in 208 cases. 8 Although bones can cause gastric perforation, 1 their higher digestibility compared to non-organic foreign bodies is unique, supporting the argument to leave them in situ. 9,10 Despite potential complications associated with foreign material in the stomach, in some cases E-bFBs actively or passively advanced into the stomach are considered successfully resolved. ...
... 45 dogs with E-bFBs, 40 had clinical signs at presentation. The primary clinical signs reported were gagging(11), vomiting(8), regurgitation (5), inappetence (3), retching (3), respiratory distress (3), coughing(2), hard swallowing(2), ptyalism(2), and reverse sneezing(1). The remaining 5 dogs were presented after bone ingestion was witnessed, before the development of clinical signs. ...
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Article
Background: Bone foreign bodies are commonly encountered in small animal practice. Esophageal bone foreign bodies (E-bFBs) warrant removal, whereas gastric bone foreign bodies might not. Objectives: Describe management and outcomes for dogs with esophageal or gastric bone foreign bodies. Animals: One hundred twenty-nine dogs with esophageal (n = 45) or gastric (n = 84) bone foreign bodies. Methods: Retrospective review of medical records. Results: Dogs with E-bFBs were younger than dogs with gastric bone foreign bodies (median age esophageal, 4 years [IQR 2-8]; median age gastric, 6 years [IQR 3-10]; P = .03), and had a higher bone cross-sectional area relative to body weight (median esophageal, 98.21 mm2 /kg [IQR 48.25-142.6]; median gastric, 28.6 mm2 /kg [IQR 17.25-64.28]; P < .001). Forty-two of 45 esophageal foreign bodies were resolved non-surgically and 3 by esophagotomy. Esophageal erosions were more likely with distal entrapment (OR 12.88, [95% CI 31.95-129.29], P = .01) and longer duration (OR 18.82 [95% CI 2.22-273.97], P = .01). Sixty-two of 84 bone gastric foreign bodies were left in situ. Endoscopic removal was successful in 20 of 22 (91%; 95% CI 70-99) attempts. Conclusions and clinical importance: While all E-bFBs were dislodged either by advancement into the stomach, endoscopic removal, or esophagotomy, the majority of gastric bone foreign bodies were left in situ for dissolution, with no reported complications. Gastric advancement of E-bFBs should be considered when oral removal is not feasible, and dissolution can be considered even with large bones.
... The 15-day mortality rate in this study was 20.7%. There is no comparable veterinary study with which to compare data; however, mortality rates reported in veterinary medicine for the most common surgical procedures encountered here, such as gastrointestinal, hemoperitoneum or GDV syndrome surgeries, range from 0.8% to 28% [18][19][20][21][22][23], 12% to 36% [24,25] and 12% to 26% [26][27][28][29][30][31][32][33], respectively. ...
... This difference may be explained by differences in range of age between humans and dogs. Moreover, in contrast with studies in people, the most common reason for surgery in the present study was a gastrointestinal foreign body causing mechanical obstruction, condition commonly reported in young dogs [21][22][23]. ...
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Article
Emergency abdominal surgery carries high morbidity and mortality rates in human medicine; however, there is less evidence characterising the outcome of these surgeries as a single group in dogs. The aim of the study was to characterise the clinical course, associated complications and outcome of dogs undergoing emergency abdominal surgery. A retrospective study was conducted. Dogs undergoing emergency laparotomy were included in the study. Logistic regression analysis was performed to identify variables correlated with death and complications. Eighty-two dogs were included in the study. The most common reason for surgery was a gastrointestinal foreign body. Overall, the 15-day mortality rate was 20.7% (17/82). The median (range) length of hospitalisation was 3 (0.5–15) days. Of the 82 patients, 24 (29.3%) developed major complications and 66 (80.5%) developed minor complications. Perioperative factors significantly associated with death included tachycardia (p < 0.001), hypothermia (p < 0.001), lactate acidosis (p < 0.001), shock index > 1 (p < 0.001), leukopenia (p < 0.001) and thrombocytopenia (p < 0.001) at admission, as well as intraoperative hypotension (p < 0.001) and perioperative use of blood products (p < 0.001). The results of this study suggest that mortality and morbidity rates after emergency abdominal surgery in dogs are high.
... The 15-day mortality rate in this study was 20.7%. There is no comparable veterinary study with which to compare data, however, mortality rates reported in veterinary medicine for the most common surgical procedures encountered here, like gastrointestinal, hemoperitoneum or GDV syndrome surgeries, range from 0.8 to 28% [21][22][23][24][25][26], 12 to 36% [27,28] and 12 to 26 % [29][30][31][32][33][34][35][36], respectively. ...
... This difference may be explained by differences in range of age between humans and dogs. Moreover, in contrast with studies in people, most common reason for surgery in the present study was gastrointestinal foreign body causing mechanical obstruction, condition commonly reported in young dogs [24][25][26]. ...
Preprint
Emergency abdominal surgery carries high morbidity and mortality rates in human medicine; however, there is less evidence characterizing the outcome of these surgeries as a single group in dogs. The aim of the study was to characterize the clinical course, associated complications and outcome of dogs undergoing emergency abdominal surgery. A retrospective study was conducted. Dogs undergoing emergency laparotomy were included in the study. Logistic regression analysis was performed to identify variables correlated with death and complications. Eighty-two dogs were included in the study. The most common reason for surgery was gastrointestinal foreign body. Overall 15-day mortality rate was 20.7% (17/82). Median (range) length of hospitalization was 3 (0.5 - 15) days. Of the 82 patients, 24 (29.3%) developed major complications and 66 (80.5%) minor complications. Perioperative factors significantly associated with death included tachycardia (P < 0.001), hypothermia (P < 0.001), lactate acidosis (P < 0.001), shock index > 1 (P < 0.001), leukopenia (P < 0.001), thrombocytopenia (P < 0.001) at admission; intraoperative hypotension (P < 0.001) and perioperative use of blood products (P < 0.001). The results of this study suggest that mortality and morbidity rates after emergency abdominal surgery in dogs are high.
... Some owners refrained from use of chewing material. The reason could be that they either fear or already experienced negative effects of providing chewing material such as tooth fractures/oral injuries (Cohen, 2006) or foreign bodies (Rousseau et al., 2007;Gianella et al., 2009;Hayes, 2009). Fear of foreign bodies seems justified as around one-third of dogs in our sample ingested non-edible materials according to their owners, and surgery because of a problem with a chewing material was reported by 1 % of our respondents. ...
... Fear of foreign bodies seems justified as around one-third of dogs in our sample ingested non-edible materials according to their owners, and surgery because of a problem with a chewing material was reported by 1 % of our respondents. In clinical studies, materials such as rawhide or bones represent only a small percentage (2.5/1.5 %) of foreign bodies removed from the stomach to the colon (Hayes, 2009); bones seem to more commonly cause obstruction of the esophagus and also rawhide or other chews and chew toys were removed from the esophagus of dogs (Rousseau et al., 2007;Gianella et al., 2009). Oral injuries were reported by around 10 % of our participants, with around 4% of dogs needing veterinary care. ...
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Chewing is a behavioural element of feeding, but dogs also chew on or dissect non-edible items. This can cause considerable problems to owners if directed at household objects. Nevertheless, the provision of chewing material, associated risks and relationships with chewing behaviour and other owner-dog activities have not been investigated so far. The aim of this online survey was to explore how dog owners manage the chewing behaviour of their dog and whether there are relationships to other owner-dog interactions. Of our self-selected participants (1439 filled in the entire questionnaire), 94% provided their dogs with edible chewing material (e.g., rawhide, dried innards, meat), 83% provided inedible chew toys, 73% provided chew toys filled with food and 51% provided hard chewing material (e.g. wood, antlers). Edible materials were provided four to six times a week by the average dog owner. Regarding risks, 67% of respondents stated that their dog never had a problem caused by the use of chewing material, whereas veterinary treatment due to a problem with chewing material was reported by 3.6%. Chewing daily on soft household objects was observed in 2.5% of dogs (other common objects for daily chewing: resting places 2.2 %, clothes/shoes 1.4%); dogs up to one year of age did this more frequently (p < 0.001). Chewing on objects was not substantially related to reported motivation of the dog to play or the frequency of activities with the dog (all rs < 0.2), but was reported to occur in contexts that may cause negative emotional states such as leaving the dog alone (rs = 0.63, p < 0.001) or changes in routine activities (rs = 0.47, p < 0.001). The average reported frequency of provision of chewing material correlated positively (rs ≥ 0.2) with motivation of the dog to play, chewing on objects, human-dog play and calm activities such as petting. Dog owners think that chewing material is important for puppies and even more for adult dogs (p < 0.001). However, it remains to be investigated how motivated dogs are for chewing on different types of materials and whether chewing, as proposed by dog professionals, reduces stress. This seems particularly important for assessing the trade-off between risks and benefits of different chewing materials and its impact on dog welfare.
... Gastrointestinal foreign bodies (FBs) are commonly encountered in first-opinion companion animal practice and may present with a variety of clinical signs depending on the location, the degree and the duration of the obstruction (Hayes, 2009). Anywhere along the gastrointestinal tract can be affected by foreign objects. ...
... Based on the location, foreign bodies were concentrated in the stomach and extended to the jejunum and ileum in present study. Radiology and ultrasonography are considered the most suitable diagnostic tool for the foreign body to detect the site of it; this is in agreement with the previous researcher (Hayes ,2009). In addition, faecolith obstructing colonic lumen was also noticed in the present study. ...
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Five clinical cases of gastro-intestinal tract obstruction in male dogs were presented to Referral veterinary polyclinic, IVRI. Highlights focused on diagnosis and treatment of animals. One case was presented with complaint of hypersalivation and open mouth breathing. Clinical examination revealed bone piece lodged in pharyngeal area. Second case was presented with history of anorexia and vomiting since few days. After the radiographic and ultrasonographic examination, exploratory laparotomy was done and a piece of cloth obstructing intestine was retrieved through enterotomy. Third case was presented with history of anorexia, and no defecation. Ultrasonography (USG) confirmed this as a case of intestinal obstruction. Intestinal portion obstructed by mango kernel was found, hence intestinal resection and anastomosis was performed. Fourth case was of intussusception diagnosed after sonographic examination and corrected with enteroplication to prevent re-occurrence. Fifth case was presented with a primary complaint of pica, anorexia and progressive emaciation. USG revealed dilated colon with reduced peristalsis. On exploratory laparotomy colonic impaction was found. All animals met uneventful recovery after proper post-operative management.
... Gastrointestinal signs are one of the most common reasons for clinical presentation [24]. Differential diagnoses for the acute onset of these clinical signs include gastroenteritis [25], gastrointestinal ileus [25], foreign bodies [25,26], gastrointestinal tumors [25], gastrointestinal ulceration [25], gastrointestinal perforation or abscesses [25], pancreatitis [24], cholecystitis [27], cholelithiasis [28] and tumors of the pancreas or the biliary system [25]. Anemia can be presented in correlation to gastrointestinal signs or as a comorbidity [29]. ...
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Background Heterotopic gastric mucosa has been scarcely reported in the veterinary literature. Its presence can be asymptomatic or associated with various clinical signs ranging from apathy, vomiting, to abdominal pain. This report illustrates the presence of heterotopic gastric mucosa in the jejunum of an adult dog. It is the first to describe severe anemia, requiring acute blood transfusion, following intestinal hemorrhage caused by heterotopic gastric mucosa. Case presentation A twelve-year-old, intact male Maltese dog was presented with a history of apathy, vomiting and anemia. The dog was on a strict diet for recurrent diarrhea, food intolerance and skin allergy. Clinical examination revealed severe anemic mucous membranes and painful abdominal palpation. Blood examination confirmed severe regenerative anemia. Ultrasonography showed an intestinal neoplasm, gall bladder sludge and non-homogeneous liver parenchyma. Three-view thoracic radiographs failed to show any metastatic lesions or enlarged lymph nodes. After initial stabilization and blood transfusion, a midline exploratory laparotomy was performed. Three different masses were found in the jejunum. Resection and anastomosis of approximately 40 cm of jejunum was performed, followed by liver and lymph node biopsy and placement of an esophagostomy tube. Two days after surgery the dog started to clinically improve and was discharged from the hospital on the sixth day after surgery. Histopathology revealed the intestinal masses to be heterotopic gastric mucosa associated with intramural cystic distensions, multifocal ulceration and bleeding into the intestinal lumen. Two years after surgery, the dog did not have a recurrence of anemia or gastrointestinal signs. Conclusions This case demonstrates that heterotopic gastric mucosa can be considered one of the differential diagnoses in case of severe anemia due to gastrointestinal hemorrhage and suspected intestinal tumors. Although in most described cases in literature the finding seems to be incidental on necropsy, our report shows that heterotopic gastric mucosa can be the etiology of life-threatening signs. In addition, because no recurrent diarrhea episodes occurred after surgical resection of the ectopic tissue, it is likely that the heterotopic gastric mucosa was the cause of the food intolerance signs in this dog.
... A longer duration of clinical signs is associated with increased mortality in patients with gastrointestinal foreign bodies. 2 Both patients initially presented with mild to moderate clinical signs, which partially responded to symptomatic therapy. Given the outcomes in this minority of cases, earlier intervention, including abdominal imaging, as well as close on-going clinical mon-itoring, should be considered for patients with known or suspected ingestion of bone meal, particularly where ingestion of a substantial volume (greater than 0.5 g/kg) is likely. ...
Article
Bone meal is a widely used fertiliser, and its ingestion in dogs is common, presumably because they are attracted by the odour. In a case series of 255 cases reported to the Veterinary Poisons Information Service, 47.1% of dogs remained well. Clinical signs were reported in 52.9% and were predominantly gastrointestinal, particularly vomiting and diarrhoea. Some dogs also displayed lethargy (14.9%) and abdominal pain (5.9%). Signs were typically mild, but in a small number of cases, gastrointestinal impaction and/or perforation (1.2%) occurred. Of the 135 symptomatic dogs that ingested bone meal, 132 recovered (51.8%), two were euthanased (0.8%) and one died (0.4%). Two dogs with gastrointestinal complications following bone meal ingestion are described in detail. Both had prolonged gastrointestinal signs, and exploratory coeliotomy confirmed gastrointestinal impaction with perforation in one case and necrosis of the gastric wall in the other. Both dogs were euthanased perioperatively due to poor prognosis.
... As a mediumsized European city, Porto is an urban environment with a high density of anthropogenic pressures (e.g., traffic, high population density) potentially leading to microplastic exposure (e.g., respiratory exposure). Exposure could also have occurred through the ingestion of contaminated food [15] or water [20], cleaning behaviors after particle deposition in the fur, or chewing and ingestion of plastic foreign material [21]. However, the numbers of suspected microplastics in tissues resulted in a median of zero particles (Table 2), and therefore median concentrations of 0 MP g −1 (Table S6). ...
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Companion animals living in urban areas are exposed to environmental contaminants, which may include microplastics. A preliminary study was conducted by collecting postmortem samples from the internal tissue (lungs, ileum, liver, kidney, and blood clots) of 25 dogs (Canis familiaris) and 24 cats (Felis catus) living in an urban environment in Porto metropolitan area, Portugal. Suspected microplastics were found in 80 samples from 35 animals (18 cats and 17 dogs), often occurring in more than one tissue of the same animal (71.4%), primarily under small sizes (50.3% as 1–10 µm). Micro-Raman spectroscopy confirmed a fraction of particles as common polymer types (e.g., polyethylene terephthalate). However, the number of particles was very low. This study highlights the possibilities of the internalization and distribution of microplastics in the internal tissues of terrestrial vertebrates.
... Measurement of electrolyte concentrations is an important component of the assessment of dogs in emergency rooms or intensive care units, particularly sodium, potassium, corrected chloride and ionized calcium concentration (50). Hypochloremia and metabolic alkalosis are common in dogs with gastrointestinal foreign bodies (51,52), and gastric dilation-volvulus syndrome (53). Our study shows a consistent increase in the values of iCa, Na and Cl. ...
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Pain management is central to veterinary practice, contributing to successful case outcomes and enhancement of the veterinarian-client-patient relationship. Analgesic drugs represent one of the pillars of the multimodal approach to acute and chronic pain management. In dogs, the most used opioids are methadone, buprenorphine and tramadol. Several episodes of hypoglycemia in people treated with tramadol and methadone have recently been described. The aim of this work is to evaluate the changes in the glycemic and acid-base balance induced by tramadol, methadone and buprenorphine in hospitalized dogs. A retrospective review of the medical records of dogs hospitalized for both medical and surgical reasons was performed. During 2018-2020, a total of 876 canine patients were treated with opioids, including 228 with tramadol, 273 with methadone and 375 with buprenorphine. Of all these dogs, only a small percentage met the inclusion criteria presented in the initial design. All the hospitalized animals were monitored daily through clinical examination and blood sampling. Blood samples were obtained before opioid administration (T0), and 24 h (T1) and 48 h (T2) after °pioid administration. The following parameters were evaluated: blood gas value (pH, pCO 2 ), acid-base state (cHCO 3 ), oxymetric values (ctHb, haematocrit), electrolyte values (K+, Na+, iCa, Cl-) and metabolic values (glucose, lactate, anion GAP K+c). The glycemic value in enrolled dogs showed a decrease over time, regardless of the type of opioid used, but remained within the physiological range. The highest average glycemic drop was recorded for methadone, between T0 and T1, followed by tramadol between T1 and T2, while buprenorphine recorded the highest overall glycemic drop between T0-T2 when compared to the other two opioids. Female dogs showed the greatest drop in glycemic value. Lactate concentration always presented values beyond the physiological range at an early stage, which then normalized quickly. Measurement of electrolyte concentrations showed a consistent increase in the values of iCa, Na and Cl. In hospitalized dogs treated with opioids monitoring of gas analytic parameters is important and more attention should be paid to patients hospitalized with certain metabolic and endocrine diseases.
... Also, foreign bodies are often associated with complications, such as perforation of the oesophagus or other gastroenteric structures, stricture, inflammation and aspiration pneumonia, all compatible with what was observed in our necropsy. The abscess formation and perforations found in the tigress are among the most common complications associated with oesophageal foreign bodies ( Hayes, 2009 ). ...
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Deliberate geophagia or sand-eating behaviour has been widely documented in herbivorous and omnivorous mammals, but never in large felids at captivity. Here we report a case of apparent lethal gastrointestinal impaction from sand intake in a 10-year-old captive Bengal tigress. After two days of anorexia and prostration the tigress was admitted to the University Veterinary Hospital with abdominal distension and diarrhoea and died shortly afterwards. A post-mortem examination revealed oesophageal perforation, abundant liquid in the stomach and pyloric obstruction due to the presence of compacted sand and some masses of poultry bones. It is hypothesized that geophagy (of sand) may have been a strategy to alleviate indigestion by consumption of rotten poultry carcasses, but evolved into a compulsive disorder over time, possibly due to a restricted and barren environment. Zoo animal welfare involves a series of challenges that include an adequate diet in quantity and presentation, as well as complex behaviours such as the motivation to ingest non-food substances under certain contexts during life in captivity.
... The presence of areas of omental adhesions in the jejunum in the present report is suggestive of previous damage to the intestinal wall, probably due to longer permanence of the trichobezoar in this area. A study showed that 63% of the obstruction of the gastrointestinal foreign bodies in dogs occur in the jejunum [6]. ...
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Background: Bezoars are accumulations of foreign material and indigestible organic substances in the gastrointestinal tract. There are different classifications for bezoars based on its primary composition. The trichobezoars are concretions composed of hair or hair-like fibers and are often associated with trichophagia in humans. The obstruction by a trichobezoar occurring in the stomach, with its tail extending to or beyond the ileocecal valve or jejunum is rare in humans. This condition is called Rapunzel Syndrome. Obstruction by trichobezoar has been reported few times in cats and dogs. This paper aims to describe an uncommon clinical presentation of a young dog with partial obstruction of the small intestine by a trichobezoar.Case: A 2-year-old, 5.5 kg, intact male poodle was referred due to kyphosis and a history of pain in the thoracolumbar region for approximately 10 months. Physical examination revealed that the dog walked without any difficulty or ataxia, but had pain on palpation of the lumbar vertebral column. Thoracolumbar spine radiographies failed to show any sign of disease. Conservative therapy for intervertebral disk disease did not shown any improvement. In addition, the dog showed signs of pain on abdominal palpation and 18-month history of hyporexia, apathy and dark colored diarrhea. Abdominal ultrasonography detected a 5-cm intraluminal intestinal structure at the ileo-jejunal junction, forming an acoustic shadow, with focal thickening of the intestinal wall. Exploratory celiotomy followed by jejunal enterotomy revealed a trichobezoar consisting of undigested hair and textile fibers partially obstructing that segment. The intestinal wall in that region formed a sacculation, so a 5 cm jejunal resection with end-to-end anastomosis was performed. Histopathology of this segment did not show any neoplastic formation. After 20 days of surgical procedure, no clinical sign was reported by the owner, the animal return to normal appetite and back pain was not present. Ultrasonography confirmed normal intestinal flow. At the last follow-up 180 days after surgery, the dog was in excellent condition with no obvious clinical sign related to the disease or surgical procedure.Discussion: The mild chronic signs presented by the animal lead to an initial inaccurate diagnosis, since abdominal pain may seem like a back pain. The ultrasonography was useful to identify the presence of an initially unknow foreign body. However, definitive diagnosis was only possible after exploratory celiotomy, since trichophagia was not reported by the owner. The trichobezoar found in this case cannot be classified as Rapunzel Syndrome, since it is not a gastric trichobezoar with a tail extending up to the small intestine. The occurrence of trichobezoar is usually associated with overgrooming, tumor or end-to-end anastomosis, but none of this conditions was present. The presence of omental adhesion on jejunum wall is suggestive of previous damage, probably caused due to long-term permanence of the trichobezoar in this segment. The intestinal perforation caused by trichobezoar is one of the most common life-threatening complication observed in human patients. A sacculation observed during surgery may have contributed to its formation. The case presented may be considered extremely uncommon, due to the partial obstruction of the intestinal lumen and long-term evolution.
... A incidência de corpos estranhos em gatos é rara [16], sendo significativamente menos frequente do que em cães, estando a dispneia presente em apenas 12% dos casos [7]. O presente relato descreve o caso de um felino com corpo estranho traqueal, com a apresentação dos achados clínicos e do tratamento bem-sucedido. ...
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Background: Acute dyspnea is a clinical emergency with a presentation similar to several etiologies. Cats are usually referred with complaints of anorexia, abdominal breathing, cyanosis, and open mouth breathing, and veterinarians should stabilize the animals as soon as possible. The incidence of aspiration of foreign bodies is low, particularly in this species. The diagnosis consists of observing the foreign structure in the lumen of the trachea, commonly performed using radiography or bronchoscopy. This report describes a case of a feline with a tracheal foreign body, with a detailed description of the clinical findings and successful treatment.Case: A 10-year-old female feline exhibited severe dyspnea and cyanosis. During the anamnesis, the owner stated that the clinical signs suddenly presented one day prior, after the animal ingested a piece of fish. Physical examination revealed changes in pulmonary auscultation, which was bilaterally muffled, and intense respiratory distress, as observed by the evident signs of exhaustion (sternal decubitus, reduced muscle tone), in addition to cyanotic mucous membranes. The animal was intubated and maintained under anesthesia with propofol infusion and respiratory support (ambu) for 1 h, during which complementary examinations were performed. Chest radiography showed the presence of a radiopaque structure (approximately 0.5 cm) in the tracheal region. Thus, we decided to remove the structure using bronchoscopy. The foreign body was located above the main bronchial bifurcation and was removed. There was an improvement in oxygenation after 20 min of maintenance of ventilatory support, followed by weaning of the animal's successful respiratory support. Antibiotic therapy and analgesia were prescribed at home, and the animal exhibited full recovery after 10 days.Discussion: Dyspnea is a clinical sign that should be treated as an emergency, as it is associated with high mortality. In these cases, positive pressure ventilation is indicated in three situations: persistent hypoventilation, severe hypoxemia unresponsive to oxygen therapy, and excessive respiratory effort or fatigue. Dyspnea may be due to impairment of the upper or lower airway or restrictive conditions. Clinically, felines with tracheal foreign bodies have a sudden onset of dyspnea, tachypnea, cough, and lethargy. In these patients, the reduction in lung sounds is a common finding, as observed in the present case. The occurrence of tracheal foreign bodies in cats is rare and, depending on the type of foreign body and its location in the airway, complete obstruction of the respiratory tract may occur. In the present case, it was possible to observe the foreign body in the trachea on radiographic images. Felines with tracheal foreign bodies generally present a structure located close to the carina, as observed in the present case. Bronchoscopy using a flexible or rigid tube is considered the gold-standard technique for removing foreign bodies from the respiratory tract, and the greatest difficulty during the removal procedure is ensuring that the airways are not obstructed by the instruments used. The use of these materials is not free of complications, as they may be responsible for the development of pneumothorax, pneumomediastinum, dyspnea, and respiratory failure. In the present case, there were no complications during or after the procedure, and the patient recovered completely.
... The clinical signs associated vary depending on the site, as well as the degree and the duration of the obstruction (Hayes, 2009). Dysphagia and regurgitation are common, but occasionally, gagging, ptyalism, discomfort, respiratory distress and cyanosis may also be observed (Abd Elkader et al., 2020). ...
Article
Oesophageal foreign bodies are a significant cause of morbidity and mortality in small animals, especially in carnivores. Due to the possibility of complications such as perforation or tracheal compression, the patient may present an upper airway obstruction, which might become a medical emergency. Here, we describe a rare case of a large cervical foreign object in a cat and review the diagnostic and therapeutic approach of this condition. A 4-year-old female cat was referred to our clinic with signs of dyspnoea, dysphagia and regurgitation. The history and clinical exam suggested an oesophageal foreign body, subsequently radiographically confirmed. Because its shape and position did not allow endoscopic extraction, the foreign body was removed via ventral cervical oesophagostomy. Due to its location and large size, it was necessary to fragment the foreign body into two pieces for complete extraction without injuring the oesophageal walls. The patient had no postoperative complications and was discharged 7 days after surgery. In this condition, an early diagnosis, followed by an immediate surgical repair and a rigorous postoperative care, correlates with patient recovery and survival, being crucial in reducing the high morbidity and mortality rates that are usually associated.
... All dogs are at risk, but young dogs are especially vulnerable. Puppies tend to be more eager to put every object into their mouths, often because they are often teething and are looking for something to chew (7). ...
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A male, Mullinoise breed, police (K9) dog, 30 kg weight and of 4 years old, had been brought to the Veterinary Clinical Hospital, College of Veterinary Medicine, University of Basrah, Iraq, with patient history and signs of anorexia, discomfort, intermittent diarrhea. On clinical examination, the diseased dog exhibited different clinical manifestations such as Abdominal type of respiration, Colicky pain and looked at his flank some times, Moderate degree of dehydration with sunken eyes, and Edema of hind legs is obvious with pits on pressure. Moreover, the diseased dog shows mild elevation in body temperature, respiratory and heart rate with mild anemia, However, electrolyte disturbances have been indicated reflected with hypernatremia and hyperkalemia. Furthermore, Hypoprotenemia was also registered. Besides, A latero-medial radiograph shows clear intestinal stenosis of a part of the large intestine of the disease dog. It could be concluded that Intestinal obstruction, complete or partial, may often lead to severe consequences in the sick animal, including unwanted clinical signs that often end in the death of the affected animal. Consequently, it must be emphasized to monitor animals that suffer from symptoms to speed up the early diagnosis of the disease.
... Direct and indirect abdominal radiography is one of the frequently used diagnostic methods in the diagnosis of mechanical ileus cases caused by foreign bodies in the gastrointestinal system (2,10,11). In the radiographic images taken in mechanical ileus cases, it is seen that there is gas accumulation in the proximal part of the occlusion area. ...
... При постановке диагноза проводятся клинические исследования, рентгенодиагностика, в том числе с использованием контрастных веществ, УЗИ-диагностика. В связи с многообразием причин развития и неоднозначностью клинических признаков проявления у мелких домашних животных непроходи-мости кишечника, развивающейся с симптомами, сходными с болезнями как незаразной, так и инфекционной и паразитарной этиологии, изучение данной патологии является актуальной для ветеринарной науки и практики [7][8][9][10][11][12][13]. ...
... The lateral radiograph confirmed the presence of penetrating foreign body in the rectum and gravel sign (gravel sign refers to the accumulation of indigestible material cranial to the site of obstruction) [3] . Survey radiographs were suitable to confirm diagnosis of gastrointestinal foreign body in the majority of cases [4,5,6] . In the present case, the obstruction in the rectum by the sewing needle was partial and the needle penetrated the dorsal wall of the rectum vertically. ...
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A Spitz bitch of 3yrs old was brought to the Veterinary Clinical Complex, with a history of foreign body ingestion, making frequent attempts to defecate, vocalizing with pain during defecation and trying to lick at the anus. All the vital signs were within the normal range. No foreign bodies were found in the oral cavity. Lateral radiograph of abdomen showed a penetrating foreign body at the level of rectum. Per rectal examination under general anaesthesia, revealed a sewing needle with thread, penetrating dorsal wall of the rectum. The needle was manipulated and released from the dorsal wall of rectum with left index finger and the thread was grasped with the right hand. The foreign body was slowly and carefully retrieved from the rectum and the bitch showed uneventful recovery.
... Sewing needles and bones were the types of foreign body identified in this study. Generally, in feline practice, a wide variety of ingested items are observed; however, bones, needles and small toys are the most commonly ingested objects [17]. ...
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Background Anatomical feline models can aid in understanding the relationships between clinical findings and anatomical features and the course of foreign bodies passing through the oesophagus. This study has two goals 1) to assess feline oesophageal foreign bodies in feline patients using physical, radiologic and endoscopic examination and, how their location influences treatment plans and complications. 2) How the anatomical sharp angle of the oesophagus contribute to foreign body lodgement. Thirty-five cats were enrolled in this study; 30 of them were clinically ill, and five cats were used for anatomical study. Results Cats with clinical signs underwent complete clinical and radiologic examination. Endoscopy was performed in only five cases. The site with the highest occurrence of foreign body lodgement was the oesophageal entrance, caudal to the pharynx (63.3%), followed by the thoracic inlet (26.7%) and the mid-cervical region of the oesophagus (10%). Two types of foreign bodies were identified: sewing needles (25/30) and bone (5/30). Radiography was able to identify the location and nature of the foreign body in all 30 affected cats. Therapeutic regimens were applied according to the nature and location of the foreign body and any associated complications. Removal of the foreign body was achieved using Rochester pean artery forceps in 17/30 cases, using full surgical intervention in 8/30 cases, and during endoscopy in 5/30 cases. Conclusion The results suggest that the location of the foreign body is strongly related to combination of consumed foreign body type and anatomic features of the cat oesophagus. The feline oesophagus has a variety of sharp angles that facilitate the entrapment of rigid linear and angular foreign bodies. Radiographic imaging remains the most frequently used diagnostic modality for determining the lodgement site and nature of radiopaque foreign bodies. Over all complication rate was low (6/30).
... The incidence rate of GIT obstruction is very high in young male dogs due to their voracious, indiscriminative feeding habits and playful nature (Kumar et al., 2000). All along the length of gastrointestinal tract foreign bodies causes obstruction but jejunum is the most common location (Hayes, 2009). Some small, sharp foreign bodies, such as pins, sewing needles, and fish hooks that are found in asymptomatic animals may be treated conservatively and they may pass uneventfully, because of contact between mucosa of intestine and foreign body results in local dilation of intestine called as mural withdrawal reflex (Guilford et al., 1996). ...
Article
The objective of this study was to describe, in detail, the lesions and pathogenesis observed in free-living sea turtles that ingested fishing lines and to relate the physical characteristics of these lines with tissue damage. Thirty sea turtles were analyzed and eight of these had ingested fishing line. Three out of eight had severe macroscopic lesions, but all eight had microscopic lesions. Therefore, ingestion of fishing line by free-living sea turtles is frequent and always causes injury, with predominance of microscopic lesions, and characterized by decrease, degeneration, congestion, and hemorrhage of the villi. The ingested fishing lines can be long or short, and monofilament or multifilament. In the severe cases, the development of intestinal plication, twisting, intussusception, and fecalomas in different portions of the gastrointestinal tract can be observed, with the ingested fishing lines. In less severe cases, there were only small quantities of line fragments. The severity of injuries to the gastrointestinal tracts of sea turtles that ingested fishing lines was revealed in this study, which demonstrated that these injuries impair quality of life and can result in death.
Article
Objectives: To describe a novel surgical technique for intestinal foreign body removal without enterotomy using a laparotomy-assisted endoscopic approach and compare short-term outcomes to enterotomy. Materials and methods: Medical records of dogs and cats with intestinal foreign bodies that underwent attempted treatment with a laparotomy-assisted endoscopic approach between June 2019 and July 2021 were extracted. The approach consisted in manoeuvring the intestinal foreign body into the stomach during laparotomy and then removing it via a gastroscopy. If the foreign body was unmovable, an enterotomy was performed. Results: Fifty-eight cases were enrolled and foreign bodies were successfully removed in 25 cases using a laparotomy-assisted endoscopic approach. The median distance between the pylorus and the proximal part of the foreign body was 55 cm (range: 0 to 300). The mean surgical time and median endoscopic time were 49 minutes (±sd 12.8) and 5 minutes (range: 2 to 28), respectively. All but two cases were discharged 1 day postoperatively. In 20 cases, the foreign body was not easily movable, and an enterotomy was performed. In three of these cases, conversion to enterotomy was required due to serosal tears that occurred as a consequence of the attempted retrograde manipulation of the foreign body. Foreign body width, length and distance to pylorus were not significantly different between the two techniques. Mean surgical time was significantly shorter for laparotomy-assisted endoscopic approach compared to enterotomy: 49 minutes (±SD 12.8) versus 61.7 minutes (±SD 14.6). Clinical significance: Surgical removal of intestinal foreign bodies through a laparotomy-assisted endoscopic approach is a feasible technique that offers satisfactory outcomes and shorter surgical time than enterotomy. Retrograde manipulation of the intestinal foreign body may result in serosal tears.
Article
The objective of this study was to characterize clinicopathologic factors and outcomes for dogs and cats with chronic small intestinal foreign body obstructions (CFBO). Medical records of 72 dogs and cats diagnosed with CFBO between 2010 to 2020 were reviewed for duration of clinical signs, pre-surgical and intraoperative findings, complications, and outcomes. A chronic foreign body was defined as clinical signs, or the observation of foreign material ingestion, at least 7 days prior to presentation. Twenty-two (31%) patients had a small intestinal resection and anastomosis (SIRA) and were more likely to have longer duration of clinical signs (P = 0.01). Eleven (15%) patients developed major post-operative complications. Sixty-eight (94%) patients survived to follow-up. Although all patients that did not survive (n = 4, 100%) had a SIRA, patients with CFBO had a high survival rate. Therefore, clients should not be deterred from pursuing surgical intervention.
Article
OBJECTIVE To determine the proportion of abnormal results for a point-of-care pancreas-specific lipase assay screening test in dogs lacking clinical evidence of acute pancreatitis with and without gastrointestinal foreign body obstruction (GIFBO). ANIMALS 50 client-owned dogs with acute abdomen syndrome between April 2019 and January 2021. PROCEDURES In this prospective observational cohort study, dogs were enrolled into a control non-GIFBO group (n = 25) or GIFBO group (25) on the basis of clinical diagnostics performed at presentation. Dogs with evidence of pancreatitis were excluded. Data collected included signalment, body weight, clinical signs, hematologic test results, abdominal imaging findings, and intraoperative findings. SNAP canine pancreatic lipase (cPL) tests were performed for all dogs within 24 hours of presentation and prior to any surgical procedure. Results were analyzed across all dogs for any clinical associations. RESULTS The proportions of abnormal SNAP cPL test results in the GIFBO and non-GIFBO groups were 12% (3/25) and 16% (4/25), respectively, with no significant difference. The only differences between groups were that GIFBO canines were more likely to be male ( P = 0.02) and had a slightly longer duration of clinical signs at presentation ( P = 0.01). Abnormal SNAP cPL test results were associated with increasing age ( P = 0.01). CLINICAL RELEVANCE SNAP cPL test results are mostly reliable but can still be abnormal in a small percentage of dogs with GIFBO. Abnormal results in dogs without pancreatitis occurred more frequently in older dogs of the present study. Abdominal imaging is advised for dogs with abnormal SNAP cPL test results.
Article
A 4‐year‐old English setter was presented for acute vomiting secondary to suspected consumption of a foreign body. Unusually extensive full‐thickness lacerations along the mesenteric border of the descending duodenum were present in association with devitalisation of portions of the ascending duodenum. To preserve the duodenum, total duodenectomy with associated biliary tract diversion was not considered. Ascending duodenectomy was performed. The descending duodenal mesenteric lacerations were managed using an internal primary closure technique through an antimesenteric duodenotomy. This particular technique is described, and its potential complications are discussed in this case report. While the outcome of this case report was excellent, more studies are needed before recommending this technique as part of the instrumentarium of duodenal repair.
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In ecological parks, the proximity to tourist activities facilitates the exploration of garbage by coatis, with possible serious consequences for the animals health . We described the contents of wild coatis feces from three ecological parks. After analyzing 62 samples, fragments of plants and animals were identified in all feces. In the feces of two parks, seeds were present between 36.4% and 48.6% of the samples. Arthropod fragments were identified in 100% of the samples from two parks, but only 87.3% in a third park. Scales, bones or bird feathers were present in some samples. Undigested material of industrial origin was detected in 34.3% to 54.5% of the samples, such as fragments of paper, string, plastic, aluminum, latex and glass. Results are in line with other studies on the diet of wild coatis, but the intake of foreign bodies, potentially harmful to health, is described for the first time. Clinical problems resulting from ingesting waste can be dental fractures, mucosal erosions, intestinal perforation, peritonitis, impaction, diarrhea, weight loss, intoxication and infections. Coatis in the three parks are at risk of health, and actions are needed to avoid clinical and potentially fatal problems. Four actions are recommended to avoid ingesting foreign bodies: increasing the environmental education of visitors; improving the storage of waste generated in parks; periodically monitor the health of coatis, in order to make interventions when possible; make a permanent program to study the ecology of species in the three parks.
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Gastrointestinal (GI) exploratory laparoscopy can be performed safely in dogs and cats provided that the minimally invasive surgeon is thorough and possesses good decision-making ability. A myriad of GI diseases affect dogs and cats, with the most common being obstructive and nonobstructive foreign bodies, infectious, inflammatory, and neoplastic conditions. An additional advantage of GI laparoscopy is the reported decreased frequency of adhesion-related small bowel obstruction postoperatively, which is a common complication in humans after abdominal surgery. A study looking at conversion rates from diagnostic laparoscopy to laparotomy found that low preoperative total solids, presence of a solitary liver tumor, and diagnosis of neoplasia were associated with an increased risk of conversion to laparotomy. The GI tract can be challenging to explore completely and accurately using laparoscopy because of its length as well as its variation in size and location within the peritoneal cavity.
Chapter
Enteral nutrition is of critical importance to perioperative surgical patients. Enteral feeding maintains the health of the gastrointestinal (GI) tract and provides critical substances essential for uncomplicated wound healing. Any perioperative patient with inadequate voluntary nutritional intake is a candidate for supplemental enteral feeding. The initial camera port is placed on ventral midline 2–3 cm caudal to the umbilicus. Laparoscopic and laparoscopic-assisted gastrostomy tube placement has not been described clinically in dogs and cats. Hospitalization time in veterinary patients undergoing laparoscopic-assisted enterostomy tube placement depends on the physical status and concurrent illness of the patient. The GI tract possesses a healing curve similar to that of the skin, but has accelerated healing properties. Laparoscopic-assisted intestinal biopsy has been described in both dogs and cats using a multiport technique. Both intracorporeal and extracorporeal GI omentalization can be performed with a laparoscopic-assisted approach.
Article
Objectives The aim of this study was to determine the incidence of and risk factors for both gastrointestinal (GI) incisional dehiscence and mortality in a large cohort of cats undergoing GI surgery. We hypothesized that cats with preoperative septic peritonitis (PSP), systemic inflammatory response syndrome (SIRS) or sepsis would have higher GI dehiscence and mortality rates than unaffected cats. Methods A medical records search identified cats with surgically created, full-thickness incisions into their stomach, small intestines or large intestines. Preoperative data, including signalment, clinical signs, comorbidities, surgical history, current medications, presenting physical examination findings, complete blood counts and serum biochemistry values, were collected. It was determined whether or not cats had PSP, SIRS or sepsis at admission. Intraoperative data, final diagnosis and postoperative variables such as vital parameters, bloodwork and (if applicable) the development of GI dehiscence or mortality were noted. Postoperative follow-up of at least 10 days was obtained in survivors. Results In total, 126 cats were included. One cat developed GI dehiscence following complete resection of a jejunal adenocarcinoma. Twenty-three cats (18.2%) died within 10 days of surgery. Cats with PSP ( P = 0.0462) or that developed hypothermia 25–72 h postoperatively ( P = 0.0055) had higher odds of mortality in multivariate analysis. Cats with PSP had 6.7-times higher odds of mortality than cats not diagnosed with PSP. Conclusions and relevance In cats receiving GI surgery, the incidence of GI incisional dehiscence was <1%. Cats with PSP had a higher likelihood of mortality. SIRS was a common finding in cats with septic peritonitis, but was not associated with mortality. Postoperative mortality during the home recovery period might be significant in cats. Future studies evaluating postoperative mortality in cats should consider extending the research period beyond the date of discharge.
Article
Objective To evaluate preoperative diagnostics in dogs with gastrointestinal foreign body (GIFB) obstruction and to identify clinical variables associated with the performance of simple enterotomy (EO) versus enterectomy (EC). Design Retrospective case control study from October 2013 to January 2016. Setting Veterinary Teaching Hospital. Animals Eighty-two client-owned dogs diagnosed at the time of surgery with GIFB obstruction. Measurements and Main Results Data were collected from medical records regarding history, initial physical examination, clinicopathologic testing, diagnostic imaging, and surgical reports. Based on univariate analysis, dogs that required EC were ill (P < 0.0001) and anorexic (P = 0.0007) for a longer duration; had a higher vomiting severity score (P = 0.005); and had worse perfusion parameters (mucous membrane color [P = 0.028] and quality [P = 0.032], poorer pulse quality [P = 0.0015], relatively lower blood pressure [P = 0.0328], greater heart rates [P = 0.0011]). Dogs undergoing EC were more likely to have altered peritoneal detail on radiographs (P = 0.0014; odds ratio [OR] = 25.5; 95% confidence interval [CI]: 2.4, 275.7) and echogenic peritoneal effusion on ultrasound (P = 0.0101; OR = 12.5; 95% CI: 1.3, 120.9), compared to the EO group. Heart rate (adjusted P = 0.028; OR = 1.07; 95% CI: 1.0, 1.1) and vomiting severity score (adjusted P = 0.028; OR = 5.6; 95% CI: 1.2, 26.1) maintained significance after multiple logistic regression. Conclusions Multiple factors in the preoperative clinical evaluation were different between dogs undergoing EO versus EC for GIFB obstruction. However, many of these variables become insignificant with multiple logistic regression. The presence of an increased heart rate or increased vomiting severity score at presentation was independently associated with undergoing enterectomy. Prospective studies with greater number of animals are warranted to validate these results.
Article
A dog presented 16 hours after an acute onset of severe generalized lingual swelling from an unknown cause. The dog had recently chewed a deer carcass. Initial physical examination and diagnostic testing did not reveal an underlying cause, and supportive care was provided. After 16 hours of hospitalization strangulating organic foreign material was found at the base of the tongue and removed. Macroglossia and secondary superficial lingual necrosis were successfully managed with supportive care while the patient was hospitalized. Thermographic imaging was used and indicated lingual hypothermia and subsequent normothermia, before and after removal of the linear foreign body respectively. Histopathologic analysis revealed the foreign body consisted of degenerate and autolyzed collagenous connective tissue, likely representing tissues such as tendon, fascia or a large thick-walled blood vessel which was suspected to have been consumed from the deer carcass. Thermographic imaging was employed and demonstrated to be consistent with hypoperfusion (hypothermia) of the affected tissue. Thermographic imaging adds value as an additional diagnostic tool for conditions with compromised blood flow.
Article
Esophageal and gastric foreign bodies (EFB and GFB) are a common occurrence in cats and dogs. The objective of this study is to evaluate the endoscopic instruments and techniques used for foreign body retrieval by internists or criticalists based on type and location of the foreign body. An online, anonymous survey was created using a commercial software. The survey was distributed to diplomates of the ACVIM (SAIM) and ACVECC through each college's listserv. Data obtained included specialty, years in practice, practice type, available instruments, and preferred instrument for various foreign bodies by location and type. Two hundred sixty-eight surveys were completed with 74% from private referral practice and 21% from academic practice. For EFB, laparoscopic or endoscopic grasping forceps were used most commonly. For GFB, grasping forceps or loop snares were used most commonly. Fifty percent of respondents reported attempting duodenal FB removal. In practices with limited financial resources, endoscopic grasping forceps and loop snares may be prioritized for purchase as these instruments may have the most application for foreign body retrieval from the esophagus and stomach.
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Article
Se reporta el caso de un gato europeo doméstico de un año y tres meses de edad presentado a consulta con patrón respiratorio restrictivo, dolor a la palpación abdominal en la región cráneo ventral, sonidos cardiacos disminuidos. Se realizó estudio radiográfico rutinario de tórax que permitió observar un cuerpo extraño lineal (CEL) radio-opaco con pérdida de definición de las estructuras y signos de derrame pleural. Se practicó toracotomía exploratoria en hemitórax izquierdo para extraer el CEL y contenido purulento. Asimismo, se colocó drenaje pleural. En el postoperatorio inmediato se administró oxigenoterapia y permaneció en hospitalización durante una semana. Al mes se realizaron estudios radiográficos de control donde no se observaron cambios aparentes.
Article
Gorilla Glue contains methylene diphenyl diisocyanate that expands significantly and hardens once exposed to moisture. Case reports of methylene diphenyl diisocyanate glue ingestion in dogs document gastrointestinal foreign body formation and mechanical obstruction. Medical record queries from four veterinary hospitals identified 22 dogs with Gorilla Glue ingestion. Records were evaluated retrospectively to characterize clinical presentation, diagnostic findings, treatment, and patient outcome. Vomiting was the most common clinical sign (n = 11), with a median time from ingestion to presentation of 42 hr. Abnormal abdominal palpation (e.g., pain) was the most reported examination finding (n = 13). Radiographs were performed in 18/22 dogs, with Gorilla Glue expansion described as granular or mottled soft tissue with gas in the stomach. In 73% (11/15) of dogs requiring surgery, history, clinical findings, and survey abdominal radiographs sufficed to proceed with celiotomy. Surgical removal of the Gorilla Glue foreign body was performed via gastrotomy (n = 14) or gastrotomy and duodenotomy (n = 1). Endoscopic removal was performed in one dog. One dog with suspected mechanical obstruction was euthanized owing to financial constraints. Remaining cases were managed conservatively (n = 5). Short-term prognosis following appropriate fluid therapy and surgical or endoscopic removal was very good.
Article
Mechanical obstruction is a common cause of acute vomiting among small animals and radiography is the first line diagnostic tool. Due to many circumstances, surgery may not be an immediate treatment option. The purpose of this retrospective, cross‐sectional design study is to determine the incidence of radiographic resolution of mechanical obstruction or gastrointestinal foreign material with medical management. Inclusion criteria included: clinical signs of vomiting, radiographic diagnosis of mechanical obstruction, suspect mechanical obstruction, foreign material suspected or definitively identified on the first set of radiographs and a second set of repeat radiographs within 36 h. Radiographic resolution was dependent on the location of dilation; 18/48 (37.5%) resolved were gastric, 6/35 (17.1%) were small intestinal, and 4/35 (11.4%) had concurrent gastric and small intestinal obstruction. Gastric dilation was more likely to resolve than SI dilation or both gastric and small intestinal dilation (P = .0119). Forty‐nine animals without resolution went to surgery, with two developing pneumoperitoneum, and seven requiring intestinal resection, three of which had linear foreign bodies and three had intestinal masses/strictures. In conclusion, only 17.1% of animals with small intestinal dilation and a radiographic diagnosis of mechanical ileus resolved on repeat radiographs, and only 11.4% of animals with both small intestinal and gastric dilation resolved. Gastric dilation alone was more likely to resolve than small intestinal dilation or a combination of both. This may help to guide practitioners in recommendations for medical management of mechanical ileus in the future.
Chapter
Flexible endoscopy is a common and routine procedure in the diagnostic workup of dogs and cats with gastrointestinal (GI) symptoms, such as retching, regurgitation, vomiting, or diarrhea. The selection of the endoscopic equipment in veterinary practice depends often on its expense and therefore on the versatility of application of one endoscope, its durability, and ease of guidance. The esophagus can be markedly dilated in dogs and cats, unless there are strictures present, thus basically all flexible endoscopes normally used in small animal GI endoscopy can be used. Diagnostic gastroscopy is always performed in conjunction with enteroscopy and possibly even ileoscopy. Functional problems and motility abnormalities cannot be diagnosed by upper GI endoscopy and neither can systemic and metabolic diseases. Therefore, a very thorough clinical workup of dogs and cats prior to gastroduodenoscopy is mandatory.
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Article
An eleven month old male, juvenile lion brought for rehabilitation at the Olusegun Obasanjo Presidential Library (OOPL) Wildlife Park was diagnosed with gastrointestinal foreign body and intussusception based on the history of persistent vomiting following ingestion of a cotton towel, and radiographic findings of a radiopaque gastric foreign body extending from the fundus to the pylorus and a cylindrical soft tissue mid-abdominal mass. The lion was premedicated with an intramuscular injections of ketamine (5 mg.kg ⁻¹ ) and midazolam (0.25 mg.kg ⁻¹ ), while anaesthesia was induced with an intravenous injection of propofol (2 mg.kg ⁻¹ ). A celiotomy followed by gastrotomy and subsequent intestinal resection and anastomosis was performed to remove the gastrointestinal foreign bodies and correct the intussus ception. The lion recovered well without any complication and was gradually introduced back into the group housing three weeks later following successful alimentation process. This report is probably the first case of intussusception in a lion that was associated with a gastrointestinal foreign body.
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Article
Objective: To evaluate gastrointestinal injury and outcomes between dogs treated with immediate surgical intervention vs those treated with delayed surgical intervention for gastrointestinal foreign body obstruction (GIFBO). Study design: Retrospective cohort study. Sample population: Client-owned dogs (n = 855) from five referral hospitals. Methods: Medical records of dogs in which GIFBO had been diagnosed between 2007 and 2017 were reviewed for preoperative management, timing of surgery, intraoperative findings, postoperative management, outcome, and survival. Surgical intervention was classified as immediate when it occurred within 6 hours of presentation and delayed when it occurred >6 hours after presentation. Results: Outcomes did not differ between dogs treated immediately (n = 584) or over 6 hours after presentation (n = 210). Intestinal necrosis and perforations were more common when surgery was delayed (P = .008; P = .019) but became nonsignificant after controlling for preoperative differences. Risk factors for necrosis and perforations included duration of clinical signs, increased lactate, linear foreign material, and timing of surgery. Enterectomies (P = .004) as well as the duration of surgery (P = .004) and anesthesia (P = .001) were increased when surgery was delayed. Immediate surgery was associated with earlier return to feeding (P = .004) and discharge from the hospital (P < .001); (5%) dogs in each group (n = 33 immediate; n = 11 delayed) either had a negative explore or the foreign body was milked aborally into the colon at the time of surgery. Conclusion: Although outcomes were not associated with surgical timing, the unadjusted prevalence of gastrointestinal injury and, thus, the requirement for complex surgical procedures was higher in the delayed group. Clinical significance: Earlier surgical treatment of stabilized dogs with GIFBO may involve fewer complex procedures and accelerate recovery.
Chapter
Gastrointestinal endoscopy is an attractive diagnostic tool for many gastrointestinal disease cases presenting to companion animal practitioners. This technique can allow direct visualization of the gastrointestinal mucosa in the esophagus, stomach, upper part of the small intestine, colon, and distal ileum. This chapter provides an overview of flexible endoscopic equipment types, correct handling and manipulation of the endoscope, and methods for obtaining biopsies. It also provides a general overview of the steps for several endoscopic procedures, and the use of flexible endoscopy for some minimally invasive therapeutic procedures such as feeding tube placement and foreign body retrieval. Duodenoscopy is commonly indicated for the assessment of small intestinal disease in companion animals. Mucosal assessment and biopsy are of value in cases with unexplained weight loss, poor appetite, vomiting, and diarrhea. Ileoscopy is strongly recommended when endoscopic examination is being conducted as part of the approach to patients with gastrointestinal disease.
Article
Four dogs presented with linear gastrointestinal foreign body (FB) obstruction caused by impacted grass fibres. The material had become anchored within the pylorus in three dogs, causing necrosis and perforation of the mesenteric border of the affected intestinal segment. Gastrotomy and intestinal resection and anastomosis were performed. The fourth case presented acutely with no intestinal necrosis or perforation, with the fibres removed via enterotomy. One dog suffered severe postoperative ileus that failed to respond to medical management. Continued deterioration prompted euthanasia 12 days postoperatively. The other three dogs survived and were discharged without complication. Grass has not previously been reported as a cause of linear gastrointestinal obstruction in dogs. It has, however, the potential to cause severe necrosis and perforation of the intestine and should be recognised as a potential linear FB in dogs.
Article
Small intestinal foreign body obstructions occur commonly in dogs, accounting for 80% of all canine intestinal obstructions. Such obstructions induce local aberrations in secretion, absorption and intestinal motility that can precipitate devastating systemic consequences, including a systemic inflammatory response, sepsis, and multi-organ dysfunction. Radiographic diagnosis is poorly sensitive relative to ultrasonography for diagnosing the presence of obstructive foreign material. Emergent surgical intervention is indicated for dogs with obstructive foreign material due to an inability to assess the degree of compromise of the intestinal wall that may precipitate intestinal perforation and to mitigate progression of life-threatening electrolyte and acid-base imbalances secondary to sequestration and emesis. Intraoperatively, an enterotomy or resection and anastomosis may be required to remove the obstructive material. A number of subjective and objective techniques for assessing the viability of intestinal tissue have been described due to the poor accuracy associated with surgeon assessment of color, peristalsis, pulsation, bleeding, and mural thickness alone. Such techniques have the potential to alter the surgeon's decision-making regarding performance of an enterotomy or resection and anastomosis, potentially reducing morbidity associated with intestinal surgery.
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Article
The records of 123 cases, treated at the Clinic for Surgery, Orthopaedics and Ophthalmology of the Faculty of Veterinary Medicine, University of Zagreb, from January 1981 to December 1998 were analysed. Analysis included the incidence of ileus caused by foreign bodies, and the distribution of patients by sex, age, breed, duration of illness, site of obstruction, types of foreign bodies and the interrelation between these parameters. Results of our research show that the number of patients with foreign body induced ileus is increasing. Males ingested foreign bodies more often than females. Foreign body induced ileus was more frequently found in animals under the age of 2 years. Foreign bodies were mostly ingested by mongrels, but also by popular dog breeds such as Dobermann, Poodle, German Shepherd and Cocker Spaniel. Most of these ileus cases were treated in June and October and the predominant clinically signs included anorexia, dehydration, abdominal tenderness and absence of defecation. The most common site of small intestine obstruction by foreign bodies was the jejunum, the most effective treatment being enterotomy. Dogs mostly ingested stones, and plastic and rubber objects. Treatment was more successful in dogs below 2 years of age. Patients that died post-surgically died mostly during the first day after surgery.
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Article
Intestinal foreign bodies are some of the most common causes of intestinal obstruction in dogs and cats. The size of the foreign body determines whether obstruction is partial or complete. Life-threatening complications caused by fluid and electrolyte imbalances, hypovolemia, and toxemia may be associated with intestinal foreign bodies. Diagnosis is made on the basis of clinical signs and results of radiography and ultrasonography and is confirmed by abdominal exploration. Most foreign bodies can be removed through one or more enterotomies.
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Article
Between 1997 and 1999, five domestic crossbred cats (four long haired, one short haired) presented with a palpable abdominal mass and were shown to have small intestinal trichobezoars at laparotomy or necropsy. Hair balls were associated with partial or complete intestinal obstruction and were situated in the proximal jejunum to distal ileum. In four cats obstructions were simple, while the remaining cat had a strangulating obstruction. Three of the cats were 10 years or older, and two were less than 4 years. In the three older cats abdominal neoplasia was suspected and investigations were delayed or declined in two of these cats because of a perceived poor prognosis. Predisposing factors identified in this series of cats included a long-hair coat, flea allergy dermatitis, inflammatory bowel disease and ingestion of non-digestible plant material. This report shows that the ingestion of hair is not always innocuous and that intestinal trichobezoars should be considered in the differential diagnoses of intestinal obstruction and intra-abdominal mass lesions, particularly in long-haired cats.
Article
Intestinal foreign bodies are some of the most common causes of intestinal obstruction in dogs and cats. The size of the foreign body determines whether obstruction is partial or complete. Life-threatening complications caused by fluid and electrolyte imbalances, hypovolemia, and toxemia may be associated with intestinal foreign bodies. Diagnosis is made on the basis of clinical signs and results of radiography and ultrasonography and is confirmed by abdominal exploration. Most foreign bodies can be removed through one or more enterotomies.
Article
Twenty-four cases of gastrointestinal linear foreign bodies (LFB) in cats were reviewed. Nine cats were successfully managed conservatively, with passage of the LFB occurring 1 to 3 days after presentation. Ten cats that were initially managed conservatively were subsequently treated surgically. The decision to operate was based on worsening of clinical signs and failure to pass the LFB. Five cats were initially treated surgically. The cats that were managed successfully via conservative treatment had a shorter duration of clinical signs before presentation, decreased incidence of abdominal pain and palpable intestinal plication, and less severe hematologic abnormalities. Radiographic signs were of little benefit in deciding whether to treat the cats conservatively or surgically. None of the cats died.
Article
Sixty-four cases of gastrointestinal linear foreign body in the cat were reviewed. Most of the cats were less than 4 years old. The most common clinical signs were persistent vomiting, partial to complete anorexia, and depression. Abdominal palpation by itself was rarely diagnostic. Diagnosis in approximately 75% of the cases was possible, however, by using a combination of oral examination and abdominal palpation. Survey radiography contributed to the diagnosis in 86% of the cases in which it was used, based on evidence of bowel plication, presence of tapered, enteric gas bubbles, gathering of the small intestine, peritonitis, intestinal needles, or bowel obstruction. Surgery (gastrotomy and multiple enterotomies) was necessary in 96.9% of the cases, and most of the cats so treated did well (83.9%). Approximately 50% of the cats with linear foreign body-induced bowel lacerations recovered.
Article
Medical records of 21 dogs and 2 cats treated for septic peritonitis were reviewed. Animals were between 1 and 12 years old, (mean, 6.5 years) and weighed between 6 and 51.4 kg (mean, 22.7 kg). Overall, 13 animals survived and were discharged from the hospital. Immediately after surgical correction of the underlying cause of peritonitis, most animals were tachycardic (mean heart rate, 148 beats/min; range, 80 to 204 beats/min), and many were hypotensive (mean arterial pressure, 84.4 mm of Hg; range, 44 to 156 mm of Hg). Hypotension was attributed to sepsis and hypovolemia secondary to extensive loss of fluid into the peritoneal cavity. Survivors did not differ from nonsurvivors with regard to mean arterial pressure immediately after surgery, and in most animals, hypotension could be corrected by IV administration of fluids. Three animals died after failing to respond to fluid treatment, despite concurrent administration of inotropic or pressor agents. Mean rate for crystalloid fluid administration was 12.8 ml/kg of body weight/h (range, 5 to 23.5 ml/kg/h) during the first 24 hours after surgery. Six of 23 animals had low urine output for a short time after surgery, but urine output increased when fluids were administered. Hypoalbuminemia developed in all animals (mean serum albumin concentration, 1.17 g/dl; range, 0.6 to 2.3 g/dl), and peripheral edema developed in 13. Neither lowest mean serum albumin concentration nor fluid administration rate was significantly different between animals that developed peripheral edema and those that did not. Fluid administration rates were significantly higher in nonsurvivors (15 ml/kg/h; range, 5.5 to 23.5 ml/kg/h) than in survivors (11 ml/kg/h; range, 5 to 17.5 ml/kg/h).(ABSTRACT TRUNCATED AT 250 WORDS)
Article
The animal with a surgical gastrointestinal emergency usually requires a rapid, thorough physical examination with concurrent resuscitation. As the diagnosis is being made, the animal must be made as stable as possible before undergoing general anesthesia. During surgery, there must be a critical evaluation of gastrointestinal viability and the use of precise technical skills to achieve the best outcome. Adept postoperative management, including careful monitoring and an index of suspicion for potential complications, is vital.
Article
To determine outcome of dogs and cats with generalized peritonitis treated by means of closed-suction drainage. Retrospective study. 30 dogs and 10 cats with generalized peritonitis. Medical records were reviewed, and information on signalment, clinicopathologic abnormalities, contamination source, results of microbial culture, surgical procedure performed, postoperative management, complications, and outcome was obtained. The gastrointestinal tract was the most common source of contamination. Abdominal fluid collected from 34 patients at the time of surgery was submitted for bacterial culture; results were positive for 28 (82%). The most commonly isolated organism was Escherichia coli. Postoperative complications included anemia (n = 21), hypoproteinemia (21), vomiting (9), edema (7), and diarrhea (5). Total solids concentration did not decrease during the first 48 hours after surgery, and all drains remained functional until removal. Twenty-eight patients survived to the time of discharge; 8 of the 12 animals that died did so within 18 hours after surgery. The only factor significantly different between patients that survived and patients that died was postoperative systolic blood pressure. Factors that were not significantly associated with outcome included detection of bacteria in the abdominal fluid, number of organisms cultured from the abdominal fluid, selection of antimicrobials for empiric treatment, and source of contamination. Results suggest that closed-suction drainage may be a useful method for treating generalized peritonitis in dogs and cats. No clinically important complications were associated with their use.
Article
To determine survival rates in dogs and cats with septic peritonitis treated with open peritoneal drainage (OPD) versus primary closure (PC) after laparotomy. Retrospective analysis of medical records from Colorado State University Veterinary Teaching Hospital from 1993 to 1999. Thirty-six dogs and 6 cats with septic peritonitis documented by cytological examination or microbiological culture of abdominal fluid. Medical records of dogs and cats with septic peritonitis treated by OPD or PC were reviewed. Age, weight, species, white blood cell (WBC) count, band neutrophil count, platelet count, serum glucose concentration, heart rate, body temperature, duration of hospitalization, and clinical outcome were recorded for each animal. Differences in treatments administered between the OPD and PC groups as well as the underlying cause of septic peritonitis were determined. There was no significant difference in survival between animals in the OPD versus PC groups (P =.26) with an overall survival rate of 71%. White blood cell count, band neutrophil count, platelet count, serum glucose and total bilirubin concentrations, heart rate, age, and weight were not significantly different between groups (P >.05). A significantly greater number of animals in the OPD group received plasma (P =.009), blood (P =.037), and a jejunostomy tube (P =.02) than animals in the PC group. There was a significant difference in the number of days spent in critical care unit with a mean of 6.0 +/- 4.1 days for the OPD group and 3.5 +/- 2.3 days for the PC group (P =.02). Open peritoneal drainage for the management of septic peritonitis in dogs and cats is an acceptable alternative to PC.
Article
The common presentations of gastrointestinal foreign bodies in cats are discussed in this article. The options for diagnostic imaging modalities and other diagnostic tests are detailed. The management of foreign body obstructions at different levels of the gastrointestinal tract is discussed. Particular attention is paid to the management of linear gastrointestinal foreign bodies, morbidity associated with this condition, and treatment. There is also a brief discussion on the types of gastrointestinal foreign bodies presenting to a veterinary teaching hospital at which both referral and primary cases are seen.
Article
To identify factors associated with leakage following intestinal anastomosis in dogs and cats. Retrospective study. 90 dogs and 25 cats. Medical records of all dogs and cats that underwent intestinal resection and anastomosis between 1991 and 2000 were reviewed, and information on 27 factors was recorded. Anastomotic leakage was identified in 13 of the 90 dogs but in none of the 25 cats. Preoperative factors significantly associated with development of anastomotic leakage in dogs included preoperative peritonitis, serum albumin concentration, a left shift, and indication for surgery (dogs with intestinal foreign bodies were more likely to have leakage than dogs that underwent surgery for any other cause). Postoperative and case management factors significantly associated with development of leakage included duration of hospitalization, supplemental alimentation, whether the dog ate the day after surgery, blood product administration, and outcome (died vs survived). Discriminant analysis was performed, and dogs with 2 or more of the following factors were predicted to develop anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration < or = 2.5 g/dL. The model accurately predicted whether leakage would develop in 67 of 80 (84%) dogs. Results suggest that a variety of factors may be associated with development of intestinal anastomotic leakage in dogs. In particular, dogs with 2 or more of the following risk factors are predicted to be at high risk for developing anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration < or = 2.5 g/dL.
Article
Wooden skewer foreign bodies were found in eight dogs. Five presented for evaluation of draining sinuses and two for inflammatory disease referrable to the thorax, abdomen or pelvic region. In an additional case, pneumothorax resulted from perforation of the stomach and diaphragm. Ingestion was considered the most likely mode of access of the foreign body in all cases. Although the wooden foreign bodies were seen radiographically in only two dogs, identification of soft tissue or bony changes, or the results of contrast sinography assisted diagnosis. Surgical retrieval led to resolution of signs in all cases.
Article
To determine the underlying cause, pathophysiologic abnormalities, and response to treatment in cats with septic peritonitis and identify differences between cats that survived following treatment and cats that did not survive despite treatment. Retrospective study. 51 cats with septic peritonitis. Medical records were reviewed for clinical findings; results of clinicopathologic testing, microbial culture, and radiography; diagnosis; treatment; and outcome. Signs of pain during palpation of the abdomen were reported for only 29 of 47 (62%) cats. Eight (16%) cats had relative bradycardia (heart rate < 140 beats/min). The most commonly isolated organisms included Escherichia coli, Enterococcus spp, and Clostridium spp. The most common cause of peritonitis was gastrointestinal tract leakage (24 cats). No definitive source could be identified in 7 cats. Treatment, including exploratory surgery, was pursued in 23 cats, of which 16 (70%) survived and were discharged. There were no significant differences between survivors and nonsurvivors in regard to heart rate, age, rectal temperature, serum lactate concentration, WBC count, PCV, blood glucose concentration, or serum albumin concentration. Results suggest that clinicopathologic abnormalities and outcome in cats with septic peritonitis are similar to those reported for dogs. However, certain features may be unique, including an absence of signs of pain during abdominal palpation, relative bradycardia, and apparent spontaneous peritonitis in some cats.
Article
To retrospectively report the complications seen after full-thickness multiple small intestinal biopsies were performed in 66 dogs. Animals that died as a result of enteric wound breakdown were compared with the surviving population to identify fatal risk factors. Seventeen dogs had hypoalbuminaemia and eight had albumin levels below 20 g/I at surgery. Twelve dogs had concurrent disease, of which seven had skin disease. Seven dogs suffered minor complications which resolved with treatment. Eight dogs (12 per cent) died or were euthanased between three and nine days postoperatively (mean [sd] 4.5 [2.1]) due to enteric wound breakdown. Seven of these dogs developed septic peritonitis and one died of haemorrhage. No statistically significant differences were identified in any of the parameters examined for the development of fatal enteric wound dehiscence. Full-thickness intestinal biopsy is not a benign procedure. However, this study concludes that there are no consistent predictors for patients at increased risk of enteric wound breakdown.
Article
Gastrointestinal foreign bodies occur commonly in dogs. The objective of the study was to describe the acid-base and electrolyte abnormalities identified in dogs with gastrointestinal foreign bodies and determine if these abnormalities are related to the site or type of foreign body present. Medical records of 138 dogs were reviewed, and information on signalment, initial venous electrolyte and acid-base values, surgical findings, relevant historical information, imaging modalities used, cost of hospital visit, intra- or postoperative complications, and survival was obtained. The site of the foreign body was recorded in 94.9% of cases and the most common site was the stomach (50%), followed by the jejunum (27.5%). The foreign bodies were linear in 36.2% of cases. The most common electrolyte and acid-base abnormalities regardless of the site or type of foreign body were hypochloremia (51.2%), metabolic alkalosis (45.2%), hypokalemia (25%), and hyponatremia (20.5%). No significant association was found between electrolyte or acid-base abnormalities and the site of foreign body. Linear, as opposed to discrete, foreign bodies were more likely to be associated with a low serum sodium concentration (odds ratio, 0.85; 95% confidence interval, 0.75-0.95). Hyperlactatemia (> 2.4 mmol/L) was seen in 40.5% of dogs. A wide variety of electrolyte and acid-base derangements are found in dogs with gastrointestinal foreign bodies. Hypochloremia and metabolic alkalosis are common in these dogs. Hypochloremic, hypokalemic metabolic alkalosis is seen with both proximal and distal gastrointestinal foreign bodies.
Intestinal obstruction by trichobezoars in fi ve cats Conservative versus surgical management of gastrointestinal linear foreign bodies in the cat
  • V R Beatty
  • J A Tisdall
  • P L Hunt
  • G B Gunew
  • M Nicoll
  • R G Malik
  • R Basher
  • A W P Fowler
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Visceral healing and repair disorders In: Disease Mechanisms in Small Animal Surgery
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