A common cause of vomiting, especially in younger animals is ingestion of a foreign object that becomes lodged in the stomach or intestines

Vomiting is usually seen with an obstructive foreign body of the gastrointestinal tract, however this is a problem that may be seen with many other diseases

What is it?

• A common cause of vomiting, especially in younger animals is ingestion of a foreign object that becomes lodged in the stomach or intestines
• Common foreign bodies include
  • bones
  • dog toys
  • children's toys
  • plastic bags
  • string, yarn
  • balls

Pertinent Anatomy

• The gastrointestinal tract consists primarily of the stomach, small intestine and large intestine
• A foreign body is usually lodged in the stomach or the small intestine
• If a foreign body is able to pass into the colon, the pet usually can expel the foreign object without much difficulty
• Movie to right: take note of the dilation of the first portion of the small intestine and stomach, which occurs secondary to a foreign body that is lodged in the intestine

Signs

• Ingested foreign bodies are more common in young animals
• Vomiting is usually seen with an obstructive foreign body of the gastrointestinal tract, however this is a problem that may be seen with many other diseases
• Generally if an obstruction of the GI tract is present, diarrhea is usually not a common symptom (as the intestines are obstructed)
• Loss of appetite
• Dehydration
• Abdominal pain
• Weight loss may be present if the foreign body is chronic

Diagnosis

• As a starting point blood work is done to determine if there are liver, kidney, pancreas, or electrolyte abnormalities.
• A complete blood cell count is used to look for signs of infection and anemia.
• Radiographs (x-rays) can be very helpful to indicate the presence of a problem in the gastrointestinal tract. Unfortunately, plain radiographs frequently are only suggestive of a problem and do not give us a definitive answer; in some cases the radiographs will be made again to see if the signs of obstruction are repeatable. As a result additional tests such as ultrasound or contrast radiographs (barium swallow) may be indicated.
• Sometimes these tests also do not give us a final answer and exploratory surgery is needed. A negative exploratory may be the result; that is, all of the internal organs appear normal. If we do not find any obvious problem with the internal organs, biopsies still are done as microscopic disease may be causing the clinical signs. Even though it may seem disappointing to not find a problem that can be surgically corrected, it is better to explore the abdomen than ignore a surgical problem that the pet otherwise could die from. Fortunately, most abdominal exploratories yield a surgically correctable disease.

Treatment

• Frequently the decision to do an abdominal exploratory is based on radiographs or ultrasonic evaluation. Many times these tests are suggestive of a specific problem involving the stomach or intestines. As a result surgery is done in order to confirm what is suspected. Occasionally the abnormal gas pattern seen on the radiographs is not due to an obstruction of the intestine and no gross abnormality is found. In this situation the pet still may have a form of infiltrative cancer or viral infection (flu-like syndrome), or bacterial infection. If this is the situation, biopsies are taken to rule out any serious problem.
• If a foreign body is found in the stomach or intestines, the object is removed by making an incision in the intestine or stomach. If a foreign body has caused a portion of the intestine to die off, this part of the bowel may need to be removed. A foreign body was found in the intestine of this dog (fig 1) at the time of surgery; the bowel was healthy enough so that the surgeon was able to simply make an incision in the intestine to remove the foreign body (Fig 2).
• Feeding tubes may need to be placed, especially if the patient is very malnourished from chronic disease. This tube can be removed in approximately 10 days if the pet is doing well. After surgery has been completed, intensive care must be provided for the best chance for a successful outcome. Intravenous fluids may be continued over night.
• Pain control is managed after surgery to keep your pet comfortable.
• Close observation is maintained to make sure that your pet is not developing a life-threatening infection of the abdominal cavity called peritonitis. Antibiotics are administered for 24 hours.
• Fluids are administered intravenously to combat dehydration.
• Feeding of the patient is started within 24 hours after surgery. If your pet is still too nauseated, food and water are with held. If your pet has a lot of vomiting a tube may be placed down the nose to the stomach in order to remove excess fluid that may be in the stomach.

Potential Complications

• As with any surgery, complications may arise. Even though rare, anesthetic death can occur. With the use of modern anesthetic protocols and extensive monitoring devices (blood pressure, EKG, pulse oxymetry, inspiratory and expiratory carbon dioxide levels, and respiration rate), the risk of problems with anesthesia is minimal.
• Infection is also an unusual complication as strict sterile technique is used during the surgery and antibiotics are administered.
• Seroma formation or fluid accumulation under the skin incision although uncommon can also occur. This problem in general will resolve with time. Occasionally the seroma or fluid that has build up may require draining.
• Peritonitis is a very serious problem that fortunately does not occur very often. The most common cause of infection of the abdominal cavity is due to leakage of bowel contents through the enterotomy or anastomosis site. If this problem is to occur clinical signs become evident 2 to 5 days after surgery. Emergency surgery is needed if this occurs.
• Intussusception can occur following intestinal surgery. This problem is where the small intestine telescopes on itself. In this situation another surgery is needed to correct the problem.

Home Care

• Feed your pet a bland diet for about 3 days, then gradually weaned onto a regular diet after about 3 days
• Check the incision for signs of infection
• Watch for vomiting or loss of appetite as this could indicate signs of peritonitis
• Exercise is restricted for a period of 3 weeks. During this time no rough-housing with other pets or people, jumping, or bounding up stairs is permitted.
• Most pets will start to feel better 2 to 4 days after surgery. By 2 weeks after surgery they should have recovered completely. Healing of the internal tissues takes longer, therefore restricted activity on a leash should continue for a period of 3 weeks after surgery.

Prognosis

• Recovery is uncomplicated in most cases
• If the bowel leaks after surgery, the prognosis is poorer, however a pet frequently can recover from this

< Back to Article Index | Top of Page

What is a Board-certified surgeon?

Click here to find out!