Spot the Foreign Body!

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Foreign bodies occur when your pet eats an object that is unable to pass through the gastrointestinal tract easily. Examples of this can include; household objects, toys, bones and certain foods that can’t be digested. These objects can cause problems such as obstruction of the gastrointestinal tract, damage and perforation of the intestines and toxicity from certain materials, such as metal. The severity of the problems caused depends on the duration the foreign body has been present, the location of it, the degree of obstruction it has caused and any problems associated with the material of the object. If perforation of the intestinal tract occurs and the contents leaks into the abdomen this can quickly lead to inflammation of the abdominal lining (peritonitis) and allows bacterial contamination (sepsis), both of which are life-threatening conditions.

If you see your pet eat something that could get stuck in their intestinal system, we would recommend you phone the practice as soon as possible. If we see an animal soon after they have ingested an object sometimes it is appropriate to induce vomiting to try and bring it back up. This is only an option shortly after the object has been swallowed because once it passes the stomach it cannot go back. We would not induce vomiting if the object could cause more harm on the way back up the oesophagus.

The common clinical signs of foreign bodies include:

  • Vomiting
  • Anorexia (loss of appetite)
  • Abdominal pain
  • Depression
  • Dehydration
  • Diarrhoea

These signs can vary depending on the severity of the foreign body. They can also be seen with other types of gastrointestinal disease, for example dietary indiscretions or viral infections therefore your pet will need a thorough physical examination to help differentiate between these diagnoses. If these signs persist for a prolonged amount of time they themselves can cause further problems too so an appointment with your vet is important. Lots of things will influence what the vet will decide to do next, this includes the animals age, breed, clinical history and physical exam. If they are suspicious that your pet has a foreign body then imaging diagnostics such as ultrasound and radiographs are often helpful in the diagnosis of one.

Ultrasound images don’t often show the actual foreign body but they can show the effects the obstruction is causing. For example, a build-up of gas or fluid that cannot pass the object. If the foreign body has damaged part of the gastrointestinal tract and the contents are leaking out this would also show up as abnormal free fluid within the abdomen.

Radiograph images can also show gas or liquid but radio-opaque foreign bodies may also be visible. This means the object absorbs x-rays so can be seen on the image i.e metal materials.

If there is strong evidence of a foreign body, then the vet will decide the most appropriate treatment approach. In many cases this involves surgical exploration of your pets abdomen to find and surgically remove the foreign body. In occasional cases, whereby we think the foreign body may pass through itself then your pet may be given time to allow this to happen, with close monitoring and support to ensure no problems arise.

We have seen a few foreign bodies at Hollybank recently, here are some interesting examples for you!

cassie-cat-litterCassie’s owner reported seeing her eating from the cats’ litter tray! The x-ray shows a gravel like consistency in the intestines but there was no evidence of an obstruction. An ultrasound scan confirmed Cassie’s guts were moving normally which was good. Gut stasis (reduction in normal movement) can sometimes be an issue with gastrointestinal disease. As the cat litter was so small and had already reached the largest part of the intestine (the colon) it was decided to allow Cassie time to pass these through naturally. She was closely monitored during this time for any changes and kept comfortable. Cassie passed the gravel soon after.

pip-corn-on-the-cobPip presented vomiting and with abdominal pain. Suspicious of a foreign body we elected to ultrasound scan her abdomen. This showed lots of gas build up in her small intestine which can be consistent with a gastrointestinal obstruction. We took an abdominal x-ray which too confirmed a gas build up. However, it was not apparent what was causing this obstruction. This is because some materials do not show as well. Although we could not see an obvious object, the combination of Pip’s clinical signs and the suspicious signs on her x-rays gave us enough evidence to warrant surgical investigation. Pip had in fact eaten a corn on the cob! This was removed and she was back to her normal self in no time!

roscoe-foreign-body-3Roscoe’s x-ray shows a round shaped object in the middle of his abdomen with a build-up of gas in the intestines prior to this. The clinical signs and images were consistent with a suspected foreign body and surgery was performed to remove the object. This one turned out to be a chewed up rubber ball! Roscoe also recovered quickly from surgery.

 

 

daisy-door-knobOn Daisy’s radiograph you can clearly see the foreign body as it was a metal material. This foreign body caused Daisy to become unwell and she required surgery to remove it. Her recovery was slightly longer than normal as we suspect there was an element of metal toxicity too. She recovered well and is back to normal.

Fortunately, all of these foreign body patients have made good recoveries and all of our patients needed this vital surgery. However, gastrointestinal surgery is not without its risks and prognosis is improved by identifying the problem and addressing this in a timely manner. If you think your pet may have eaten something or is showing concerning gastrointestinal signs then it is always best to get your pet checked out.

Hollybank Work Experience

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As vet’s, we remember all too well the hours of work experience required to show our commitment and passion for the profession. Without the support of our local vet practices we wouldn’t have been able to gain the experience needed for university application therefore we all feel strongly about offering students the opportunity to see practice at Hollybank.

More often than not our students return to us over a number of years. It is lovely to follow them through the process and see their hard work pay off at the end. We currently have a number of students in differing years of their veterinary degree who come back to see practice with us regularly. Most recently, Charlotte who also lives locally has been accepted to study veterinary medicine at Liverpool university. She has in fact just started her course and we are very excited for her!

Charlotte has kindly written a piece about why she wanted to become a vet and how important it is to carry out such work experience. We hope Charlotte’s experience encourages other aspiring vets and vet nurses to find the placements that they need.

“Owning a variety of pets means I have been on many trips to the vets from a young age. It immediately intrigued me on these visits the way in which the vets were able to diagnose the problems without the animals verbally telling them the issues in the same way in which I would tell my doctor. It was at this point I realised vets have to use other methods to find the animals’ problems in order to apply their knowledge to create a treatment plan. It was as the vets explained to us their diagnoses that I was also interested in the reasons why my pets’ bodies were malfunctioning and how the treatment would work in solving these problems. All of this is in addition to the clichéd but true fact that I love interacting with animals and want to help prevent and ease their suffering. So, it was at a young age that I decided I wanted to be a veterinary surgeon.

When applying to vet school it is important to have a wide range of work experience under your belt so when I was 15 I started looking for a placement at a vet’s practice so that I could see what the job involved and whether it was what I definitely wanted to do. Having a dog, Evie, and a cat, Tigger, who are regulars at Hollybank, it was a good start to apply here as I knew it was an excellent vets to do work experience at and I already knew the team. It was in the summer of 2014 that I spent my first week of placement here and I absolutely loved it, so much so that for the past two years I have been watching practice here every Thursday evening, and spending a week whenever possible.

I love watching practice at Hollybank as there is such a wide variety of cases to see and things to do. I can say I am a lot better at cleaning since working here, much to my Mum’s pleasure, as it is always a priority for the practice to be clean and hygienic. I also spend a lot of time watching consults between the vets and clients, which made it apparent that working as a vet involves dealing as much with the humans that come with the pets as well as the animals themselves. These consults have also provided me with the information of a lot of different illnesses and their accompanying treatments, which I always find interesting to hear about. In addition to this I also enjoy watching the operations carried out by Richard and the team, one of my favourites so far being a caesarean on a Bulldog, partly due to the puppies being very cute. I also try to help the vets and nurses when needed, such as by tidying up between consults, helping to clean or helping to hold animals. However, it appears that my main role at the practice is keeping everyone well fed with cakes!

Hollybank is my favourite veterinary practice to work at as there is always something exciting going on for me to do, the practice is very welcoming and clean, and all the veterinary surgeons, nurses and receptionists are very friendly and are always willing to help and explain things to me. My work experience at Hollybank has confirmed my ambition of becoming a vet as I thoroughly enjoy working here, and despite the hard work involved in being a vet I am still fascinated by the job and the range of skills it requires. I am very grateful to Richard and all at Hollybank for giving me this amazing opportunity and helping me with all they have done.”

Please see our ‘work experience’ page if you are considering applying to do work experience

 

Brave Pet Of The Month…Kodi!

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DSCF0665_2sKodi is a very handsome and clever German Shepherd Dog (GSD). He presented to us with the concern of weight loss, a ravenous appetite and frequent bouts of watery diarrhoea. Kodi had in fact lost 6 kg in 3 months! However, his remaining physical examination was unremarkable.

Weight loss despite a really good appetite suggests there is some form of abnormal digestion and/or utilisation of the nutrients he is receiving. This type of disorder could also be the reason for his diarrhoea. However, there can be lots of other reasons for diarrhoea and these too must be considered.

GSD’s are a breed known to suffer from a condition called exocrine pancreatic insufficiency (EPI). The pancreas contains specialised ‘exocrine’ cells which produce enzymes; the enzymes are transported to the small intestine where their role is to digest food. In dogs with EPI their is a loss of these exocrine cells. This leads to reduced enzyme production and therefore significantly reduced digestion.

Due to this lack of digestion and nutrition, dogs suffering from EPI will inevitably lose weight. They respond to the malnutrition with an increased appetite and the undigested food travels through the GIT in the form of diarrhoea.

kodi_9_hdr4So why does EPI occur more commonly in GSDs? The destruction of the pancreas is due to inappropriate immune attack on the pancreas, in other words, their body attacks their own pancreatic cells. The exact reason for this unclear. However, it is thought to be a hereditary condition. In theory, any breed can suffer from immune mediated EPI and any disease affecting the pancreas can result in the destruction of pancreatic cells, for example, severe cases of pancreatitis.

Based on Kodi’s history and breed  we were keen to rule in or out EPI. This requires a specific blood test. His results were supportive of EPI. What next? The pancreas cannot regenerate new exocrine cells so EPI is a lifelong condition requiring medical management. The bulk of this management is the addition of  ‘replacement enzymes’ on Kodi’s meals.

Unfortunately, this alone is often not enough and the overall management can be very complex with a number of other things that must be addressed:

  • These dogs often have concurrent deficiency in vitamin B12 requiring regular Vitamin B12 injections.
  • The condition can be ‘diet responsive’ so changing to one high in fibre and low in carbohydrate must be considered.
  • They can also be prone to small intestinal bacterial overgrowth and at least in the early stages of diagnosis and stabilisation antibiotics may be required.
  • Last, but not least, there can be concurrent GIT disease. This can be particularly true for GSD’s who can be more likely to suffer from conditions such as inflammatory bowel disease (IBD). In fact, we think this is the case for Kodi as he responded very well to feeding a lamb and vegetable diet (diet-responsive IBD)

dscf1194It has taken lots of time, patience and fine tuning of his medications. However, thanks to his owner’s commitment Kodi is currently doing very well! He has gained weight and has normal faeces which are important indicators of how stable his condition is.

With frequent visits to the vets we think Kodi definitely deserves recognition as a brave pet!