Bronchial foreign bodies in four dogs

This paper describes the history, clinical signs and diagnosis of cereal ear foreign bodies in four dogs. Presternal tracheotomy was required for removal of the foreign bodies in three out of the four cases and the technique is described.     

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.     

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.     

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.     

The use of magnetic resonance imaging in the management of pharyngeal penetration injuries in dogs

Objectives: To investigate the correlation between the magnetic resonance imaging findings and subsequent surgical findings for a series of dogs presenting with suspected pharyngeal stick injuries to the Animal Health Trust, Newmarket, between 1995 and 2004. Methods: Magnetic resonance imaging findings were reviewed for patients undergoing a scan of the pharyngeal or cervical area for suspected foreign bodies during the years 1995 to 2004. Results: Case signalment, history and clinical signs were similar to those reported in previous studies. Magnetic resonance imaging demonstrated foreign material in six of seven cases where this was present. There was good correlation between diagnosis of a foreign body at magnetic resonance imaging and subsequent surgical identification. Clinical Significance: Compared with other imaging modalities, magnetic resonance imaging is very helpful for this type of injury, especially in chronic cases where radiographic evidence of a foreign body is unlikely. It is a valuable aid in the diagnosis of pharyngeal penetration injury and in surgical planning.     

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.     

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.     

Metallic foreign bodies in the mouth or pharynx of horses: seven cases (1983-1989).

Seven horses with metallic foreign bodies in the mouth or pharynx were examined at the Colorado State University Veterinary Teaching Hospital from 1983 to 1989. The horses had variable clinical signs, such as purulent nasal discharge, swelling of the throatlatch area, and dyspnea. Most of the horses had clinical signs for more than 2 weeks, and had no or only temporary improvement with conservative medical treatment (antibiotics, nonsteroidal anti-inflammatory drugs). The definitive diagnostic test in all of the cases was radiography, which also aided in the plan for surgical removal of the foreign body. Once the foreign body was removed from each of the horses, their clinical signs resolved. Most of the foreign bodies were small pieces of wire, the sources of which could not be determined, but that may have been incorporated in baled hay.     

Conjunctivitis and ulcerative keratitis secondary to conjunctival plant foreign bodies in a herd of alpacas (Lama Pacos)

Purpose To describe six cases of conjunctivitis and ulcerative keratitis secondary to plant foreign bodies from weed‐contaminated grass hay which were lodged within the temporal conjunctival fornix in a herd of alpacas. Methods A total of 21 alpacas from the same farm developed blepharospasm and mucopurulent ocular discharge. Six of the 21 were evaluated at the University of Tennessee College of Veterinary Medicine within a 2‐week period. The six animals evaluated received an ophthalmic examination including slit‐lamp biomicroscopy, fluorescein staining, and topical corneal anesthesia for foreign body removal when necessary. Results Six animals had conjunctivitis characterized by hyperemia and mucopurulent discharge. Five animals had superficial ulcerative keratitis with intense corneal neovascularization and edema. In all cases, the keratitis was located at the temporal limbus. Seven plant foreign bodies were observed and were removed following topical corneal anesthesia in five animals. The plant seeds were identified as three common weed species found in orchard grass hay. Complete resolution of all clinical signs was achieved with foreign body removal and medical therapy. Conclusions Fan‐shaped temporal corneal ulcers may signify the presence of conjunctival foreign bodies in alpacas. Plant foreign bodies should be considered in addition to ocular infection when multiple animals of a herd are affected as outbreaks may occur with weed‐contaminated hay.     

Metallic foreign bodies in the tongues of 16 horses

The history, clinical signs, results of diagnostic imaging, treatment methods and outcome of 16 adult horses with a metallic foreign body in the tongue are reviewed. All the horses had a swollen tongue, they salivated excessively and were partially to completely anorexic. Less common clinical signs were fever, an enlarged and painful intermandibular space, dysphagia, unilateral tongue paralysis and halitosis. Most of the horses had shown clinical signs for less than 24 hours. The foreign bodies were diagnosed by oral examination, radiography and ultrasonography; they were removed from the tongue of four of the horses during the initial oral examination, and were removed surgically from nine others; the other three horses were treated medically without attempts being made to extract the foreign bodies. Twelve of the bodies were small pieces of wire and one was a hypodermic needle. All the horses received a combination of antimicrobial and non-steroidal anti-inflammatory drugs and they all made an uneventful recovery. Feeding hay and the use of cable-framed tractor tyres as feeders were commonly associated with the cases.     

Tracheal foreign bodies in the cat and the use of fluoroscopy for removal: 12 cases

OBJECTIVES: To gather information to support the use of fluoroscopically guided removal of tracheal foreign bodies in cats. It was also the intent to produce a case series and look at the long-term outcome following tracheal foreign body removal. METHODS: A retrospective study was performed. This looked at cases of tracheal foreign bodies in cats seen at the University of Bristol veterinary school at Langford over an eight-year period. Outcome was assessed via telephone conversations with the owners. RESULTS: Twelve cats were presented with tracheal foreign bodies during this time. Ten of these foreign bodies were successfully removed using fluoroscopy and two using bronchoscopy. All cats survived. Follow-up was available for nine cats and showed no long-term complications. CLINICAL SIGNIFICANCE: Forceps removal under fluoroscopic guidance is a rapid, safe, and effective method for removal of tracheal foreign bodies in cats. It should be considered as an alternative to bronchoscopy for removal of tracheal foreign bodies in cats. Indeed, in cases where bronchoscopy has failed, it can be attempted to avoid thoracotomy. Successful removal of tracheal foreign bodies in cats is associated with a good long-term outcome.     

Aetiology and diagnosis of persistent nasal disease in the dog: a retrospective study of 42 cases

Forty-two dogs with a history of persistent nasal disease were evaluated by a combination of clinical examination, thoracic and nasal radiography, retroflexed endoscopy and biopsy, and anterograde rhinoscopy and blind nasal biopsy. A definitive diagnosis was made in 91 per cent of cases. Neoplasia was the most common diagnosis (33 per cent of cases), followed by inflammatory rhinitis (24 per cent). Other diagnoses included periodontal disease (10 per cent), aspergillosis (7 per cent) and foreign bodies (7 per cent). Adenocarcinoma was the most common tumour diagnosed. The clinical findings were found to be too variable to be used as specific diagnostic criteria. Anterograde rhinoscopy and retroflexed endoscopy had higher specificity and sensitivity than radiology for the diagnosis of neoplasia, inflammatory rhinitis, aspergillosis and foreign bodies. With a systematic approach to the investigation of persistent nasal disease, a definitive diagnosis can be successfully obtained in the vast majority of cases.     

The clinical and radiological diagnosis of gastric foreign bodies in ornamental birds

Sometimes curious foreign bodies placed in the proventriculus/ventriculus of companion birds are causes of single case diseases. Clinical signs include atypical symptoms such as distress, lameness, vomiting and diarrhea. In cases of heavy metal intoxication, e.g. lead poisoning, CNS-disorders are found. Radiographs taken in a ventro-dorsal and a latero-lateral view show the presence of foreign bodies in suspicion. In most cases of foreign bodies in birds a surgical intervention (Gastrotomy) is indicated.     

Nasopharyngeal trichobezoar foreign body in a cat

CASE SUMMARY: A 5-year-old male neutered indoor cat presented for evaluation and treatment of an acute onset of nasal discharge and open-mouth breathing of 3 days' duration. He had been treated for asthma prior to presentation, but his clinical signs were more consistent with upper airway disease. Thoracic radiographs were suggestive of asthma. However, a soft tissue mass was noted in the nasopharynx on a lateral cervical radiograph. Nasopharyngeal examination revealed the mass to be a trichobezoar (hair ball) lodged in the nasopharynx, removal of which led to resolution of clinical signs. The cat re-presented with a second nasopharyngeal trichobezoar approximately 1 year later, which was also successfully removed. CLINICAL SIGNIFICANCE: Nasopharyngeal disease has myriad potential infectious, inflammatory and neoplastic etiologies. However, simpler causes such as foreign bodies can be considered in cases of acute-onset nasopharyngeal disease. To the authors' knowledge, this is the first reported case of a nasopharyngeal trichobezoar foreign body in a cat.     

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.     

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.     

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.     

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.     

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.     

Feline gastrointestinal foreign bodies.

The common presentations of gastrointestinal foreign bodies in cats are discussed in this article. The options for diagnostic imaging modalities and other diagnostic tests are detailed. The management of foreign body obstructions at different levels of the gastrointestinal tract is discussed. Particular attention is paid to the management of linear gastrointestinal foreign bodies, morbidity associated with this condition, and treatment. There is also a brief discussion on the types of gastrointestinal foreign bodies presenting to a veterinary teaching hospital at which both referral and primary cases are seen.