Exploratory Surgeries

I’m sure you know the feeling of anticipation and excitement just before you open a present on your birthday.  That is a similar feeling that veterinarians and veterinary technicians feel when they are doing an exploratory surgery on a dog or cat.  Radiographs are analyzed, wagers are made, and eyes crowd the surgery door window in hopes of seeing what the surgeon removes from the gastrointestinal tract.  There is also a feeling of worry and dread (at least by the vet) about what damage that foreign body has wrought on the GI tract.

Recently the staff at Four Lakes had two dogs present within a week with suspected foreign bodies.

SAMSUNG CAMERA PICTURESChief was a 2 year old Labrador Retriever.   He had been vomiting and not feeling well all weekend.  He was dehydrated, so we started him on IV fluids and then took an abdominal x-ray.  We were excited to find:

ChiefrocklatA heart-shaped something!  And lots of gas in his intestines.  No wonder Chief didn’t feel very good!  With the very obvious foreign object, he was taken right into surgery.  Because he had been vomiting and not feeling well for 4-5 days and had a high white blood cell count,  I was very worried about what his intestines would look like, if there was a perforation, and if part of the intestine was going to need to be removed.

Because “exploratory” means just that, the incision made is a long one.  Every organ is examined and the entire length of intestines (estimated to be about five to six times the length of the animal’s body) are “run” through the fingers to feel for any abnormalities. SAMSUNG CAMERA PICTURES In Chief’s case, when I first started to “run the bowels” a firm area was felt.  When that part of the intestine was opened, a wad of black fur and food was found.  I removed it, but that was not the bright white object seen on the x-ray.  I kept going and suddenly found very “angry” intestines–a dark red, inflamed area surrounding a large, hard mass.

I was concerned about the viability of this very inflamed intestinal area.  But removing a portion of intestines and then reattaching the two ends is not a procedure to take lightly.  I removed the hard object (which turned out to be a rock) and then watched the intestines for awhile.  SAMSUNG CAMERA PICTURESThe inflamed area had a good pulse to it and I didn’t see any areas that looked black or that were oozing anything, so I opted to leave them all intact.  Hoping that by removing the obstruction, everything would slowly heal and go back to normal.

 I worried about Chief for days afterwards, but he recovered well.  He started eating soon after surgery, with no further vomiting, and finally passed stool a couple days later.  By the time his skin sutures were removed, he was all back to normal!

The next day a client brought in her new dog, Nelson.  She had adopted him from the Humane Society five days before.  He had been fine, playing with her other dog and then suddenly became lethargic, unable to get comfortable, stopped eating and started vomiting.  On physical exam he was dehydrated and not passing any stool.  We started with x-rays to see if there was a rock in Nelson, too.  His “survey” radiograph showed some odd gas patterns, so we decided to give him some barium dye and see if it passed normally through his intestines.  Barium can help show foreign objects or an obstruction, but it also helps to coat the intestines and can improve gastroenteritis signs.

nelsonbariumlat  Here you can see the barium dye in Nelson’s stomach and the gas in his intestines.

When a barium series is performed, the animal is given the dye orally (sometimes they will eat it up with some canned food) and then x-rays are taken every 30-90 minutes to watch the dye pass out of the stomach and through the intestines.  In Nelson’s case, however, the dye didn’t move at all after 2 hours and then he vomited it up.  His blood work also showed a high white blood cell count, so off to surgery we went.

I was worried about what we were going to find in Nelson, too.  Once anesthetized, he was found to have high blood pressure and an elevated heart rate. I anticipated that whatever it was would be in the stomach, since the dye didn’t pass through, but the stomach was empty.  But I quickly found a dark red, distended area in the intestines. SAMSUNG CAMERA PICTURES I made an incision in the healthy intestines right next to the area and started pulling out this hard, black rubbery substance.  It was a large chunk and I had to cut it in pieces to remove it.  But once it was out, Nelson’s blood pressure and heart rate immediately dropped to normal and the red tissue started looking healthier.  I worried about Nelson after surgery, too, but not as much as with Chief!

The black chunks turned out to be chunks from a hard rubber ball he had been playing and chewing on over the weekend. SAMSUNG CAMERA PICTURES  Luckily he had some insurance coverage from his recent adoption, so part of the surgery was covered.

Both Chief and Nelson recovered well and continue to be healthy, happy dogs.  We much prefer that, but did enjoy talking about their surgeries and the strange things dogs eat for days afterwards!