Friday, February 8, 2008

Foreign Body Friday Feb. 8

I've been ant-blogging my way through my January trip to Florida, but here's a grasshopper-style, hot-off-the-presses, report on a case I saw today. By the way, you may want to wait to read on until after you eat. It's another icky one!

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My patient is a 14.5 year old Labrador Retriever. If you are familiar with the breed, you can relate to the following truisms:

Labs will eat anything.

When Labs don't eat, they are sick.

This guy never had a habit of getting into the garbage, at least not until recently. He has been feeling bad since Wednesday, his primary signs being anorexia, vomiting, and lethargy. Yesterday, he was examined, had bloods tests, X-rays, anti-vomiting injections and IV fluids. Abdominal X-rays showed the following:

Do you remember how to read X-rays? Dog's head is on our left, tail on our right. Backbone across the top. Air is black, bones are white, organs are shades of gray. Do you see anything that bothers you?

How about now? (Unfortunately, X-rays don't come with labels that point out the lesions. I have to figure them out for myself.)

We took the dog to surgery this afternoon. Here is what I took out of his stomach:

The cellophane wrapper was the biggest problem. The pieces of bone and other materials were probably small enough to have passed out of his system, but the wrapper (from a packet of peanut butter-cheese crackers, FYI) was acting as a net, collecting all the other stuff and preventing it from moving on. It is actually lucky that the bones were there as a radio-opaque marker. Without the bones for contrast, I would never have seen the cellophane.

Now that we know what was in the dog, let's take a closer look at that suspicious area of our X-ray:

Can you see me now?

Dog is doing fine tonight, and we have plans to send him home in the morning, with strict orders to stay out of the garbage!


Holly said...

Head? Warned? Most? Armed?

holly said...

Ok, now my first post makes no freaking sense at all.

For latecomers, when I got here, todays post said only "Fore". I even waited awhile and refreshed, and all I got was "Fore". So I thought maybe this was an online version of a guessing game show.

KatDoc said...

Very funny, Holly. I was typing in "Foreign Body" when I accidentally hit the wrong key and entered a blank post. Read it now, babe!


holly said...

I did read it. Then I remembered my first post and thought "Aw....mannnnn..."

Sara said...

Labs do have a way of finding trouble, don't they ? Interesting post, thanks ! For an elderly dog, do you alter the usual anesthesia protocol ? Or drink extra coffee, so you can work really fast ? :)

KatDoc said...

Good question, Sara. First of all "Age is not a disease." For ALL of our surgery patients, we require a pre-op physical examination and lab work. Anesthesia protocols are tailored for each patient on that basis.

In this dog's case, his lab work was all normal, so I didn't have to worry about kidney or liver problems. He got my "standard" cocktail, which also includes IV fluids for every anesthesia patient. (Keeps the blood pressure up, helps the body excrete the anesthetic agents, and gives us access to a vein if we need to give any drugs during surgery or recovery.)

As for speed, well, I am always working as quickly as possible, within the margins of safety and thoroughness. "Time is trauma," surgeons say, and the less time under anesthesia the better for everyone's sake. Still, I think it is safe to say, I am a little more conscious of time when it comes to the elderly than in a younger pet.


Kathy said...

I'm glad the dog will be okay, thanks to your excellent care. I did notice that area of the x-ray and wondered if that might be the problem. I keep my garbage can up on a table where the doggy noses and mouths can't explore it. Seems like dogs just love to eat strange stuff.

Sara said...

Kathi, thanks for answering my questions, it is very kind of you to share your knowledge. I hope this patient and Grace are both doing well today.

Mary said...

Oh, Lord. It's a wonder that lab has lived for so long. They DO eat anything.