Foreign body ingestion

Photo: Contributed

Thistle recovering from surgery.

Despite his huge size and quite intimidating appearance, Thistle is probably one of the sweetest, most gentle patients I have ever had. He is usually a happy fellow and will always joyfully accepts treats. Therefore when he all of the sudden became depressed, vomited repeatedly and would not eat, his owners got very concerned. Thistle's diagnosis was challenging as every test that was done came back negative. As a last resort, when no test showed the reason for Thistle's condition, we decided to perform a surgical exploratory operation. Sure enough, the surgery revealed that Thistle had swallowed a corn cob that obstructed his bowls.

Even though, I was the one that saved Thistle, I will forever be indebted to him. Thistle's case showed me that in medicine everything is possible, and despite the fact that the tests did not show the foreign body signs, it was still there. I learned that although it is rare, our diagnostic tools' ability can be limited. I now trust my gut feeling more than ever before. Pets owners have to be familiar with the risk of gastrointestinal obstruction in their pets and its signs in order to prevent it from happening, or detecting it readily if already occurred.

Dogs and cats, especially the young ones, are naturally curious and playful hence they tend to chew and swallow various objects. The foreign object may lodge in any part of the gastrointestinal system; the esophagus, the stomach or the intestine. Dogs have been known to swallow bones, balls, corn cobs, toys, sticks, stones, pins, needles, wood splinters, cloth, rawhide, leather, strings, fruit pits, and other objects. The most common foreign bodies found in cats are strings. Any household object your pet chews on can become a foreign body problem. Although some smaller objects can get through the gut without getting stuck, the larger pieces can result in serious gastrointestinal complications. The presence of the foreign body can lead not only to either partial or complete obstruction but also to a tear of the gastrointestinal tract. Some foreign objects ingested such as coins and batteries can lead to intoxication.

Partial obstruction allows limited passage of fluids and gas through the gastrointestinal tract, whereas complete obstruction does not allow any passage of gas and fluids past the obstruction. A complete obstruction is a very severe condition, usually with a rapid progression and poses potential severe consequences if not treated right away. Gastrointestinal blockage can lead to impairment of the blood flow and often to a permanent damage to the area of the blockage and infection due to bacterial overgrowth and severe dehydration.

The clinical presentation of foreign bodies depends on the location of the object and whether the object caused a partial or complete obstruction.  The most common symptom associated with a gastrointestinal foreign body is vomiting. In a complete obstruction the vomiting will be profound and frequently will be accompanied also by lethargy, loss of appetite, and depression. A pet with an untreated case of complete obstruction will probably die within only a few days. In a partial obstruction the symptoms will be less severe and intermittent. The animal will lose weight, but as long as the animal keeps drinking it may live for 3-4 weeks.

Foreign bodies are usually diagnosed by imaging. Some objects can be seen on a plain x-ray, in other cases the object itself cannot be seen, but the shape of the intestine reveals a typical pattern that highly suggests the presence of a foreign body. Sometimes a contrast x-ray is required. In this type of test the animal is fed a special dye material that helps determine if there is an obstruction and its nature. Some foreign bodies can also be diagnosed by ultrasound or an endoscopic exam.

Once the diagnosis of a foreign body is established the treatment depends on the location of the object and the pet’s medical condition. If the pet’s condition allows it, the vet will repeat the x-rays in order to assess whether the object is moving and can pass on its own. In many cases a surgical intervention is required. In simple cases the surgery involves only removing the object. In more complicated cases, where the blockage has caused permanent damage, the surgery is more involved and may include a partial removal of the damaged intestinal segment.

Beside removing the object most animals also require hospitalization with intravenous supply of fluids until the animal gets back on track and is able to drink and eat on its own. The treatment usually also involves medication such as antibiotics and electrolytes supplementation.

Prevention is very important and may spare your animal from going through a very painful and potentially life threatening condition. It is important to pet proof your house. Keep away any object that your pet might ingest. Make sure that the toys that you give to your pets are large enough so they cannot be swallowed. Also make sure that the toys are made of good quality and cannot be broken into pieces easily. Some dogs tend to chew on objects more then others - I would keep away toys from these kind of dogs - better be safe than sorry. It is very important to make sure that your pet will not have access to garbage and garbage bins. Some dogs have an extreme tendency to chew on an object when they are walked outdoors. If that is the case with your dog and you feel that you are having difficulty controlling what your dog chews on, you can consider walking it with a muzzle on.

If your pet shows any of the symptoms mentioned, especially severe or intermittent vomiting, take it to be seen by your vet. Your vet can gather information on your specific pet's habits and living environment  and suggest more methods of preventing gastrointestinal foreign bodies.