RESULTS OF COMPUTED TOMOGRAPHY IN DOGS WITH SUSPECTED WOODEN FOREIGN BODIES

Detection of wooden foreign bodies in dogs can be challenging. A retrospective, cross‐sectional study was done to describe computed tomographic (CT) signs associated with wooden foreign bodies, and to estimate the accuracy of CT for detection of wooden foreign bodies. Patient records and CT images were reviewed for 72 dogs that had a history of suspected stick injury and CT of the affected body part, or possible wooden foreign object reported on CT, and had surgical exploration during the same period of hospitalization. Duration of clinical signs was acute in 48 (67%) dogs and chronic in 24 (33%). Wood was removed from 55 dogs, including a piece of a tree or shrub in 33 (60%) instances, kebab stick in 8 (15%), piece of bamboo garden cane in 2 (4%), cocktail stick in 2 (4%), thorn in 1 (2%), and unidentified wood in the remaining nine instances. Based on review of CT images with knowledge of the surgical findings, sensitivity of CT for wooden foreign bodies was 79% (95% CI 65%–89%), specificity 93% (78%–98%), positive likelihood ratio 11.5 (2.9–44.1), and negative likelihood ratio 0.23 (0.13–0.41). Wooden foreign bodies were predominantly rectangular or linear, with median length 48 mm (range 2–270 mm), median thickness 3 mm (range 1–22 mm), and median attenuation 111 HU (range ?344 to +640 HU). A CT finding of gas in soft tissues was significantly associated with acute cases, whereas suspected foreign material, cavitary lesions, fat stranding, and periosteal reaction on adjacent bones were associated with chronic cases.     

CT findings in 20 dogs and six cats with confirmed nasal foreign bodies

The diagnosis and treatment of nasal foreign bodies usually includes a combination of rhinoscopy and imaging techniques, such as CT. The purpose of this retrospective, multicenter study was to describe the CT characteristics of nasal foreign bodies in dogs and cats and to determine if different nasal CT features exist between acute and chronic cases. Twenty dogs and six cats met the inclusion criteria. Eleven nasal foreign bodies (42%) were detected confidently with CT. The foreign body had a linear shape in 81% of cases and displayed a “tubular‐like appearance” in 54% of cases. In five cases (19%), a foreign body was suspected but not clearly visible. Additional CT changes were present in the nasal passages in 96% of the cases. The presence of turbinate destruction (P = .021) and mucosal thickening (P = .014) on CT were associated with the presence of a chronic nasal foreign body. In this sample, the nature of the foreign body did not influence its visibility and was not associated with specific CT characteristics. Computed tomography may be useful in the investigation of nasal foreign bodies, however, a negative CT examination does not exclude their presence.     

Ultrasonographic detection of ingested and perforating wooden foreign bodies in four dogs

Four dogs that had ingested wooden foreign bodies were examined. All 4 dogs were young and were examined because of lethargy and a mass involving the left flank that was partially responsive to antimicrobial treatment. Ultrasonography of the flank mass revealed inhomogeneous subcutaneous tissues representing seroma, edema, or reactive tissue. Long, linear, bright interfaces representing the wooden foreign bodies were identified in the stomach of 3 dogs and in the abdominal cavity of 1 dog. The interfaces were associated with uniform shadowing in 3 dogs. Local omental and mesenteric changes suggestive of focal peritonitis were evident in 1 dog. In all 4 dogs, the foreign bodies were removed through an exploratory celiotomy. All dogs recovered without complications.     

ULTRASONOGRAPHIC DIAGNOSIS OF FOREIGN BODIES ASSOCIATED WITH CHRONIC DRAINING TRACTS AND ABSCESSES IN DOGS

This is a retrospective study that describes the historical, physical exam, radiographic, fistulographic, ultrasonographic, and surgical findings associated with non-gastrointestinal and extrathoracic foreign bodies in six dogs. All dogs had a chronic draining tract or abscess. Although radiographs were obtained in five of the six dogs, no foreign bodies were identified with this modality. Fistulography was performed in four of the six dogs, and a filling defect consistent with a foreign body was found in two of four dogs. A foreign body was identified in five of the six dogs with ultrasound. Foreign bodies were removed surgically in five of six dogs. This report clarifies the importance of ultrasound in the evaluation of chronic draining tracts and abscesses in dogs.     

Acid-base and electrolyte abnormalities in dogs with gastrointestinal foreign bodies

Gastrointestinal foreign bodies occur commonly in dogs. The objective of the study was to describe the acid-base and electrolyte abnormalities identified in dogs with gastrointestinal foreign bodies and determine if these abnormalities are related to the site or type of foreign body present. Medical records of 138 dogs were reviewed, and information on signalment, initial venous electrolyte and acid-base values, surgical findings, relevant historical information, imaging modalities used, cost of hospital visit, intra- or postoperative complications, and survival was obtained. The site of the foreign body was recorded in 94.9% of cases and the most common site was the stomach (50%), followed by the jejunum (27.5%). The foreign bodies were linear in 36.2% of cases. The most common electrolyte and acid-base abnormalities regardless of the site or type of foreign body were hypochloremia (51.2%), metabolic alkalosis (45.2%), hypokalemia (25%), and hyponatremia (20.5%). No significant association was found between electrolyte or acid-base abnormalities and the site of foreign body. Linear, as opposed to discrete, foreign bodies were more likely to be associated with a low serum sodium concentration (odds ratio, 0.85; 95% confidence interval, 0.75-0.95). Hyperlactatemia (> 2.4 mmol/L) was seen in 40.5% of dogs. A wide variety of electrolyte and acid-base derangements are found in dogs with gastrointestinal foreign bodies. Hypochloremia and metabolic alkalosis are common in these dogs. Hypochloremic, hypokalemic metabolic alkalosis is seen with both proximal and distal gastrointestinal foreign bodies.     

Migration of wooden skewer foreign bodies from the gastrointestinal tract in eight dogs

Wooden skewer foreign bodies were found in eight dogs. Five presented for evaluation of draining sinuses and two for inflammatory disease referrable to the thorax, abdomen or pelvic region. In an additional case, pneumothorax resulted from perforation of the stomach and diaphragm. Ingestion was considered the most likely mode of access of the foreign body in all cases. Although the wooden foreign bodies were seen radiographically in only two dogs, identification of soft tissue or bony changes, or the results of contrast sinography assisted diagnosis. Surgical retrieval led to resolution of signs in all cases.     

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.     

Gastrointestinal foreign bodies in dogs and cats: a retrospective study of 208 cases

O bjectives : To establish predilection sites of obstruction and to investigate clinical factors associated with a poor outcome.
M ethods : A retrospective study of 208 consecutive cases over a 48-month period from first-opinion practice.
R esults : Overall, 91 per cent of cases recovered with higher survival rates from discrete foreign bodies (94 per cent in dogs and 100 per cent in cats) as opposed to linear foreign bodies (80 per cent in dogs and 63 per cent in cats). English bull terriers, springer spaniels, Staffordshire bull terriers, Border collies and Jack Russell terriers were over-represented. In dogs, 63 per cent of obstructions occurred in the jejunum but foreign objects were encountered at all points along the gastrointestinal tract. A longer duration of clinical signs, the presence of a linear foreign body and multiple intestinal procedures were associated with significantly increased mortality. Neither the degree of obstruction (partial or complete) nor the location of the foreign body was shown to have a significant influence on survival.
C linical S ignificance : Prompt presentation, diagnosis and surgical intervention improve the outcome of gastrointestinal obstruction by foreign bodies. At surgery, the minimal number of intestinal procedures should be performed to restore the integrity of the alimentary tract.     

Experimental studies of intrabronchial foreign bodies in the dog

Results obtained from clinical, endoscopic, bacteriological, and roentgenological investigations, following artificial introduction of foreign bodies into the tracheobronchial system of dogs, are reported in this paper. The foreign bodies included gauze pads, plastic halma pieces, larch, alder, and wood cones. Twenty of the 22 foreign bodies artificially placed into the bronchial tree of the experimental dogs were spontaneously coughed up, 16 of them between the 1st and 14th days from introduction. The cause underlying such high spontaneous healing rate of tracheobronchial foreign bodies in dog is discussed in some detail.     

一例母犬胃内异物合并绝育手术的诊疗

文章研究治愈母犬胃内异物的同时做绝育手术的效果。对病犬采用临床检查、血常规检查、血清生化检查、影像学检查等方法确诊胃内有异物,并通过手术取出胃内异物的同时进行绝育。结果表明:从母犬胃内取出一块大小为2 cm×1 cm×1 cm的石子,并成功给母犬做绝育,术后恢复效果较好。该病例的诊疗经验为临床上犬胃内异物的诊治和绝育手术提供参考。     

Incidence of foreign-body-induced ileus in dogs

While playing or simply because of avidity, dogs may ingest a variety of foreign bodies. Ingested foreign bodies, which are not stopped in the mouth or oesophagus, enter into the stomach. Once a foreign body has passed through the pylorus, jejunum and ileum appear to be the most common sites of the small intestine obstruction. The records of 103 cases, treated at the Clinic for Surgery, Orthopaedics and Ophthalmology of the Veterinarian Faculty, University of Zagreb from January 1981 till December 1998 were analysed. The analysis included the incidence of ileus caused by foreign bodies and the distribution of patients by sex, age, breed, duration of illness, site of obstruction, types of foreign bodies and the interrelation between these parameters. The results of our research show that the number of patients with foreign body induced ileus is increasing. Males ingested foreign bodies more often than females. Foreign body induced ileus was more frequently found in animals below 2 years of age. Foreign bodies were mostly ingested by mongrels, but also by popular dog breeds such as Dobermanns, Poodles, Cocker Spaniels and Rottweiler. Most of these ileus cases were found in March and October and the predominant clinical signs included anorexia, dehydration, abdominal tenderness and absence of defecation. The most common site of small intestine obstruction by foreign bodies was the jejunum, and the most effective treatment was enterotomy. Dogs mostly ingested stones, plastic and rubber objects. The treatment was more successful in dogs below 2 years of age. Patients that died post-surgically, died mostly the first day after surgery.     

Laparoscopic removal of gastric foreign bodies in dogs--comparison of manual suturing and stapling viscerosynthesis

This study was an attempt to evaluate the application of various laparoscopic techniques of removing foreign bodies from the stomach in dogs in comparison to conventional laparotomy. The research was conducted on two groups of 10 dogs each with clinically confirmed foreign bodies in the stomach. In case of all patients, a laparoscopic instrument, EndoBag, was used for the removal of the foreign body from the stomach and the abdominal cavity. Manual suturing with the use of Szabo-Berci suturing kit was used for the gastrotomy wound closure in group I. In group II, linear staplers were used for viscerosynthesis. All patients were subjected to radiological assessment of tightness of anastomosis. No significant differences between the quality of the performed stomach anastomosis were shown. Therefore, the competitiveness of an economical manual suturing in comparison with the very expensive mechanical suturing preferred in human surgery was confirmed. The described procedures of laparoscopic gastrotomy seem to be applicable for removing foreign bodies from the stomach in a clinical veterinary practice.     

DIAGNOSTIC VALUE OF COMPUTED TOMOGRAPHY IN DOGS WITH CHRONIC NASAL DISEASE

Computed tomographic (CT) studies of 80 dogs with chronic nasal disease (nasal neoplasia (n = 19), nasal aspergillosis (n = 46), nonspecific rhinitis (n = 11), and foreign body rhinitis (n = 4)) were reviewed retrospectively by two independent observers. Each observer filled out a custom-designed list to record his or her interpretation of the CT signs and selected a diagnosis. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the diagnosis of each disease. The agreement between observers was evaluated. The CT signs corresponded to those previously described in the literature. CT had an accuracy greater than 90% for each observer in all disease processes. The sensitivity, specificity, PPV, and NPV were greater than 80% in all dogs with the exception of the PPV of foreign body rhinitis (80% for observer A and 44% for observer B). There was a substantial, to almost perfect, agreement between the two observers regarding the CT signs and diagnosis. This study indicates a high accuracy of CT for diagnosis of dogs with chronic nasal disease. The differentiation between nasal aspergillosis restricted to the nasal passages and foreign body rhinitis may be difficult when the foreign body is not visible.     

Use of ultrasonography to facilitate surgical removal of non-enteric foreign bodies in 17 dogs

Plant material foreign bodies may cause vague clinical signs at the time of initial presentation but can progress to cause persistent or recurrent abscessation, sinus tract formation and debilitating disease, due to migration of the foreign body, severe tissue reaction and secondary infection. Ultrasonography is a non-invasive technique that can be used to identify precisely the presence, location and size of radiolucent foreign bodies. Early identification of foreign bodies using ultrasonography facilitates surgical retrieval before further migration and tissue injury occur. This paper reviews the ultrasonographic findings and outcome in 17 dogs with non-enteric, radiolucent, plant material foreign bodies.     

Percutaneous endovascular retrieval of an intravascular foreign body in five dogs, a goat, and a horse

CASE DESCRIPTION-5 Dogs, 1 goat, and 1 horse underwent percutaneous endovascular retrieval of intravascular foreign bodies between 2002 and 2007. CLINICAL FINDINGS-Foreign bodies were IV catheters in 4 dogs, the horse, and the goat and a piece of a balloon valvuloplasty catheter in 1 dog. Location of the foreign bodies included the main pulmonary artery (1 dog), a branch of a pulmonary artery (4 dogs), the right ventricle (the goat), and a jugular vein (the horse). TREATMENT AND OUTCOME-The procedure of percutaneous endovascular retrieval of the foreign body was easy to perform in all instances. One dog was euthanized 41 days after retrieval because of worsening of another disease process, and 1 dog had abnormal neurologic signs secondary to a brain mass. All other animals were clinically normal during the follow-up period (follow-up duration, 3 to 57 months). None of the animals developed long-term complications secondary to the foreign body retrieval procedure. CLINICAL RELEVANCE-Intravascular foreign bodies that result from catheters or devices used during minimally invasive techniques are rare but may cause substantial morbidity. Percutaneous endovascular retrieval of intravascular foreign bodies was easily and safely performed in the 7 animals reported here. Use of percutaneous endovascular retrieval techniques should be considered for treatment of animals with intravascular foreign bodies because morbidity can be substantially decreased; however, proper selection of patients for the procedure is necessary.     

Endoscopic removal of foreign bodies from cats or dogs

Foreign bodies in the airways or intestines of dogs or cats are a common problem in companion animal practice. Improved endoscopic techniques, together with their greater availability, mean that it is often possible to remove the foreign body endoscopically, making surgery unnecessary. This article describes 53 cats and dogs in which a foreign body was detected and, where possible, removed. Results are compared with those in the literature. Practical guidelines for foreign body removal in specific cases are described, focusing on therapy and prognosis.     

Risk factors for leakage following intestinal anastomosis in dogs and cats: 115 cases (1991-2000)

OBJECTIVE: To identify factors associated with leakage following intestinal anastomosis in dogs and cats. DESIGN: Retrospective study. ANIMALS: 90 dogs and 25 cats. PROCEDURE: Medical records of all dogs and cats that underwent intestinal resection and anastomosis between 1991 and 2000 were reviewed, and information on 27 factors was recorded. RESULTS: Anastomotic leakage was identified in 13 of the 90 dogs but in none of the 25 cats. Preoperative factors significantly associated with development of anastomotic leakage in dogs included preoperative peritonitis, serum albumin concentration, a left shift, and indication for surgery (dogs with intestinal foreign bodies were more likely to have leakage than dogs that underwent surgery for any other cause). Postoperative and case management factors significantly associated with development of leakage included duration of hospitalization, supplemental alimentation, whether the dog ate the day after surgery, blood product administration, and outcome (died vs survived). Discriminant analysis was performed, and dogs with 2 or more of the following factors were predicted to develop anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration < or = 2.5 g/dL. The model accurately predicted whether leakage would develop in 67 of 80 (84%) dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a variety of factors may be associated with development of intestinal anastomotic leakage in dogs. In particular, dogs with 2 or more of the following risk factors are predicted to be at high risk for developing anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration < or = 2.5 g/dL.     

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.     

Oesophageal foreign bodies in dogs: factors affecting success of endoscopic retrieval

Oesophageal foreign bodies are common in dogs. Endoscopic removal is a viable treatment option but few studies have assessed the clinical and radiographic features that would be useful in decision-making and prognosis.Dogs (n = 44) with oesophageal foreign bodies presented to the University Veterinary Hospital were assessed. Terriers and West Highland White Terriers were significantly overrepresented (p < 0.0001) and in those breeds the foreign body was significantly (p < 0.0001) more likely to be located caudal to the heart base. The majority (88.6%) of foreign bodies were bones or bone fragments.Group 1 (n = 30) included animals where endoscopic removal was successful and Group 2 (n = 14) animals where it was unsuccessful or not attempted because of evidence of oesophageal rupture. There was no statistically significant difference in age, sex, body weight, type, location and size of foreign body, recovery rate, short-term complications and long-term outcome between the two groups. Duration of signs prior to presentation and time to spontaneous oral feeding were significantly longer (p < 0.01 in each case) in Group 2 (five days and 120 hours, respectively) compared to Group 1 (2 days and 24 hours, respectively). Mortality was 11.1%. Long-term follow-up of 29 dogs suggested oesophageal stricture formation manageable by feeding alone in seven (24.1%) cases.Terriers appear predisposed to oesophageal foreign bodies. Success of endoscopic removal is adversely affected by duration of signs prior to presentation. Surgical removal negatively influences time to recovery. Stricture formation appears to be a relatively common complication and alternate measures for its prevention should be sought.     

Comparison of ultrasound, computed tomography, and magnetic resonance imaging in detection of acute wooden foreign bodies in the canine manus

We evaluated the diagnostic sensitivity of ultrasound, nonenhanced computed tomography (CT) and nonenhanced magnetic resonance (MR) imaging in detecting wooden foreign bodies in the canine manus. Identical wooden splinters were manually inserted into 30 cadaver canine manus, and the limbs were evaluated using ultrasound, CT, and MR imaging by independent observers. All sites were rated as positive or negative for the presence of a foreign body, and observer certainty was scored on a 1-10 scale. Using receiver operating characteristic analysis, CT was the most accurate modality for detection of wooden foreign bodies overall and within each of the three individual regions, followed by ultrasound and MR imaging, respectively. Ultrasound evaluations were most limited in the metacarpal pad, where distal acoustic shadowing from the pad surface hindered evaluation of the tissues in some specimens.