TOA
PAYOH VETS
toapayohvets.com
Date:
08 November, 2013
Focus: Small
animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits |
|
A young Silkie vomited daily for 19 days |
|
toapayohvets.com
Be Kind To Pets Veterinary Education
Project 2010-0129.
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:
08 November, 2013
|
November 6, 2013
Today, I insisted that
the owner had 4 X-rays
taken of his dog. 4
X-rays are the minimum
number to show whether
his dog has chicken
rib bones lodged
inside his throat (2 X
rays), chest -
oesophagus (1 X ray),
and abdomen - stomach
or intestines (1
X-ray).
The owner
protested: "Vet 2 had
taken X-rays of the
chest and abdomen on
Oct 21 and had stated
no chicken bones were
presented!"
Vet 2 had also used
ultrasound on October
28 and reported no
chicken bones. I found
out that Vet 2 had not
taken X-rays of the
throat and so had
advised. As the dog
was still vomiting
lots of white froth
after drinking, the
owner got him X-rayed
this morning and was
not keen on another 2
"unnecessary" X-rays
since Vet 2 had done
it with negative
results.
From my experience,
it is best to repeat
the test since the dog
had not recovered
after 19 days. He
swallowed chicken rib
bones after scavenging
the rubbish bin on Oct
18 and was sent to Vet
1 and was treated but
still continued
vomiting. Vet 2 did
the X-rays and
ultrasound and gave
medication but the dog
still vomited.
"He would want to
bite us if we feed him
medication," the
father said today.
"But this morning he
was active and barked.
For the past 19 days
he was sleepy and his
stomach was heaving.
He kept vomiting and
would not eat."
The father had
consulted me on Nov 2
but did not approve
any X-rays. So I
treated the dog with
IV drips and sent him
home on Nov 4. He
continued to vomit on
Nov 4 and 5 and so he
had to be reviewed
again. That meant
X-rays, a minimum of
4.
Sometimes vets try
to accommodate the
owner's wishes to save
medical expenses. In
this case, if I had
not insisted on the
repeat of the chest
and abdominal X-rays
and just did the
throat's X-rays, the
outcome for this dog
would be very bad as
he really has a large
chicken rib bone in
the chest X-ray!
The throat X-rays may
have bone fragments
but his main problem
was the big rib bone
in his caudal gullet
near his stomach. For
19 days, he could not
retain his water and
hence he would vomit a
few times, retching
and heaving to the
distress of the family
members daily for the
past 19 days!
Now that the
problem of the stuck
rib inside the caudal
oesophagus is evident,
what is the treatment?
TREATMENT OPTIONS
1. "Any drug to
dissolve the bone?"
the father asked me.
"No," I said. I
consulted a senior vet
who told me that the
gastric acid from the
stomach would dissolve
chicken bones after
some time. This would
not apply to pork rib
bones though.
"It has been 19
days," I said.
2. "The second
approach is to pass a
stomach tube to push
the bone into the
stomach," he advised.
"However you may
rupture the oesophagus
although it is a tough
muscular tube. You
would need to do
surgery then."
"The dog would be
dead then," I said.
3. "The third
method is to open up
the chest and extract
the bone from the
gullet. There is
little space to
maneouvre and the
surgical costs would
be around $2,000."
4. "How about
extracting the bone
via the stomach using
forceps to grasp it?"
I asked him.
"I don't think you can
do it."
DIAGNOSIS
So now, I have a
diagnosis. My solution
will be the least
traumatic and
cheapest. To use
Method 4. But the dog
is in poor health. "No
blood test as the dog
had normal results
from Vet 2," the owner
disapproved my
request. The blood
test taken by Vet 2
was on Oct 30, 2013
and now it is Nov 6,
2013. I am giving him
the IV drip for the
next 2 days before
surgery as there is no
other option unless
the bone "dissolves".
This may be science
fiction but there is a
possibility.
At around 5 pm, I gave
the dog 2 ml of
Spasmogesic and
Baytril. He was still
panting and his
abdominal movements
were marked.
I video-taped his
abdominal movements.
He vomited canned food
just eaten. When the
owners and friends
numbering 8 people
came to visit him at 7
pm, he was barking
furiously and jumping
about wanting to go
home. "His bone had
gone down to his
stomach," Dr Daniel
remarked. I thought of
taking another X-ray
but the owner would
have to pay for it and
the X-ray was just
taken this morning. So
I did not insist.
|
|
|
|
Chest & abdominal X-ray
(original at left &
photoshopped)
Chicken rib bone was seen in
the caudal oesophagus 24
hours before surgery |
|
|
|
|
Head & neck X-ray showed
some small bone fragments? |
|
|
|
|
Original X-ray |
Vet 2 reported no bones but
the dog vomited daily. Blood
tests were normal |
THE SURGERY
Nov 7, 2013
The dog was active and
barking furiously at
one time to get
attention in the
morning. In the
afternoon, he was
operated by Dr Daniel
and I. A long tissue
forceps was used to
grasp the bone inside
the caudal oesophagus
but there was no solid
bone. A stomach tube
passed into the
stomach without
encountering obstacles
at first. The tube was
full of gastric froth
and withdrawn. It was
passed again.
There was some
obstruction. It was
withdrawn and passed
into the stomach
again. The bone was in
small fragments. An
examination of the
small and large
intestines, all
inflamed, was
undertaken. No large
bones. The gastric
incision of 1 cm was
stitched. The chicken
rib bone had
disintegrated and was
no longer intact as in
the X-ray.
As at 9 pm, the dog
had recovered from
anaesthesia. He should
live a normal life and
must be kept away from
scavenging the garbage
bins for chicken
bones. .
|
|
Updates will be on this
webpage:
http://www.sinpets.com/dogs/20131107
chicken_rib_bone_oesophagus_dog.htm
More
info at:
Dogs or
Cats
To make an appointment:
e-mail
judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326 |
Toa
Payoh Vets
Clinical Research |
|
|
|
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.