Difference between revisions of "Gastric Foreign Objects"
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| − | + | {{dog}} | |
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==Signalment== | ==Signalment== | ||
| − | Dogs affected more often than cats due to their less selective eating habits | + | *Dogs affected more often than cats due to their less selective eating habits. |
| + | *Puppies are prone. | ||
| + | |||
| + | ==Description== | ||
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| + | Ingested objects that are able to pass through the oesophagus may subsequently become a gastric or intestinal foreign object. If small enough, the object may pass through the pylorus and the entire gastrointestinal tract. Others may become intestinal or rectal foreign bodies. Objects that remain in the stomach may be subsequently expelled by vomiting, otherwise they may continue to cause gastric outflow obstruction, gastric distension and irritation. | ||
| − | ==History== | + | ==Diagnosis== |
| + | |||
| + | ===History=== | ||
Reports of the owner witnessing the animal ingesting an object is obviously very helpful in obtaining a diagnosis. However, there is not a history of this in most cases. | Reports of the owner witnessing the animal ingesting an object is obviously very helpful in obtaining a diagnosis. However, there is not a history of this in most cases. | ||
| − | ==Clinical Signs== | + | ===Clinical Signs=== |
| − | Some animals may be asymptomatic | + | Some animals may be asymptomatic, otherwise the following signs may present: |
| − | |||
| − | ==Abdominal Palpation== | + | *vomiting - due to gastric outflow obstruction, gastric distension and/or irritation. |
| + | *inappetence | ||
| + | *anorexia | ||
| + | *dehydration - may occur as a result of prolonged vomiting. | ||
| + | *hypovolaemic shock - uncommon unless the stomach has been perforated. | ||
| + | |||
| + | ===Abdominal Palpation=== | ||
Occasionally it may be possible to palpate an object that is lodged in the stomach. | Occasionally it may be possible to palpate an object that is lodged in the stomach. | ||
| − | ==Laboratory Tests== | + | ===Laboratory Tests=== |
| − | + | *Haematology | |
| − | + | **May detect dehydration and a hypoproteinaemia if the patient has a protein-losing enteropathy. | |
| − | + | **Anaemia due to gastric bleeding is rare | |
| + | *Biochemistry | ||
| + | **Hypokalaemia, hypochloraemia and hypokalaemia may be detected as a result of vomiting due to gastric outflow obstruction. | ||
===Radiography=== | ===Radiography=== | ||
| − | Plain survey radiographs of the abdomen may reveal a radiopaque object or mass within the abdomen. | + | *'''Plain survey radiographs''' of the abdomen may reveal a radiopaque object or mass within the abdomen. |
| − | Contrast radiography in the form of a gastrointestinal barium contrast study may be indicated if plain radiographs are unremarkable. | + | *'''Contrast radiography''' in the form of a gastrointestinal barium contrast study may be indicated if plain radiographs are unremarkable. |
===Endoscopy=== | ===Endoscopy=== | ||
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Small foreign object may be allowed to pass through the gastrointestinal tract if they are very unlikely to damage. However, it is advisable to remove most. | Small foreign object may be allowed to pass through the gastrointestinal tract if they are very unlikely to damage. However, it is advisable to remove most. | ||
| − | Medical | + | *Medical |
| − | + | **Induce vomiting with apomorphine or hydrogen peroxide in the dog or xylazine in the cat. It must be ensured that the object does not have sharp edges or points that may cause trauma when expelled. | |
| − | Endoscopic removal | + | *Surgery |
| − | + | **Exploratory laparotomy and gastrostomy may be performed to remove the object in cases where the induction of vomiting is prohibited. This procedure is carried out under general anaesthesia and it is essential to assess the patient's hydration and electrolyte status prior induction. | |
| + | *Endoscopic removal - Performed under general anaesthesia. Radiographs should be taken prior to this procedure to ensure that the object is still in the stomach. | ||
==Prognosis== | ==Prognosis== | ||
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==References== | ==References== | ||
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Revision as of 13:38, 19 August 2009
 |
This article is still under construction. |
Signalment
- Dogs affected more often than cats due to their less selective eating habits.
- Puppies are prone.
Description
Ingested objects that are able to pass through the oesophagus may subsequently become a gastric or intestinal foreign object. If small enough, the object may pass through the pylorus and the entire gastrointestinal tract. Others may become intestinal or rectal foreign bodies. Objects that remain in the stomach may be subsequently expelled by vomiting, otherwise they may continue to cause gastric outflow obstruction, gastric distension and irritation.
Diagnosis
History
Reports of the owner witnessing the animal ingesting an object is obviously very helpful in obtaining a diagnosis. However, there is not a history of this in most cases.
Clinical Signs
Some animals may be asymptomatic, otherwise the following signs may present:
- vomiting - due to gastric outflow obstruction, gastric distension and/or irritation.
- inappetence
- anorexia
- dehydration - may occur as a result of prolonged vomiting.
- hypovolaemic shock - uncommon unless the stomach has been perforated.
Abdominal Palpation
Occasionally it may be possible to palpate an object that is lodged in the stomach.
Laboratory Tests
- Haematology
- May detect dehydration and a hypoproteinaemia if the patient has a protein-losing enteropathy.
- Anaemia due to gastric bleeding is rare
- Biochemistry
- Hypokalaemia, hypochloraemia and hypokalaemia may be detected as a result of vomiting due to gastric outflow obstruction.
Radiography
- Plain survey radiographs of the abdomen may reveal a radiopaque object or mass within the abdomen.
- Contrast radiography in the form of a gastrointestinal barium contrast study may be indicated if plain radiographs are unremarkable.
Endoscopy
May be indicated if the plain radiographs are unremarkable. A very effective means of obtaining a definitive diagnosis.
Treatment
Small foreign object may be allowed to pass through the gastrointestinal tract if they are very unlikely to damage. However, it is advisable to remove most.
- Medical
- Induce vomiting with apomorphine or hydrogen peroxide in the dog or xylazine in the cat. It must be ensured that the object does not have sharp edges or points that may cause trauma when expelled.
- Surgery
- Exploratory laparotomy and gastrostomy may be performed to remove the object in cases where the induction of vomiting is prohibited. This procedure is carried out under general anaesthesia and it is essential to assess the patient's hydration and electrolyte status prior induction.
- Endoscopic removal - Performed under general anaesthesia. Radiographs should be taken prior to this procedure to ensure that the object is still in the stomach.