I was trained to start at the point of fixation, in this case, Snowball’s stomach. The luxury of pulling a linear foreign body out of a single incision is unusual, especially for an object as intent on getting out the other end as this one, so opening the stomach affords the surgeon his or her first glimpse of the culprit as well as an opportunity to cut the anchor, breaking the drawstring effect and releasing the tension on the bowel.
It takes two more small incisions in the intestine to remove the entire problem, and after everything is sutured up and Snowball is resting comfortably in recovery, I head to the waiting room.The Duggan family sits watching television, but they are up on their feet as soon as they see me approach.
The answer to this mysterious foreign body had been in front of my eyes the whole time. Mrs. Duggan was wearing pumps. Mr. Duggan, a pair of well-worn work boots. Kerry Duggan sported a pair of old sneakers made unusual by one feature common to both feet—crisp, white, brand-new shoelaces. Guess what happened to the old ones?
7 common items with obstructive potential
By Dr. Nick Trout
Sharing our lives with creatures gifted in the art of scavenging and chewing could easily turn us into neurotic helicopter parents, overseeing and stifling all that natural, wonderful canine curiosity. In order to strike the balance, here are a few potentially risky items (in addition to shoelaces, socks, and loose threads on looped and fringed rugs) best kept out of harm’s way.
Diapers and tampons
(both virginal and, unfortunately, used)
These foreign bodies can be rescued from the trash, a changing table or a bathroom vanity. Their absorbent properties and subsequent expansion can necessitate surgical removal.
Shiny, pointy, sharp objects
Sewing needles, fish-hooks, safety pins and bottle caps can easily seduce an inquisitive mouth. If you see a length of thread or fishing line dangling from one or another of your dog’s orifices, leave it in place. Sometimes it can be helpful in locating and extracting the culprit.
If that innocent rubber duck in the bathtub looks like “good eats,” then there’s no chance for the cast of Toy Story kicking around on the living room floor. Remove temptation. When choosing a toy specifically for your dog, make sure it is sizeappropriate for the breed, cannot be swallowed whole and has no extraneous tags or buttons. Be prepared to supervise and take away if necessary.
U.S. pennies minted after 1982 contain zinc and can be toxic if swallowed. Loose change makes for an interesting X-ray and an easy diagnosis, but it needs to stay in pockets or piggy-banks.
Decorative refrigerator magnets may be an edible alternative when the door to dogs’ favorite appliance is closed, so keep them up high and out of reach. Some of the extremely strong, neodymium magnets can be particularly dangerous. There have been several cases of dogs swallowing magnets that have found each other on their journey through the intestine with an attraction strong enough to cause bowel perforation.
Potentially obstructive in their own right, with the added bonus of further damage if they are chewed and leak their contents when swallowed. If you are sure the battery went down whole, then you can offer a large, soft meal and induce vomiting (try 3% hydrogen peroxide, 2 to 5 ml/kg body weight). If there is any doubt, surgical removal is probably the best option.
Unlike most household glues, which do not cause problems when ingested, Gorilla Glue expands dramatically by polymerization to produce a large, solid, indigestible foam. Do not induce vomiting. Surgical removal of the obstruction is invariably required.
Nick Trout is a Diplomate of the American and European Colleges of Veterinary Surgeons and a staff surgeon at Angell Animal Medical Center in Boston. facebook.com/DrNickTrout