Geezer first came in to see our vet Tom on a Sunday out of hours after vomiting a couple of times and not seeming himself. This wasn’t all that unusual for him as he had a naughty tendency of eating things he shouldn’t! Tom gave him a good check over, treated him with some anti sickness medication and booked him for a check up the next day. Many cases of vomiting in dogs are due to dietary indiscretion leading to inflammation within the stomach. These cases are generally self limiting and improve rapidly with symptomatic treatments like those which Tom prescribed to geezer.
Unfortunately the next day Geezer was no better, he was very depressed, not eating and still persistently vomiting. The owner mentioned that little Geezer has been seen having a snack on the rubber parks swings at the weekend but we weren’t sure how much he had eaten! Hazel examined him and decided x-rays where needed to investigate his symptoms further; geezer was admitted that morning for fluids, sedation and abdominal imaging. Initial x-rays revealed an enlarged fluid filled stomach, this suggested that there was either something blocking the outflow of fluid and food, or that the stomach wasn’t contracting properly due to inflammation. The rest of Geezers abdomen looked normal on the x-ray, with no indication of a small intestinal obstruction at this stage. When we are looking for evidence of foreign bodies on an abdominal x-ray we face the problem that many things that dogs will eat do not show up clearly. If a dog eats a stone or a piece of bone we can see it straight away, as these objects appear bright white on the image-just like the dogs own bones. If, however a piece of rubber, cloth or sock is stuck somewhere it will appear the same density as the intestines so we have to look for secondary changes within the guts to suggest a blockage. These include abnormal areas of gas within the small intestine which have built up before the obstruction or areas of intestine which appear puckered up in cases of a long foreign body like a piece of string.
It was still possible in Geezer’s case that there was something obstructing the outflow of his stomach but we didn’t feel there was enough evidence to justify exploratory surgery, as this doesn’t come without increased risks. He ate well with us and felt much better after some IV fluids, so he went home for the evening with the plan to x-ray again tomorrow if things weren’t looking better. Sadly poor Geezer had vomited several times overnight again so he was admitted straight away for further imaging. It was a similar picture, still with no small intestinal gas build up but an enlarged fluid filled stomach. We would have expected a motility issue to be improving by now so our concern was that there was a blockage. After a long discussion with Geezer’s owner we decided that the best course of action was to do an exploratory operation to confirm our suspicion that something was stuck and blocking the outflow of Geezers stomach. Whenever surgery involving opening up the intestine is performed there is a small (~10%) risk of infection and for the first 5 days close monitoring of the patient is required.
Geezer was prepped for surgery and we proceeded straight away. It didn’t take long to find the cause of the problem. There was a piece of rubber from the swing that Geezer had taken a fancy to lodged in the very first section of his small intestine! This was removed routinely and the rest of his abdomen was checked to ensure this was the only finding. Everything else was normal so he was closed up and taken to recover with the nurses. Geezer initially did well and was up and about the next day. Sadly he didn’t continue to improve as we would expect and over the next few days he developed a high temperature and didn’t want to eat. A sample of fluid was taken from his abdomen and this confirmed that he had developed an infection. This was a very serious situation for Geezer as peritonitis (infection within the abdomen) can be life threatening. His owners were completely dedicated and wanted us to do everything so we immediately went ahead with a second surgery to give him the best chance we could. A section of devitalised intestine needed to be removed; his abdomen was copiously flushed with sterile saline, before placing a special drain which would stay in place during his recovery to allow the infected fluid to leave his abdomen. Finally we placed an oesophageal feeding tube which would allow us to get important nutrition into Geezer while his appetite was still poor.
Over the next week Geezer stayed in the vets and really did become part of the family! He required very intensive care, with multiple intravenous drugs throughout the day, cleaning and emptying his abdominal drain, 4-6 tube feeds over the day and not to mention lots of cuddles! Geezer’s owners visited him daily; spending time sitting outside in the sun together and tempting him with food. It was touch and go, but after days of seeing minimal improvement he turned the corner and went from strength to strength. We were all so pleased when he started to play with his favourite ball in the kennels and wag his tail again! The drain was removed and he went home where his owners continued tube feeds while he gained strength. Another couple of days later and we were able to remove this tube and sign him off. We were all so pleased that he was back at home but everyone was going to miss him. Let’s just hope he steers clear of eating unusual objects in the future.
A Big Thank You...
...to all our patient's owners who gave their kind permission to share their stories
Sat 8.30am - 12.20pm
Leonard Brothers Veterinary Centre
501 Crewe Road
Sat 8.30am - 12.20pm
Leonard Brothers Veterinary Centre
Unit 7-8 Brownlow Street Arcade