Sand impaction in a dog

Re: Sand impaction in a dog

Will McMullan — Fri, 19 Sep 2014 16:32:54 GMT

Seems to be passing with IVFT, laxatives and another enema today. The sand has mostly passed into the colon now. Dog still not eating but very bright. Pretty glad I didn't rush into an ex lap. Thanks for the replies!

Re: Sand impaction in a dog

Neil Wheadon — Thu, 18 Sep 2014 21:43:14 GMT

Worth checking the electrolyte status and appropriate fluid therapy as hypernatraemia could be present, if from beach ingestion. Lactated ringers a good choice as at 130, lower than plasma concentrations, so bring it down slowly so reducing chances of cerebral oedema if decrease a high sodium too fast Again i'd avoid the knife and liquid paraffin, it's hydration these cases need Neil

Re: Sand impaction in a dog

Evelyn Barbour-Hill — Thu, 18 Sep 2014 20:47:43 GMT

I've only ever treated one case such as this, quite a long time ago. We treated it medically and by enemata, and it died.

What's going to break up a sand blockage (which is cohered by surface tension) is lots and lots and lots of water or aqueous fluid, together with gentle agitation. I'd be thinking of giving this dog lots of water per os or by stomach tube or even by duodenal tube if you've got the facilty to do that.

If it came to surgery I'd be thinking of a laparotomy in order to guide a tube or tubes, maybe one from each end, to apply copious irrigation of the blockage; maybe a puncture of the intestine so that copious irrigation could be applied more directly by needle or a fine tube (14g i/v catheter maybe?); the aims being to break up the cohesion of the sand mass and to artificially dilate the intestine. It would be a horrid business, but not as horrid as multiple enterotomy which I would say would be the very last resort.

Re: Sand impaction in a dog

Joyce Whitehead — Thu, 18 Sep 2014 19:47:00 GMT

I'm not sure of it would work in small animals but in horses we use psyllium husk in their food (available from health shops) as it absorbs fluid and pushes the sand along. Or maybe oral movicol?

Re: Sand impaction in a dog

Ceri Gruffudd Jones — Thu, 18 Sep 2014 18:18:23 GMT

I'd also go for medical management. If there's an obvious cause for sand ingestion (e.g. playing ball / digging on beach) then just unblock BUT, I once saw a case of a labrador who presented with a partial gastric torsion who had been eating plaster from a sack in the garage. It transpired he had CRF and was manifesting pica.

Re: Sand impaction in a dog

Hannah Wynne Richards — Thu, 18 Sep 2014 15:54:27 GMT

I'd alsobe very cautious about surgery. I'd add liquid paraffin to the treatment, and also covering antibiotics,else you'll have a horrendous 2y infection once the sand starts to abrade the lining of the LI.

Wynne

Re: Sand impaction in a dog

Braden Collins — Thu, 18 Sep 2014 14:41:56 GMT

Opened one up once which was a young puppy. The owner had poured the fat from a roast onto the ground and the puppy ate a huge amount of sand. I was a new grad at the time and jumped in to surgery. It was a horrible surgery. The entire small intestine was impacted and because you can't milk the sand through very effectively I had to make a lot of incisions in the intestines. I think I got a lot of sand in the abdomen and the dog died around 24 hours post-op. I don't know if it would have done better with medical treatment but I would suggest exhausting all medial options first before putting it under the knife.

Re: Sand impaction in a dog

Utlendigur — Thu, 18 Sep 2014 13:27:57 GMT

We've seen a few (surgery 100m from beach) - usually after licking a jellyfish. IV fluids - they get very dehydrated which makes the impaction worse - and enemas have always worked so far. Often need some analgesia aswell. Never had to open one up and would be worried about just spreading sand everywhere.