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| Clyde |
Clyde is a 3
year old Shih-tzu who came to us with a history of severe bloody
diarrhea and vomiting for 2 days duration. Taking the usual history, we
found that there was no exposure to toxins or new food, however the
owner had given Clyde a large ham bone to chew on 3 days prior to
arrival.
On presentation, Clyde was anxious
and somewhat depressed. His gums were pale and grey. His heart rate was
elevated and he was panting at rest. On palpation, his abdomen was
painful and very tense.
Rectal exam revealed bloody
mucinous diarrhea.
Our rule-outs in this case
included:
Intestinal obstruction,
pancreatitis, Hemorrhagic Gastroenteritis or other metabolic disease.
The history of the bone ingestion pointed towards obstruction as the
most likely problem. Hence, we took radiographs before going
further. The films below show a boney foreign body located in the
colon (circled in red).
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Pre operative radiographs. Note the
boney foreign body in colon (click on image for larger view) |
Pre operative radiographs. Note the
boney foreign body in colon (click on image for larger view) |
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Clyde's pale color, his racing
heart and the pain he was experiencing indicated that he was in
shock and we needed to act promptly to save him. Due to
the large nature of the foreign body, it was unlikely that we
could remove it with an enema or through colonoscopy. We
recommended an abdominal exploratory surgery. The owners
agreed and we got Clyde ready for surgery. Pre op
blood tests showed that Clyde was dehydrated but fortunately his
major organs were ok. His white cell count was elevated
probably due to the stress and pain, but possibly from the
invasion of bacteria from the intestines, damaged by the sharp
bones.
We promptly installed an IV catheter
and began rehydrating Clyde. At the same time we
administered intravenous antibiotics along with pain medication
and pre operative sedatives.
We induced anesthesia and prepped
Clyde for surgery. We made a long incision down the middle
of his abdomen which enabled us to examine all of the abdominal
contents.
Examining the stomach and intestines,
we were happy to see that there was no evidence of perforation
of the intestines. The foreign body was located in the
colon as our radiographs indicated. We isolated the colon
outside of the body and removed the foreign body through a 2
inch incision, being very careful to avoid contamination of the
abdomen with bacteria laden fecal contents. The colon was
closed in two layers to provide a watertite seal.
The seal was tested before closing by injecting sterile water
into the site and squeezing gently to see if the water leaked,
it did not. The abdomen was lavaged with 3 liters of
sterile saline, and the adominal wall was closed in the routine
manner.
Post operative radiographs showed that
we got the entire foreign body . |
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Post Operative radiographs. Notice the colon is clear of
foreign body |
Post Operative radiographs. Notice the colon is clear of
foreign body |
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It took 3 days of supportive care
before Clyde was willing to eat. The bone fragments must
have severely irritated the intestinal lining. Fortunately, he
came around and was discharged to his happy owners.
Clearly, this was the last and most expensive bone that
Clyde was ever going to get!
Many people are under the false
impression that bones are good for their dogs. Bones are
very hard and frequently cause fracturing of the teeth when they
are gnawed upon. This case illustrates just how
destructive a bone can be once it lodges in the intestines.
If you want to give your pets toys to chew on, we recommend
rawhide bones, nylabones and kong toys. Avoid anything
that can be broken apart into fragments which might get lodged
in the intestines. While we are on the subject, do not use
cow hooves as toys as they are a common cause of tooth fracture.
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