Monday, October 18, 2010

A vomiting Chihuahua (Impaction of the stomach)

INTERPRETATION OF THE X-RAYS FOR THE OWNER

Chihuahua, Male, 6 years. Vomiting and not eating. What is the problem? The dog was warded for observation.


ABDOMINAL PALPATION

A soft mass in the stomach. No pain on palpation. The intestines were firm as if they were "sausage" rolls.

X-RAYS
Lateral view:



The stomach was impacted with some foreign body. The white arrows showed a fullness of the stomach pressing against the diaphragm (which separates the chest cavity from the abdominal cavity). The white foreign body inside the stomach and intestines (black arrows) would be fibers from the chew rope. The dog had been swallowing chew ropes for many months based on the owner's report. Chew ropes are commonly sold at Singapore's pet shops. This dog prefers to eat the pieces and they accumulate and fill the stomach. This medical condition is called impaction of the stomach.

Laxatives given showed fibers and hairs inside the stools. The owner told me the dog farted. He did not pass stools for the first 4 days. I/V drips and antibiotics prevent dehydration and death.

Ventral-Dorsal view
The full stomach is not so easily seen by the layman. There is no solid foreign body such as a bone or stone and so interpretation of this view is difficult without the clinical examination and history.


The outline of the stomach is shown by the black arrows. White foreign body of fibers impact the stomach. There is a dark area in the lower half of the stomach. This will be the gas. "Sausage-like" rolls of the intestines can be seen below the stomach. I have not marked the rolls.




The bladder shows a opaque urine which is not normal. Urine tests confirmed a moderate amount of struvite crystals which cause this whiteness of the bladder. On discharge of the dog, the dog peed with difficulty on the grass. This was seen by the owner.

Dietary management to dissolve the struvite crystals
is an alternative to surgery. However the owner must know that it may take 2-4 months to see results and there must be strict compliance with veterinary instructions including diet and urine tests and X-rays of the bladder till no struvite crystals are present.

Two blood tests were taken. The second blood test showed liver disorder. In conclusion, the dog recovered after 4 days and went home. Dietary management to dissolve the stones had been discussed with the owner. A follow-up by the owner must be done in the next few days.


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