Myocardial perforation by a stick foreign body in a dog

Objective: To report a case of myocardial perforation by a stick foreign body in a dog. Case Summary: A 3‐year‐old castrated male Labrador Retriever was examined because of a puncture wound seen after an unsupervised run in the woods. The wound was suspected to penetrate into the thoracic cavity on the basis of physical exam and radiographs. Uniform ventricular premature complexes (VPCs) and junctional beats were noted on electrocardiogram (ECG). Thoracotomy was performed and a 6‐cm wooden stick was seen protruding from the right ventricle through the pericardium toward the sternum. The stick was removed while purse string sutures were tied around the resultant myocardial defect. Follow‐up echocardiography revealed intact intracardiac structures. VPCs were treated with lidocaine and resolved completely within 24 hours of presentation. New or Unique Information Provided: Thoracic trauma can result in myocardial injury; penetration into the myocardium represents a life‐threatening situation for the emergency clinician. Cardiac injury should be included in the differential diagnoses of penetrating thoracic foreign bodies.     

Identification of a periorbital wooden foreign body as the cause of chronic ocular discharge in a horse

The clinical, diagnostic and therapeutic features of a horse with a wooden foreign body embedded in the deep portion of the right masseter muscle adjacent to the right orbit are presented. The purpose of this report is to describe the clinical presentation, magnetic resonance imaging findings and treatment of a penetrating wooden foreign body in a horse that had no history of trauma or evidence of a puncture wound. This report documents the usefulness of magnetic resonance imaging to detect a wooden foreign body embedded in the soft tissues of a horse with a chronic copious ocular discharge. Two surgical procedures were necessary, which is a frequent complication encountered with wooden foreign bodies.     

Penetrating injury at the thoracic inlet in a Paint‐Arab mare

A 12‐year‐old Paint‐Arab mare was admitted for evaluation of a penetrating chest laceration at the thoracic inlet. The left brachiocephalic muscle was transected and the recurrent laryngeal nerve was traumatised. Subsequent to the injury, the horse developed Horner's syndrome on the left side of the neck and face, Grade IV left laryngeal hemiplegia, dysphagia, cough and subcutaneous emphysema. The defect was closed in multiple layers. Antimicrobial and antiinflammatory therapy was instituted along with local wound care. The mare remained bright and responsive and the wound healed normally. The mare showed no signs of respiratory distress. Dysphagia and ptosis persisted at 30 days post trauma.     

Pharyngeal stick penetration injuries in the dog

Sixty-five dogs were examined and treated for stick penetration wounds of the pharynx. Dysphagia, pain, pyrexia and local cellulitis were common presenting signs amongst recently injured dogs. Injuries involving the oesophagus resulted in subcutaneous emphysema and dyspnoea associated with pneumomediastinum. Longstanding wounds presented with discharging sinuses of the head, neck or cranial thoracic region. Wooden foreign bodies were recovered from 37 dogs (57 per cent) with subsequent resolution of their clinical signs. No foreign body was retrieved from a further 18 dogs (28 per cent) but their clinical signs resolved after appropriate wound management. Four dogs (6 per cent) died shortly after the injury from major oesophageal tears which allowed mediastinal contamination. Six dogs (9 per cent) had no foreign body recovered at surgery and the discharging sinuses persisthed. The need for vigorous management of the fresh injury in order to preclude the development of chronic complications is emphasised.     

A novel internal abdominal oblique muscle flap to close a major abdominal wall defect

This report describes a novel technique for abdominal wall reconstruction using an internal abdominal oblique muscle flap in an Australian kelpie. En bloc resection of a chondrosarcoma and biopsy scar centred on the 13th rib was performed to include full thickness thoracic wall (12th rib, extending caudally) and lateral abdominal wall (including the vascular pedicle of the external abdominal oblique muscle). The diaphragm was advanced to close the thorax. A flap using the caudal internal abdominal oblique muscle with the base dorsally was elevated and rotated 90° to fill the dorsal defect. The ventral defect was closed using the composite ventral abdominal muscles. The skin was closed primarily. The dog developed a self-resolving seroma. Twelve months postoperatively, the dog was able to engage in agility competitions. A viable muscle flap using the internal abdominal oblique muscle provides a useful alternative to previously described techniques for autogenous closure of a large abdominal wall wound.     

Surgical Removal of a Descending (Small) Colon Foreign Body through a Secondary Paramedian Approach

Intestinal obstruction due to foreign body ingestion is one cause of colic in horses. Although it occurs more frequently in juveniles, adult horses also may be affected. The small colon is a common location in which foreign bodies can be found. Depending on the location of the obstruction in the small colon, different techniques to dislodge the foreign body toward areas where it can be safely exteriorized and removed can be attempted. Alternatively, different approaches to the abdomen can be performed to facilitate exteriorization of the obstructed segment and removal of the foreign body. This paper describes a case of large and small colon obstruction in an adult horse caused by two distinct foreign bodies. The large colon obstruction was removed through a pelvic flexure enterotomy using the ventral midline approach, and the small colon obstruction was removed through a small colon enterotomy using a paramedian approach. Information regarding signalment, history, clinical signs, surgical treatment, and follow-up status of the horse are described.     

Surgical removal of an intramedullary chopstick fragment penetrating the spinal cord in a cat

A 3-year-old male domestic shorthair cat presented with sudden ataxia. Neurologic examination showed complete loss of proprioception in the thoracic and pelvic limbs. Computed tomography and magnetic resonance imaging revealed a non-metallic foreign body penetrating the spinal cord. The foreign body was removed by the ventral approach to the atlanto-occipital junction. Mild improvement of proprioception was observed the day after surgery. In a follow-up two months after surgery, the owner reported a complete recovery of the patient, showing a normal gait. To the author’s knowledge, this is the first case report describing successful removal of an intramedullary foreign body penetrating cervical spinal cord by ventral approach in a cat.     

Hypertrophic osteopathy associated with a bronchial foreign body and lobar pneumonia in a dog

Hypertrophic osteopathy was diagnosed in a dog with a bronchial foreign body and lobar pneumonia. Hypertrophic osteopathy is generally associated with primary or secondary neoplasms of the lungs and rarely associated with nonneoplastic thoracic lesions. The foreign body and affected lung lobe were removed by pneumonectomy, resulting in recovery of the dog and resolution of the hypertrophic osteopathy lesions.     

INPACTION OF THE PHARYNX, LARYNX, AND ESOPHAGUS BY AVIAN BONES IN THE DOG AND CAT

Avian osseous (mandible, thoracic and caudolateral processes and furculum) foreign body impaction in the larynx, pharynx, and esophagus is described in three cats and one dog. All animals were presented because of gagging. Radiographic assessment revealed the foreign body in each animal. Each foreign body was successfully removed. Three of the animals recovered uneventfully, and one had a persistent change of voice.     

Metastatic Osteolytic Angioleiomyosarcoma Induced by a Foreign Body in a Kangaroo (Macropus giganteus)

An adult female Eastern Grey kangaroo (Macropus giganteus) was examined for lameness due to a mass located at the right tibiotarsal joint. Radiographs revealed a metal arrowhead‐shaped foreign body within the mass alongside a pathologic fracture. Grossly, at necropsy, there was a multilobulated and haemorrhagic mass with intralesional metal fragments, associated osteolysis of the tibiotarsus and pulmonary metastatic nodules. Histologically the neoplasm was composed of plump elongated and fusiform cells that often formed concentrically around small vessels. The pulmonary nodules were composed of similar neoplastic cells, necrosis and haemorrhage. Neoplastic cells were positive immunohistochemically for vimentin and smooth muscle actin. The histological features, immunohistochemical profiles and behaviour of this tumour support a diagnosis of a primary angioleiomyosarcoma with lung metastasis associated with a metal foreign body.     

Ultrasonographic and magnetic resonance imaging diagnosis of an oropharyngeal wood penetrating injury in a dog

A 5 yr old female intact English setter with a 17 day history of a penetrating oropharyngeal wound was referred for cervical swelling and pain. Physical examination revealed swelling at the left lateral aspect of the cranial cervical region. Pain was elicited upon flexion, extension, and leftward movement of the neck. Neurologic deficits were not identified. Cervical ultrasonography showed a 0.4 cm × 2.3 cm linear, hyperechoic structure in the soft tissues ventrolateral to the first (C1) and second (C2) cervical vertebrae. MRI demonstrated a linear structure 2 cm in length adjacent to the cranial aspect of C2. The foreign material was isointense to hyperintense on precontrast T1-weighted images, isointense on postcontrast T1-weighted images, and hypointense on T2-weighted images relative to adjacent muscle. Abnormalities within the spinal canal were not identified. Upon surgical exploration, a reed foreign body was identified deep to the serratus ventralis muscle. The patient was normal on follow-up evaluations 4 wk postsurgically.     

Traumatic gastropericarditis in a horse

An ingested metallic foreign body migrated from the stomach and induced restrictive pericarditis in a horse. Necropsy revealed chronic abdominal and acute thoracic lesions. Although rare, ingested foreign body migration should be considered in the differential diagnosis of body cavity disease in horses.     

Successful surgical management of a perforating oesophageal foreign body in a cat

CASE PRESENTATION AND SURGICAL INTERVENTION: a 3-year-old cat was presented with a recent history of dysphagia and intermittent regurgitation. Radiography revealed a bony oesophageal foreign body at the level of the thoracic inlet. Endoscopic retrieval was attempted but resulted in severe dyspnoea due to the development of pneumomediastinum, pneumothorax and subcutaneous emphysema secondary to perforation of the oesophageal wall. Immediate surgical exploration was carried out. Extensive necrosis of the oesophagus resulting from the presence of the foreign body led to a decision to perform an oesophageal resection and anastomosis. CLINICAL RELEVANCE: this is the first clinical report of a cat treated successfully by oesophagectomy following oesophageal perforation due to an obstructive foreign body. The authors suggest that prompt surgical intervention, the ability to convert to a surgical procedure under the same anaesthetic as a non-surgical retrieval, placement of a gastrostomy tube and the availability of advanced anaesthetic and critical care support are important factors to consider when managing feline patients with a perforating oesophageal foreign body.     

The Role of Bronchoscopy in Foreign Body Removal in Dogs and Cats: 37 Cases (2000–2008)

Background: Foreign body aspiration is a differential diagnosis for acute or chronic cough that requires medical or surgical management in animals. Hypothesis: Success of bronchoscopy in airway foreign body removal is dependent on the size of the animal, duration of clinical signs, and location of the foreign body. Animals: Thirty‐two dogs and 5 cats with airway foreign bodies identified at the UC Davis Veterinary Medical Teaching Hospital. Methods: Retrospective case study evaluating the role of duration of clinical signs and body size in successful bronchoscopic removal of foreign bodies. In addition, radiographic localization of disease was compared with bronchoscopic identification. Bronchoalveolar lavage (BAL) culture and cytologic findings are reported. Results: Bronchoscopy was successful for removal of airway foreign bodies in 76% of animals (24/28 dogs and 2/5 cats), and in dogs was independent of duration of clinical signs or body size. One‐third of thoracic radiographs lacked distinctive features of an airway foreign body, and therefore radiography was unable to predict the affected site. BAL fluid at the site of the foreign body contained more neutrophils and more often had intracellular bacteria than lavage fluid from a separate site. Conclusions and Clinical Importance: Bronchoscopy was successful in removing airway foreign bodies regardless of animal size or long duration of clinical signs. Results of this study confirm the utility of bronchoscopy with lavage in management of suspected foreign bodies, even in the absence of localizing radiographic findings.     

Wounds associated with osseous sequestration and penetrating foreign bodies

Nonhealing wounds can present a frustrating clinical challenge to the veterinary practitioner. In many cases, healing is delayed by the presence of a foreign body or sequestrum; a review of wounds complicated by the presence of osseous sequestration and penetrating foreign bodies is presented. The typical signs include delayed wound healing and the presence of serous to exudative drainage, which may vary from intermittent to continuous. The use of radiographic or sonographic imaging modalities is often of value in reaching a diagnosis. Removal of the sequestra or foreign body is generally curative.     

Gastrocutaneous fistula as a result of migration of a foreign body in a dog

A six-year-old, female Tibetan terrier was referred for investigation of a non-healing wound on the left caudal thorax. A subcutaneous swelling had initially developed on the chest wall, followed by a draining tract from which seropurulent fluid drained for two months. There had been no response to antibiotic treatment. Following radiographic and ultrasonographic examinations, a bone sequestrum from a fractured rib or a foreign body was suspected. Surgical exploration of the wound identified a sinus tract and a wooden foreign body (an ice-lolly stick) was located in subcutaneous tissues. Partial wound dehiscence of the surgical site occurred postoperatively, but healed after 10 days. One month later, fluid began to discharge from the area again. Further surgical exploration confirmed a gastrocutaneous fistula. Dissection of the fistula and surgical closure of the stomach, body wall and skin led to resolution of all signs.     

Chronic bronchocutaneous fistula caused by toothpick foreign body in a Maltese dog

A 7-year-old, 1.76 kg Maltese dog presented with a 4-year history of a chronic pustular lesion and a wet cough. Erosive lesions were seen at the left thoracic wall. Radiology and computed tomography (CT) revealed a bronchocutaneous fistula connecting from the left cranial bronchus to the skin. On definitive surgery, a long wooden toothpick was observed within this tract, and clinical signs resolved after retrieval of the foreign body. Three-dimensional CT was useful to identify the characteristics of the bronchocutaneous fistula. However, the wooden foreign body was not apparent on CT. Here, we report the clinical, clinicopathological and diagnostic imaging findings of a chronic bronchocutaneous fistula caused by a foreign body in a dog.