Saturday night, I was presented with a Labrador retriever named Bing. His owner reported that he had been vomiting all day and all night, was lethargic, and didn't have any interest in food. According to her, Bing was suddenly ill.
When I examined him, I was confronted with a dumpy, very THIN Lab. His abdomen felt strangely doughy but was not particularly painful (a hallmark of GI foreign bodies). He was dehydrated and quiet. I asked his owner about Bing's weight. She reported that he'd been losing weight for the past 3 months. He was also vomiting at least once a day. They'd recently adopted a Labrador puppy, and she attributed his weight loss and vomiting to this puppy in the house keeping Bing active and slightly anxious. I was not convinced.
Xrays showed questionable material in the stomach. We proceeded to a barium study (a contrast study). After 14 (!) xrays and a lot of time and struggling with Bing, we had the answer from the radiologist...likely a foreign body. I called the owner and explained to her at length my recommendations: exploratory surgery with the risk of not finding a foreign body and needing to take GI biopsies. After much discussion, Bing's owner elected to proceed.
Sure enough, his duodenum (upper small intestine) was in a huge bunch - indicating the worst of the worst for foreign bodies - a linear FB that had already plicated. Luckily, the intestines were pink and healthy, hardly even angry looking. A plastic something was palpable in the stomach, with a mass of cloth material extending into the intestines, ending at a similar plastic piece in the upper jejunum. Two incisions into the intestines and one into the stomach later, and the whole wad was out.
Bing recovered rapidly from surgery. We are now almost 72 hours out. No evidence of peritonitis or surgery site leakage yet. I'm not quite relaxed, as the first 4 days are crucial post-enterotomy. Luckily for Bing, I did not have to actually remove any intestines, as everything looked healthy.
The kicker? Mom looked at the material stuck in his stomach and informed us that Bing had chewed up that particular object in JUNE! It had been stuck since then, causing his weight loss and vomiting.
I'm quite happy to think that - as long as Bing gets through the post-op period with no complications - he should begin gaining weight and feeling better soon!
Interestingly, the very same night, I had to take an eye of round bone out of another dog. It was a busy night in the OR for me.
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