Charlie is a 6 year old terrier mix who presented to us with a 3 day history of not eating, drooling and vomiting. According to his owners, Charlie had had no exposure to any drugs or toxins that they knew of. He is a predominantly indoor dog and has had no history of digestive problems. He is fed a commercial diet and no treats or human food. Because of the three day history, the owners had taken him to the emergency clinic to be evaluated. Radiographs were taken there and deemed to be normal. Charlie was given symptomatic care consisting of anti-vomiting medication and stomach acid reducers.
The next morning, Charlie continued to vomit and drool excessively. The owners brought him to us for re-evaluation. On presentation, Charlie was depressed. His gum color was pale and grayish and he was drooling excessively. The oral examination revealed moderate periodontal disease, but no bad teeth or oral foreign bodies were found. He was dehydrated and lethargic. Abdominal palpation was painful and his belly was very tense. We reviewed the radiographs taken at the emergency clinic and the stomach looked as if it were full of something. Since Charlie had not eaten in 2 days, that, in and of itself is abnormal. Therefore we took another set of radiographs (see below). The red circles indicate something in the stomach. Based on the presence of this material, in a dog who had been vomiting for 3 days, we could be fairly certain that something was stuck in Charlie’s stomach!
Lateral view of abdomen, note the material in the stomach outlined in red
Ventral Dorsal view of abdomen, note the material in the stomach outlined in red
Considering how bad Charlie was feeling, we suggested and exploratory surgery as soon possible. The owners authorized the surgery and we prepared Charlie by inserting an IV catheter, giving fluids, antibiotics and pain medications. We did routine pre op blood tests which showed an elevated white blood count compatible with stress or infection. At this point, we were worried about a possible perforation of the intestines.
We placed Charlie under anesthesia, prepped him for surgery and began our exploratory.
As we opened the abdomen, we could see that the intestines were bunched up close to the stomach. We could feel something in the stomach and when we opened it, we found a large piece of a towel. When we tried to extract it from the stomach, we found that part of the towel had entered the intestine, and was stuck there. This thin piece of the towel acted as a “linear foreign body”. As it moved down the intestines, the intestines, because of their constant peristaltic motion, “climbed” up the string. As this continues, the string cuts into the intestine, much in the way a piece of wire can be used to cut cheese. You can see how thightly compressed the intestines were in the photo below.
Since this had been going on for a number of days, the intestines, which were bunched up on the string appeared non viable. As a result, we had to excise that piece of intestine and reattach (anastamose) the healthy intestine back to the stomach. Fortunately, we did not have to sacrifice the portion of the intestine which contains the pancreatic and bile ducts. The surgery went smoothly and Charlie recovered steadily over the next few days. Despite losing 2 feet of intestines, Charlie has every expectation of living a normal life.
Cloth, string, carpet, thread, fishing line, tinsel and ribbons are some of the most dangerous foreign bodies that pets can swallow. The action of the intestines bunching up on the string frequently leads to perforations and peritonitis. Charlie is 6 years old and had no history of every swallowing things around the house. This shows us that any pet is liable to ingest things regardless of their history. So we must always be vigilant about leaving things around the house.
Entering the Stomach
Removing the stomach portion of the Foreign Body
Base of Foreign Body Removed
Stomach being Prepared for closure
Close-up of Intestines
Foreign Body (Rag)