Thursday, October 24, 2013

He ate what?!?

Gastrointestinal upset in household pets – which usually signifies vomiting and/or diarrhea – is probably the most common clinical complaint seen by Veterinarians on a regular basis. Thankfully the causes are often mild and self-limiting - like a bad batch of pet food or that chicken bone stolen from the trash. Occasionally, though, more serious internal medical conditions can be involved such as liver, pancreatic or endocrine diseases. Bland diets and medications usually relieve or correct these situations. But one of the more perplexing and potentially lethal problems your veterinarian faces are the suspected and too-frequent cases of intestinal foreign bodies or “FB” as known to most DVM's.

An FB can be anything from the indigestible twist tie off that bread sack to the rawhide dog chew that was swallowed whole rather than chewed slowly. (Mother always told you to chew 30 times before swallowing, remember? So Muffin didn’t get the memo?)

The FB can be a diagnostic challenge even for the experienced clinician. Many uncertainties are involved including size of pet and diameter of patient GI tract, composition and shape of the FB (sharp edges?) and degree of dehydration or pain involved. There is no single or simple diagnostic test to rule in/out the suspected FB. Endoscopy may help if the FB is still in stomach or colon. Radiographs are sometimes helpful if the FB is radio-dense like some metallic objects but often FBs are “invisible” to the eye on most X-Rays. Veterinarians can often use contrasting upper or lower GI studies to identify partial or complete obstructions. Newer barium impregnated spheres can be given and traced radiographically. Occasionally abdominal palpation is revealing if the FB is unusually large. Ultrasound is often helpful but not always available in the average office. In short, there is no simple way to diagnose GI obstructions and too many pets and owners have needlessly suffered through painful (and expensive) ordeals.

Often, smaller FBs will pass through the GI tract without causing internal damage (small smooth objects like broken beads for example) but even simple and small things like string can “saw” their way through intestinal lining causing perforations and peritonitis. Cats are notoriously curious and most veterinarians have seen at least one episode with a Kitty that swallowed a sewing needle and thread. (Yummy! You can just imagine the damage caused here!) Unfortunately, some FBs will never be passed and surgery is the only option to avoid fatal GI obstructions. A national veterinary journal catalogued and recently reported just some of the FB items veterinarians have removed surgically. Ready? – an arrowhead embedded in raw deer meat, a 22 inch choke chain, pendant ear rings, three (yes three!) cell phone chargers, 9 golf balls from one stomach, a charm bracelet and an entire box of staples! Here at Dove Creek, we have removed 23 metallic push pins stolen off party favors, a child’s ballerina slipper and a ladies thong.

There is an old saying that “everything in a dog’s world is edible”. In other words, they’ll eat everything or anything and throw up later what didn’t taste good. That is mostly true – especially for the young and curious puppy but even the older dog or cat can fall victim. Just imagine you’re that owner waiting on "Bosco" to “pass” that diamond engagement ring he swallowed or those $50 dollar bills you left rolled up on the nightstand. (Both actually happened!)

A few tips: 1. Don’t leave small clothing articles or children’s toys lying around the house. No one should be surprised if a puppy tries to swallow a sock or sweat-soaked “undergarment”. 2. Be careful what you buy and give to your pets even if it’s sold as a “chew toy” at PetSmart or Petco. And If you see the word “durable” appearing on the label of something meant to be chewed – but not swallowed - ask yourself how would a dog should know the difference? And finally, don’t make “tug-of-war” a game you teach your puppy. That tugged item can later be shredded or destroyed and swallowed after you have gone off to work and puppy gets bored and misses you.

Lastly, vomiting can be either a harmless or serious clinical symptom. Dogs and cats have a voluntary emetic (vomiting) reflex . This means they can vomit at will unlike most humans. (eating disorders excluded?) This means if they vomit ONCE, simply clean it up and move on. But if they vomit more than four times in any four-hour period – or more than eight times a day, seek veterinary attention IMMEDIATELY.

David C. Zoltner, DVM
Dove Creek Animal Hospital
1200 Bent Oaks Ct., Denton, TX.  76210