Small animal veterinary case study – Meg the labrador

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Case study

History & signalment

Nine month old FN Labrador.

She was observed eating a glove 2-3 days prior, so far the glove had not passed in the faecal material. The dog was now lethargic, off food and vomiting. Vomitus consisted of undigested food and bile. Supportive care was initiated. 

Physical examination
The dog was bright and alert and in good body condition. Mucous membranes were pink and moist and CRT was less than 2 seconds. Thoracic auscultation was unremarkable. Cranial abdominal palpation was resented.

Basic bloods were unremarkable.

Imaging findings
Lateral and D/V abdominal radiographs were obtained under sedation, followed by abdominal ultrasound

 

Questions

  • 1. What radiographic changes are present? 1. Gastric dilation and volvulus 2. Small intestinal dilation 3. Abdominal mass 4. No significant findings

    1. D. Right Lateral abdomen- gas is present in the fundus and gas is also present throughout several loops of SI although these loops are not significantly dilated. The gastric pylorus is fluid filled. Mineralised material is mixed with faecal material in the descending colon. Superimposition of several structures could give the false impression of a mass effect on the lateral view but is not present on additional views.
  • 2. What ultrasound artefact is present and how does this aid our diagnostics? 1. Acoustic enhancement 2. Acoustic shadowing 3. Mirror image artefact 4. Side lobe artefact

    1. B. There is a highly echogenic surface with distal acoustic shadowing within the stomach. This suggests a solid object within the lumen and increases the suspicion of a gastric foreign body if this is a persistent finding. There was no significant intestinal dilation in the small intestines (not shown)
  • 3. What is the next most logical step? 1. Endoscopy 2. Exploratory surgery 3. Monitoring

    1. A & B are both feasible options. Endoscopy to confirm and retrieve the foreign body was performed here. As the dog continued to vomit, it was likely that the fb was causing an obstruction. Gastric fbs can be retrieved endoscopically in many cases (as long as the fb will be unlikely to damage the oesophagus during the retrieval process). In this case ultrasound, in addition to the history, gave us additional evidence to support the need for gastroscopy. Gastroscopy negated the need for surgery in this case and recovery time is much shorter.

    In this case, the glove was successfully retrieved using the gastroscope and the tripod graspers. The dog had no further vomiting and was discharged.

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