History: Poor appetite for 4 days. Vomited twice 3 days ago. Lethargic. Had Cerenia 2 days ago and the next days there was no more vomiting.
Ate 1 cup chicken and rice at 6:00 pm last night-no food since. Blood work pending.
Questions to ask upon reviewing Radiographs:
- Is the history accurate and how does that affect what I think the contents of the stomach are?
- What do I think of the small intestinal pattern, especially in the right abdomen on the ventrodorsal projection?
- Is there evidence of perforation?
Still images from Ultrasound, performed 6 hours post radiographs:
Questions to ask upon reviewing Ultrasound images:
- How complete do I think the sonographer was and what do I know to be true based on the radiographs?
- Do I believe the radiographs or the ultrasound more, and would it make a difference in my recommendations?
Findings (Abdominal Radiographs):
There is a moderate amount of heterogeneous soft tissue material within the stomach as well as short wispy mineral to faint metallic strands and a short thin curvilinear metallic wire. The small intestines are diffusely plicated with multiple irregular small gas opacities. The largest loop of intestine containing gas likely represents the colon +/- cecum. The colon also contains normal fecal material. No abnormalities of the liver, spleen, kidneys, retroperitoneal space, urinary bladder, or region of the prostate or urethra are seen. Serosal detail is adequate. The caudal thorax is unremarkable. The osseous structures and external soft tissues are unremarkable.
Conclusions: There is a small intestinal linear foreign body with a moderate amount of gastric foreign material +/- food. There is no evidence of perforation.
Recommendations: Exploratory laparotomy is recommended.
Results: The patient went to exploratory laparotomy. A linear foreign body was not present, however he passed pantyhose in his stool during recovery. A gastrotomy was performed yielding socks, underwear, and human hair out of his stomach.
Textbook of Veterinary Diagnostic Radiology: The Small Bowel [Chapter 45 in the 7th ed]
Atlas of Small Animal Ultrasonography: Gastrointestinal Tract [Chapter 8 in either edition]
Small Animal Diagnostic Ultrasound: Gastrointestinal Tract [Chapter 12 in the 3rd edition]
Root, Charles R., and Peter F. Lord. “Linear Radiolucent Gastrointestinal Foreign Bodies in Cats and Dogs: Their Radiographic Appearance 1.” Veterinary Radiology 12.1 (1971): 45-52.
Hoffmann, Karon L. “Sonographic signs of gastroduodenal linear foreign body in 3 dogs.” Veterinary Radiology & Ultrasound 44.4 (2003): 466-469.
Tyrrell, Dayle, and Cathy Beck. “Survey of the use of radiography vs. ultrasonography in the investigation of gastrointestinal foreign bodies in small animals.” Veterinary Radiology & Ultrasound 47.4 (2006): 404-408.
Hayes, G. “Gastrointestinal foreign bodies in dogs and cats: a retrospective study of 208 cases.” Journal of small animal practice 50.11 (2009): 576-583.