OVER the years, this diary has described a number of different scenarios where we have had to surgically retrieve various objects from the gastro-intestinal tracts of animals, the unfortunate patients nearly always being dogs, writes Dominic Plumley.
That said, I’ve also made mention of at least a couple of cats and, if memory serves me correctly, a cow; the latter unfortunately swallowing some stray wire buried in its silage.
The dog may be man’s best friend but that doesn’t preclude it from being daft enough to eat anything and I mean anything.
It can be a bit like Christmas morning. You will have to bear with me here. The symptoms are usually fairly typical, a dog that can’t keep anything down, even water. A gentle feel of their abdomen usually pin-points a painful focus and the prerequisite X-ray reveals a lot of gas in the intestine and if we are really lucky an apparent radio-opaque obstruction.
Unfortunately, many things don’t show up on X-rays, and here’s where the Christmas analogy comes in, you know there is something in there, but until you unwrap it you don’t know what it is. Over the years we have found golf balls, socks, gloves, long-lost toys and even a bra, all the kind of things you might expect to find under the tree.
Last week we had an unusual coincidence involving intestinal foreign bodies, the technical term for such cases. The idiosyncrasy was not in what we retrieved but the patients involved. On consecutive days we operated on two Dalmatians.
The first, Tess, had managed to swallow a large piece of material, possibly a dish cloth, so hopefully not a Chrimbo present.
The long rag was inching its way down Tess’s duodenum (part of the small intestine), causing both complete obstruction and no small amount of inflammation to the bowel. In fact, a section of intestine was so badly damaged that surgeon Jo Mouat had to remove it completely, suturing the two ends of bowel back together once the cloth was removed.
Freda, our second spotty dog of the week, had evidently been a bit more festive in her choice of obstruction, the offending item being some mince pies. How can mince pies cause a blockage, I hear you cry? Well, they tend to be more problematic if you don’t stop to take them out of their foil trays. In this case, the evidence was there to see on the X-ray, the metal objects showing up clearly.
This time surgeon Jean-Paul Schmidt faced a slightly more complicated problem, the knot of foil having made it as far as the caecum, the junction between the small and large bowel. A large backlog of hair and other material had accumulated behind the metal obstacle and the surrounding intestine wasn’t looking very healthy at all.
Unfortunately, this section of the digestive tract does not lend itself quite so well to the wholesale removal of compromised tissue and J-P was left with little choice but to make an intestinal incision just large enough to remove the blockage but leave the damaged bowel in situ. For Freda, this made her prognosis over the first few days post operation a little more tentative, with the concern that the incision site might break down.
As you might imagine, two dogs that are happy to wolf down, I guess that expression says it all, dish cloths and mince pies in their wrappers are pretty quickly back on their grub after their ordeal. In years gone by, it was recommended to starve these patients for at least 48 hours after surgery – presumably to negate concerns that the wound in the bowel might leak. More recently it has been demonstrated that patients should be encouraged to eat as soon as the have recovered from their anaesthetic, the process of food moving through the digestive tract actively encouraging healing.
I am glad to report that both Tess and Freda are making excellent progress, the latter apparently through the potentially most problematic phase of recovery. We are just battening down the hatches for the other 99 blocked Dalmatians next week.