Monday, July 1, 2013

The Bounty Of Summer And The Picnic Pitfall. The Corn Cob Intestinal Obstruction. Warning Surgery Photos.

5 days in the stomach and they still look just like they did going in.

As we all prepare for the festivities of the Fourth of July I thought it might be helpful to remind everyone that our plans should include some basic safety prevention tips to help protect our pets.

This is the story of Hurley, an eight year old Golden Retriever who decided one day out of the blue to counter surf.

Seems he was feeling a bit left out when his family decided to have corn on the cob and he wasn't provided any. So, in typical tenacious, determined, crafty dog style, he helped himself by jumping up on the counter and absconding his self-allotted ration of four whole corn on the cobs.

His family had placed them on a dish on the counter and a few minutes later Hurley appeared in the living room "looking guilty."  When they traced his tracks back to the kitchen all of the corn was gone. They knew he had eaten them and so began the clock, and the wait and see, stake out. (We all know the easiest way to find corn is by watching the output for evidence). That was Saturday.

A day later he was not acting his normal happy self.

By Monday he was vomiting.

On Tuesday we got a call and a recant of the whole story. Hurley was quiet and slightly depressed. It was decided to bring him in the next day if he wasn't any better.

By Wednesday he still wasn't eating and was still depressed so he came in for an x-ray. The radiograph revealed a full stomach.

A normal healthy pet should have an empty stomach about 2-4 hours after eating. An x-ray and/or an ultrasound can be used to look at the stomach or intestinal tract to see if there is any evidence of abnormal contents. When we see "stuff" (stuff in most cases is unidentifiable and indistinguishable unless it is a highly dense or a reflective consistency like bones, or metal), we look for dilatation of the stomach or position of the stomach. We like to take an x-ray or ultrasound on an empty stomach so that stomach contents do not obscure our ability to interpret the picture. Normally we advise about 8 hours of fasting in a normal adult pet. If there is any sign of stuff in the stomach after fasting we are highly suspicious of foreign bodies or incomplete emptying of the stomach. A foreign body can be anything from grass, stones, clothing, material, carpet, toys, nuts, or at Fourth of July time; corn cobs.

Thursday Hurley was still not eating, still slightly depressed and still had evidence of "stuff' in his stomach. The family decided to not feed him for 12 hours and to give Hurley overnight to see once again if his any of the stomach contents moved over the next 12 hours. He was scheduled for a re-check first thing the next morning.

On Friday morning little had changed and Hurley went in for exploratory surgery.

Hurley's story is not an uncommon one. Many times we suspect that there is something that doesn't belong in the gastrointestinal tract of a pet..but many times we cannot be sure until we go in and take a look for ourselves. This, of course, requires anesthesia and the expense of surgery, often at the tune of about a thousand dollars. But often it is all we have left to do. In the hope of restoring health we have to go in, take a look, and remove whatever we find.

In the case of corn cobs, (I have seen the same with rocks, nuts, clothing, carpet, tampons, etc.) they lodge in the base of the stomach (anatomically it is the pylorus) or the intestines where it acts like a cork.

The stomach and intestines are essentially muscular tubes. They can concentrically contract and push down their length. It is an amazing act of squeezing and pushing, like a snake it can move ingesta (food being broken down) the pipe to its final resting place,,out the other end. Put a cork along that route and without quick relief it will kill you.

Hurley had four broken up corn cobs sitting in his stomach. Corn cobs are so hard that the stomach cannot digest them. So there they sat for Sunday through Friday. Obstructing his ability to digest food and to pass anything down into the intestines.

Thankfully for Hurley the only foreign bodies were in his stomach, so only one incision was needed to remove them. There are times where we have to open multiple places along the g.i. tract. Each time we make a hole (an enterotomy if in the intestines) we enter a greater and greater chance of contamination into the abdominal cavity and each time we risk the chance of dehiscence (opening of a surgical site). Ideally, we make as few openings as is possible. The less we cut, the less there is to heal, and the greater chance of a quick and complete recovery.

It has been two weeks since Hurley's surgery. He has made a quick and full recovery..

Have a happy Fourth of July everyone! \And be safe! 

If you have any questions or comments please find me at @FreePetAdvice, or @Pawbly, or

I look forward to hearing from you.

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