Surgical Blog: Intestinal Foreign Body
Leeloo, a 9 year-old female spayed Italian Spinone, presented for vomiting, pacing and a decreased appetite. Upon examination Leeloo was depressed and dehydrated.
It was clear Leeloo needed inpatient care; she was placed on IV fluids, had digital abdominal x-rays taken and blood work was done in our in-house laboratory.
An increase white blood cell count, indicating inflammation/infection, was the only abnormality. Intravenous antibiotics and anti-nausea medications were administered. After 24 hours Leeloo had not improved so an abdominal ultrasound was performed. It yielded no abnormal finding.
That evening and into the next morning Leeloo seemed to improve, appearing both more energetic, not vomiting and eating a little food for the first time! It was decided to send Leeloo home and see how she did.
The next day the owners informed us that she had no interest in eating and had vomited multiple times. Sadly, Leeloo had to return to the hospital for further testing. When tests for Addison’s disease and pancreatitis came back normal, we repeated the abdominal x-rays from a few days prior. One segment of intestine (cecum) was very filled up with the gas.
At this point Leeloo’s owners and the NVC team knew we had to do exploratory surgery. Upon exploratory laparotomy I found a small intestinal foreign body that had become obstructive and the intestine around the obstruction had begun to die. An intestinal “resection and anastomoses” was performed to remove the foreign body and the dead section of intestine around it. Leeloo has recovered well.
I hope this case illustrates the importance of two things:
1. Not everything shows up on testing.
2. Exploratory surgery, although many times a difficult choice, offers a chance to diagnose or cure many difficult cases.