Odd case, no money....

RE: Odd case, no money....

Clare Tapsfield-Wright — Thu, 13 Aug 2015 21:43:34 GMT

Have to say I'd have a look too , even if it's not a swab it will put your mind at rest . I had one once where everything looked ok at ex lap and once the "evil vapours" were released he never looked back. I could only assume coincidence or that there was some adhesion or partial twist which resolved.

RE: Odd case, no money....

Glenn Hodgson — Thu, 13 Aug 2015 21:35:06 GMT

Have a look inside him? I agreeable swab risk

RE: Odd case, no money....

Noweia — Thu, 13 Aug 2015 20:43:54 GMT

Have a nurse's dog where adhesions have caused a huge amount of trouble after an op to remove a FB. He has bloated a couple of times since, has intermittent abdominal pain, lost lots of weight before we could pinpoint the reason behind it. At the worst times we thought he was close to euthanasia, at other times he was almost back to normal. After many referrals we have him semi stable on Budesonide but it's still not great.

RE: Odd case, no money....

Anthony Todd — Thu, 13 Aug 2015 13:54:19 GMT

Abdominal tap? Quick, easy, and cheap and, even with very little fluid, you get so much information.

Usually you can suspect spinal involvement if the pain increases with a certain spinal manipulation.

RE: Odd case, no money....

Andrew Kent — Thu, 13 Aug 2015 11:41:08 GMT

I agree with the others that a post-op complication has to be considered - however swabs often take longer than this to cause problems and I might expect to see a reaction around something, or at least some free fluid, on ultrasound. How confident are you in the ultrasound findings?

The other thought I had is how certain you are this is abdominal pain, rather than something like back pain. We see dogs quite often where the distinction is very difficult. The relaxation and positioning associated with anaesthesia can lead to exacerbation of disc disease so a spinal radiograph might be useful if it is not clear cut.

Andy

RE: Odd case, no money....

Bob Russell — Thu, 13 Aug 2015 10:48:56 GMT

Pancreatitis?

A number of years ago I referred a patient that turned out to have a swab left inside by a locum! Bill and support picked up by VDS.

Actually was a very experienced vet so it can happen to (almost) anybody!

RE: Odd case, no money....

Martin Atkinson — Thu, 13 Aug 2015 08:40:19 GMT

My immediate thought was along the same lines as Wynne - what is the risk of a post operative complication? What is causing the bloating?- I presume your scan would show fluid if it was there and it would be more ill if it was infected. If you think there is a possibility of this being a complication of previous surgery then I think you owe it the the client to investigate/treat that FOC or at least at cost, even if that means an ex. lap. If it is not then it is not your responsibility if the client won't let you do further investigations/refer and I wouldn't lose any sleep over it.

PS Just read you last post so add: or pass it back to the boss!

RE: Odd case, no money....

Busybee — Thu, 13 Aug 2015 08:35:32 GMT

yep, haematology all within normal limits.

I didn't do the surgery, it was my boss. No we don't use swabs with an x-ray strip that's an idea though....

RE: Odd case, no money....

Hannah Wynne Richards — Thu, 13 Aug 2015 08:16:09 GMT

Did your baseline bloods include haematology? Also while not wanting to cast aspersions on your surgery, do you use swabs with an X ray strip, and did you count them afterwards?

Wynne