The Pearl in the Gut. AKA Swallowing Rocks, And Fishing To Extract Them

This is Titus. He is a rambunctious, energetic, animated, effervescent 18 month of Doberman.

He is the puppy of an avid life-long Doberman breeder who has come to realize that "a puppy is an awful big handful when your life is slowing down and you are well into the comforts of retirement." He is loved, but he is too much to handle for his mom. It was a hard pill to swallow and an even harder confession to make. But, her ability to care for him, hold him safely and confidently at a walk (or lunge), and her ability to meet all of his mental and physical needs.

I give her kudos and credit. It is often a difficult thing for people to admit, but it is imperative to be making tough decisions that are in the best interest of your pet. Be honest, be open, and be kind. If you can follow these all things are possible and in the end you can live with the decisions that are made.

When titus came to visit it was because he had developed a very bad habit. He was eating rocks. When it was reported to me I asked "Why? Why do you think that he is eating rocks?"

"Well, because he is a Dobe," she replied.

"I don't know what that means?" I answered.

"Because they are all stupid. They do stupid things."

"I just don't eat things without a reason." I said it and I stand by it. I always believe there is a reason.

When I find a pet doing an odd, nonsensical thing I start to dig. I encourage my clients to start digging and we don't stop digging until we figure out the reason, we solve the problem, and we are prepared for a recurrence. That's our duty as guardians.

Things to investigate;

1. Diet
2. Intestinal fecal check
3. Boredom/behavior/anxiety/fear, etc
4. Check a full blood work panel and urinalysis (including thyroid).

When Titus arrived he was not his normal hyper-crazed self. He was a bit subdued, and he had been vomiting off and on for a few days. He was dehydrated, and his belly was sore to the touch.

We took an x-ray and there is was. a big honkin' stone stuck dead smack in the middle of his intestines.

OK, here is the big dilemma when we are humming and hawing over whether or not it is time to go in and explore a belly. 

If you have a dog that is vomiting every time they eat, or vomiting everything they eat, or stops producing feces it is my vote to go in and take a look. I have regretted waiting and not going in far more often than I have regretted going in. Keep an excellent history, monitor very closely and use x-rays and ultrasound and most importantly your own gut feeling when deciding whether or not to do an exploratory surgery.

I have gone into dogs bellies and expected to find an obstruction and instead found only a quiet not moving gut. But even in those cases after massaging the intestines, exploring every inch of it, those dogs have woken up and felt better. 

I spoke to his mom about my concerns. That stone was too big to make it through the intestines. I was pretty sure of that. She wanted to wait overnight, and if his vomiting continued she would be back in the morning.

The next morning we were met by an early call from a very concerned mom. Titus wasn't eating and he was vomiting persistently. He arrived a few minutes later. A repeat x-ray showed the same big stone in the same place.

Getting prepped for surgery.

The stone is next to my left hand, and the intestines beside my right hand is significantly bruised.
This is where the stone was stuck, and the gut bruised and then the stone moved a little bit further down stream.
Repeated bruising to the gut leads to scarring, inability to function, perforation and even death.

The stone has been removed and the intestine is surgically closed,
being very careful to not spill any intestinal contents and
suturing very carefully so that the incision doesn't open.
The gut is a very strong muscular tube. It has to be able to withstand liquid moving through it,
and lots of motion.
Dehiscence (opening of the incision is a real concern).

An omental wrap is placed to help keep the incision closed and aid in healing.

After a leak test (move ingesta through the area of the intestines where the incision was made another look through the abdomen is done, and lastly we flush the belly with warm saline to remove any ingesta that may have spilled or leaked.

Closing the abdomen.

In an exploratory surgery it is often required to make a large incision. In almost all cases the incision extends from the rib cage to the pelvis.

Titus's pearl.

Now all we have to do is figure out why he thinks he should eat stones and prevent him from doing it again. (AKA, now the real work begins).

If you have any questions or comments please leave them.

If you have any pet related questions you can reach me at Pawbly.

Baby Titus

On October 15, 2013 Titus was put down due to severe aggression and dominance issues. I was not present, and I could not participate. It was the decision of his family who feared that after biting three people he could not be trusted. I am sorry to all who were a part of this awful conclusion and deeply saddened by the sequence of events. Life just isn't fair and there are sometimes no reasons to try to accept the hand that life deals you.