I carried out an operation yesterday on a dog which had swallowed a plastic object which turned out to have been a part of a child’s toy.
Any vet who deals with dogs and cats will be very familiar with this type of surgery, it is quite a satisfying operation as it is a life saver, if you carry out surgery quickly then all is usually well, if the condition is not diagnosed then there is a very real chance that a portion of bowel will perforate or become necrotic, peritonitis will set in and death will follow. The procedure itself is quite a big operation with a number of considerations, first you opening into the abdominal cavity usually through a mid line incision on the abdomen. The next step is to find the piece of bowel where the obstruction is and bring it out through the incision to the surface, the bowel then can be cut open and the obstruction removed. Suturing up the bowel requires care as the wound has to be watertight as bowel contents cannot be allowed to leak into the abdomen, the main incision is then closed. I asked the young vet who was helping me what the main thing to remember with this operation is and the correct answer in my view is once you have removed the foreign object from the bowel you should have a good look through the whole intestinal tract to see there is not another one, I bet lots of vets have been caught out with this one over the years. These dogs are on a drip throughout the procedure and go home on antibiotics and pain relief for a further five days.
This animal was on my operating table within an hour of arriving for a consultation, so how did I come to my diagnosis? If you are going to carry out a laparotomy you have to be reasonably sure of yourself, no one wants to open a dog up for nothing. In this case the dog had been repeatedly vomiting the day before, it had marked tension and pain when I palpated its abdomen, and it was lethargic and not eating. A quick x-ray under general anaesthetic revealed gas filled loops of bowel and the suspect foreign body. Having the animal under general anaesthetic also gives you a good chance to palpate the abdomen and of course when the abdomen is relaxed you can often feel any obstruction which of course all adds up towards an accurate diagnosis.
This dog will be going home today and I will shortly be talking to the owners about aftercare. This will be gentle lead exercise until the stitches come out in ten days time, a buster collar so the animal cannot get to its stitches and a five day course of antibiotics as well as a five day course of analgesics to take care of any post operative pain. Correct diet after this type of surgery is advisable so that the area of the bowel where the sutures are is not put under any pressure, for the first week this animal should be fed small frequent meals, the food being of a very soft consistency.
Over the years I have removed a number of different foreign bodies from animals intestinal tracts, one was a kinder egg which made for a pretty X-ray and another springer spaniel was so addicted to eating large stones that I had to open it up on an emergency basis on no less than five occasions. Dogs also seem prone to eating items of clothing, I remember once removing a pair of tights from the intestines of a dog belonging to a lady client. As a joke I said to her ” I never thought I would ever get my hands on your underwear ” as I held up the by now partially dissolved tights to show her what had caused the obstruction. I knew as soon as I had said it that this was a very inappropriate thing to say but luckily she saw the funny side and laughed and laughed!
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