Wall-E is a 4 year old, male Boston terrier dog from Rancho Cucamonga who presented our veterinary hospital with a history of not eating and vomiting and diarrhea for 5-6 days. While taking the history, the owner indicated that it was possible that Wall-E had eaten some wood while outdoors but they were uncertain if this had actually happened. Over the previous 5 days, Wall-E had shown minimal interest in food and was lethargic.
On presentation to our veterinary hospital, Wall-E was found to be quiet, yet alert. His gums were a bit pale and he appeared mildly dehydrated. His heart and lungs were fine and we were unable to feel any masses in the abdomen. On rectal exam, a metallic foreign body was found and removed. It turned out to be a penny, which was undergoing a fair amount of decay.
Based on these findings, we were suspicious of additional foreign material being the cause of the symptoms. We proceeded to take a radiograph (x-ray) and found the following:
Note the bright white area in the center of the radiograph. The brightness indicates that the foreign body is metallic, and when we inspected more closely, it appeared that there were a number of coins in the stomach. Considering the fact that Wall-E had been sick for 5 days, it was obvious that these coins were not going to get out of the stomach. Based on that, we advised a surgical solution. The owners consented and we admitted Wall-E to the hospital. We ran blood and urine tests prior to surgery to determine if there might be any complicating factors, which might make surgery problematic. The blood tests were fairly normal with a mild anemia (lack of red blood cells) and some inflammation in the pancreas.
Knowing that we had just removed a partially digested penny from the colon, we were leary of the anemia being caused by toxicity from the zinc found in the coins. Zinc is a mineral, which can cause blood cell destruction at high enough doses. The anemia could have also been caused by bleeding in the stomach or intestines. A normal dog has about 35% of his/her blood made of red blood cells. Wall-E’s was at 30% prior to surgery. This mild anemia is not a reason not to do surgery in most cases.
We took Wall-E to surgery and found $3.85 cents worth of coins in the stomach. The coins were all removed without incident and the stomach was closed in a routine manner. After the surgery Wall-E appeared to be in pretty good shape. We kept him without food for 24 hours to allow the stomach wound to seal. When we tried to feed him, Wall-E had no appetite, which can be normal after surgery. As we continued to monitor his blood count, we found that his blood count (hematocrit) had fallen from 30% to 20% in 1 day. At the same time, his serum (the part of the blood without the cells) was turning yellow, indicating that the red blood cells were probably being broken down in the body as opposed to him actively bleeding. Over the course of the next 24 hours, Wall-E ‘s hematocrit continued to fall until he was so anemic that we had to transfuse him with whole blood to keep him alive. Essentially, we were in a race to maintain his blood count long enough for the zinc to leave the system. Once out of the body, the effects of the zinc would stop.
After the transfusion, the blood count was brought up into the low 20’s, which is more compatible with life. Over the next 24 hours, the blood count started to rise slowly, giving us hope that the hemolysis (breakdown of the blood cells) had stopped. A day later, Wall-E was eating again and was able to be discharged into the owner’s care. We will continue to monitor his blood count until it is normal, but we expect a full recovery.
It is interesting to see how all of this trouble came from the single penny that was in the batch of change that Wall-E ate. Pennies are 97% zinc and they do dissolve in the stomach acid. Had it been only nickels, dimes and quarters, we still would have had to do surgery, but the risk of hemolysis would have been minimal. Of course, we urge you to be careful with respect to leaving change on the floor or allowing your pets access to any other small metallic objects which may contain zinc.