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An x-ray of the abdomen is often one of the first tests performed. While some objects such as rocks and metal will show up on an x-ray, many do not (cloth and various toys). The doctor will examine the x-ray for characteristic patterns that suggest an obstruction is present. If the x-ray is not entirely convincing of an obstruction, yet the pet continues to experience sickness, then an abdominal ultrasound is performed by one of our radiologists or internal medicine specialists. This test is often conclusive in determining whether a pet needs to be taken to surgery.
If foreign objects are lodged in the stomach they may be retrieved with a flexible endoscope (camera) thus sparing the pet from undergoing an exploratory surgery. If it cannot be retrieved with the endoscope, then surgery is necessary. This entails making an incision into the abdominal cavity and palpating the entire gastrointestinal tract as well as examining the abdominal organs. Once the obstruction is identified, an incision is made in the wall of the stomach or small intestine and the object is retrieved. If the blood supply of the bowel is severely compromised, the diseased intestine needs to be removed and healthy bowel is spliced together using sutures or staples. This is called a resection and anastamosis. Once all of the foreign material is removed, the bowel is sutured and the abdomen is thoroughly rinsed using a warm sterile fluid. The abdominal cavity is then closed using sutures and the pet is awakened from anesthesia.
There are several factors that determine the recovery period following surgery. Issues such as how sick the pet was prior to surgery, the extent of damage from the ingested foreign object, the presence of a bowel perforation, possible placement of a feeding tube and the nature of the surgery influence how long the pet will need to be hospitalized. In instances when the obstruction is identified early in the course of sickness and the bowel is reasonably healthy, then usually one night in the hospital is necessary. The attending doctor will formulate a treatment plan which often includes intravenous fluid and antibiotic therapy, pain medication, and withholding food and water for a specific time to reduce the workload on the bowel. Very sick pets and/or those with a severely compromised bowel may need to spend two to seven plus (at least 2) days in the hospital. It is important to recognize that surgical treatment is not a guarantee of success in all GI obstruction patients. Fortunately, most pets recover uneventfully from this condition. Once pets are back at home restricted activity is recommended for two weeks and an Elizabethan collar and/or T-shirt is placed to prevent licking of the incision.
The sooner we can examine a pet that is suspected to have a GI obstruction, the higher the likelihood that surgery will be successful. If your pet has not eaten for 24 hours and is vomiting or acting lethargic please call the hospital at (303) 761-7063. A physical examination by one of our veterinarians is important to rule out this potentially fatal problem.