To wait or operate?

RE: To wait or operate?

Clive Ansell — Sat, 21 Jan 2017 16:11:38 GMT

RE: To wait or operate?

Neil Wheadon — Sat, 21 Jan 2017 12:17:31 GMT

[quote user="Clive Ansell"]

The sock is no more, has ceased to be within the dog, it has been vomited, so the condition no longer exists - therefore cannot really be pre existing if an insurance policy is taken out in future.

They could however ask if it, or similar, has ever happened before, and exclude on that basis.

[/quote]

Thanks Michael

www.youtube.com/watch

RE: To wait or operate?

Clive Ansell — Sat, 21 Jan 2017 12:10:54 GMT

The sock is no more, has ceased to be within the dog, it has been vomited, so the condition no longer exists - therefore cannot really be pre existing if an insurance policy is taken out in future.

They could however ask if it, or similar, has ever happened before, and exclude on that basis.

RE: To wait or operate?

Neil Wheadon — Sat, 21 Jan 2017 11:10:24 GMT

Apomorphed a 6 month old cocker this morning and as expected up came the sock, relief all round

The client then asked about insurance for future.

Would this be a pre-existing condition?

I said to contact the insurance company but does a single sock swallow count against future foreign body?

Neil

RE: To wait or operate?

Bob Russell — Thu, 15 Dec 2016 15:24:03 GMT

So less likely to be seen on radiographs! Less likely to cause blockage!

Overall correct decision seems to be to watch and see!

RE: To wait or operate?

Martin Atkinson — Thu, 15 Dec 2016 15:20:19 GMT

[quote user="Anthony Dennison"]

Update: the dog vomited up the sheep, in pieces earlier this week!

[/quote]Is that a win/win resolution or a 1-1 draw?

RE: To wait or operate?

Anthony Dennison — Thu, 15 Dec 2016 13:01:47 GMT

Update: the dog vomited up the sheep, in pieces earlier this week!

RE: To wait or operate?

Anthony Dennison — Mon, 05 Dec 2016 15:31:42 GMT

[quote user="Gillian Mostyn"]So you're no better off than you were then. [/quote]

Well, they're not. I tried to tell them it wasn't worth them spending their money but hey, they're the clients and if they want it. At least I've proved there isn't any blockage.

[quote user="Anthony Todd"]So your unqualified staff are dictating clinical decisions..... to say nothing of putting the dog through an ex lap plus possible gastrotomy etc. etc.??[/quote]

Not my staff Tony. I work in private practice and visit the shelter on a weekly basis to do all their vet work.

RE: To wait or operate?

Anthony Todd — Mon, 05 Dec 2016 15:05:08 GMT

So your unqualified staff are dictating clinical decisions..... to say nothing of putting the dog through an ex lap plus possible gastrotomy etc. etc.??

As I'm the king of the ex-lap at first hint of a FB I say "not until there's a reason."

Better ex.lap all your stray dogs on admission then 'cos you never know for certain unless you do!

RE: To wait or operate?

Gillian Mostyn — Mon, 05 Dec 2016 14:33:09 GMT

[quote user="Anthony Dennison"]I tried to talk them out of it but they just wanted to be sure.[/quote]

So you're no better off than you were then.

RE: To wait or operate?

Anthony Dennison — Mon, 05 Dec 2016 11:12:00 GMT

[quote user="Kate Richardson"]

But surely the whole point of this thread is whether action if necessary if the dog is asymptomatic?

[/quote]

Yes I know. I tried to talk them out of it but they just wanted to be sure. They're now panicking it will become symptomatic after the dog has been rehomed (which he isn't likely to be before Christmas anyway) despite the fact that all the BIPS were in the transverse colon showing no blockage

[quote user="Virginia Campbell"]Got any liquid barium? If the sheep is there at all, it's in the stomach and liquid barium would find it.[/quote]

I would have thought with it being a latex, air filled toy there would be some gas in the shape of a sheep in the stomach, but there was nothing. Dog is still fine.

RE: To wait or operate?

Kate Richardson — Mon, 05 Dec 2016 08:57:00 GMT

But surely the whole point of this thread is whether action if necessary if the dog is asymptomatic?

RE: To wait or operate?

Virginia Campbell — Sun, 04 Dec 2016 21:18:42 GMT

[quote user="Anthony Dennison"]

Just an update on this case:

After almost 2 weeks of the dog being fine and no clinical signs, the shelter staff were getting a little worried and edgy and wanted investigations. I took some abdominal radiographs this morning after the dog was given BIPS last night, and all the spheres were in the transverse colon. No sign of a sheep.

I'm actually a little disappointed, I was really looking forward to seeing the outline of a sheep on the xray!

[/quote]

Got any liquid barium? If the sheep is there at all, it's in the stomach and liquid barium would find it.

RE: To wait or operate?

Anthony Todd — Sun, 04 Dec 2016 15:16:45 GMT

[quote user="Martin Atkinson"]

[quote user="Anthony Dennison"]Just an update on this case:[/quote]For what did one star man see fit to rate this post so? Seems eminently sensible to me.

[/quote]

Yes, Arlo. make it a Xmas present to all the poster's on here! No more anonymous one stars without a comment, any comment is OK, if it's pertinent, and not personal.

Personal comments should just be deleted anyway!

RE: To wait or operate?

Martin Atkinson — Fri, 02 Dec 2016 17:46:28 GMT

[quote user="Anthony Dennison"]Just an update on this case:[/quote]For what did one star man see fit to rate this post so? Seems eminently sensible to me.

RE: To wait or operate?

Gillian Mostyn — Fri, 02 Dec 2016 17:11:28 GMT

Great that the dog is fine but...

[quote user="Anthony Dennison"] the shelter staff were getting a little worried and edgy and wanted investigations[/quote]

RE: To wait or operate?

Anthony Dennison — Fri, 02 Dec 2016 16:58:10 GMT

Just an update on this case:

I'm actually a little disappointed, I was really looking forward to seeing the outline of a sheep on the xray!

RE: To wait or operate?

mariette asselbergs — Sun, 27 Nov 2016 15:11:57 GMT

Another one about what you can find in a dog's stomach: I once collected a cadaver for practicing surgery skills from a shelter. The staffie had been euthanised because of age and chronic ill health without obvious reason and was thin, BCS 3.5/9. When I opened him up his stomach was full of a load of small chewed up pieces of football mixed with food. When I asked the shelter he had had a bit of a picky appetite but never vomited.

On the other hand, my own old English bull terrier once passec a whole raw potatoe with a diameter of 4 cm. She was a bit of food for a day or two, no vomiting.

I totally agree with Malcolm, lots of foreign bodies are normal in a dog's GIT. I have actually now decided to change the title of one of my cert case reports....!

Mariette

RE: To wait or operate?

Evelyn Barbour-Hill — Sat, 26 Nov 2016 16:24:31 GMT

[quote user="Robin Grimmer"] Does anyone still use barium?[/quote]

Of course.

It still works, fortunately.

RE: To wait or operate?

Stephanie Wellings — Sat, 26 Nov 2016 08:09:06 GMT

Still? I only graduated in 2013 and we learnt about it then.... I use barium occasionally, if I have a symptomatic dog and want to rule out obstruction (I wouldn't use it in the case here because even if it 'finds' the foreign body it wouldn't necessarily be an indication for surgery).

I would love to be better at ultrasound though, because barium takes a lot of time, repeated x-rays, and ends up being fairly costly for the owner (potentially on top of an enterotomy...)

RE: To wait or operate?

Robin Grimmer — Fri, 25 Nov 2016 23:16:43 GMT

You can usually palpate an intestinal foreign body but not necessarily a gastric one. Does anyone still use barium?

RE: To wait or operate?

Kate Richardson — Fri, 25 Nov 2016 22:15:40 GMT

Fascinating what passes through some dogs and what causes a problem- last obstruction we had was a knobbly lump of carrot! Would have thought gastric acid would have broken that down!

RE: To wait or operate?

Julian Earl — Thu, 24 Nov 2016 11:21:43 GMT

Sounds like we've all seen chronic foreign bodies. We operated on aBoxer for a cancerous retained testicle and while there found two gastric foreign bodies: plastic balls, one crushed into a lemon-shape but still10cm long and similar diameter before crushed. Incredible that these reached the stomach even after thorough chewing. The owners thought they'd left the balls behind when collecting the dog from kennels but noted the dog hadbeen a regular vomiter for six months!

In answer to the OP, can you palpate the mass to .ocate it? Ifthe dog is asymptomatic I would play for time I think. Unless on palpation a hard FB was felt that might not pass through atraumatically.

Hope that helps?

RE: To wait or operate?

Anthony Todd — Wed, 23 Nov 2016 12:11:33 GMT

[quote user="Martin Atkinson"] the right decision to make in this case.[/quote]

Nice rule of thumb; if it´s radio-opaque Xray it (classic Daily Moan) of a house Yale key in the stomach of a small kitten..... If you won't see it for certain on Xray, wait and see.

In fact you´re in a bit of trouble if you don't Xray and it goes wrong ( the owner did tell you!!)

And, of course, you can usually feel a FB.....

RE: To wait or operate?

Tim Browning — Wed, 23 Nov 2016 12:08:24 GMT

I agree heartily with Malcolm here. We see a lot stuff removed in a panicky way and cries of 'there's a foreign body coming down OMG' before any assessment. It's opened up before any signs of obstruction and is obviously a 100% success as have the evidence.

I had a case recently of dog that swallowed jewellery (rings and a bracelet) which I thought odd as not a usual FB. I ignored the hysterical owner and it all passed apparently. She returned 2 weeks later and the dog had swallowed more jewellery and now its companion dog had swallowed ceramic objects. I am now thinking some sort of attention seeking Munchhausen's by proxy situation as the owner is extremely strange.

Of course if it had swallowed coins I would have said wait and see if there is any change...