CT findings in seven dogs with perforating wooden skewer foreign bodies from the gastrointestinal tract.

Background: Perforating foreign bodies from the gastrointestinal tract, such as wooden skewers, are reported in the small animal literature producing inflammatory/infectious lesions in the thorax, abdomen, and musculoskeletal system, which can be life-threatening in some instances. Several imaging modalities have been used, and advanced imaging techniques have shown a great advantage in its diagnosis and pre-surgical planning. Aim: The objective of this study is to describe the computed tomographic findings in a group of seven medium to large breed dogs with perforating wooden skewers and foreign bodies migrated from the gastrointestinal tract. Methods: The medical records database was searched for dogs with a suspected diagnosis of a perforating wooden foreign body migrated from the gastrointestinal tract in which a computed tomographic study was performed. Signalment, history, and clinicopathological findings (when available) were retrieved, and the computed tomographic studies were reviewed. Results: Clinical signs vary depending on the anatomical regions affected through the perforating pathway. All foreign bodies were identified and showed a median attenuation of 79 HU, with the most common localization being the stomach followed by the jejunum. Peritoneal fat stranding surrounding the perforation site was the most frequent computed tomographic finding. The presence of peritoneal free fluid and/or gas was uncommon. Pleural effusion, pulmonary perforation, and pneumothorax were present in most of the cases with the foreign body traversing the pleural space. Pulmonary cavitary lesions were always reported when the ending tip of the wooden skewer was within the pulmonary parenchyma. Soft tissue abscessation was recognized in all cases where the ending tip was lodged in muscular or subcutaneous tissues. Conclusion: Findings supported the variability of the secondary lesions caused by this type of foreign body and the utility of computed tomography in their recognition, as well as in the identification of the wooden skewer.

A case report of live-stranded rough-toothed dolphin (Steno bredanensis) with plastic debris ingestion on the Pacific coast of Japan.

A juvenile rough-toothed dolphin (Steno bredanensis) was live-stranded and rescued in Kanagawa Prefecture, Japan. From the results of diagnostic examinations, blood tests indicated that the dolphin was malnourished, dehydrated, and anemic. The dolphin died on sixth day of rescue despite treatment. At autopsy, 570 g of foreign material, including 34 pieces of cellophanes and plastic debris (PD), were found in the forestomach. Additional gross findings, including some endoparasitism and presence of accessory spleens were also identified. This is the first case in Japan which accidental ingestion of foreign bodies, including PD, was suspected to be the cause of death in a cetacean.

Depraved appetite in dromedary camels: Clinical, ultrasonographic, and postmortem findings.

Background: Camels are subjected to a wide variety of nutritional deficiencies as they are largely dependent upon grazing desert plants. As a consequence, the syndrome of pica or depraved appetite is occasionally seen in dromedary camels. The condition is manifested as chewing or eating abnormal things such as wood, dirt, bones, stones, clothes, plastics, mud, sand, or other inanimate objects. Aim: This study was designed to investigate the clinical, ultrasonographic, and postmortem findings in dromedary camels with pica or depraved appetite. Methods: Twenty-five camels of 5 days to 15 years were examined. Owner complaints included depraved appetite, loss of body condition, regurgitation of stomach content, and partial or complete absence of feces. Symptoms described were present for a period varying between 3 days, up to 12 months. The stomach compartments and small and large intestines were scanned using ultrasonography from the right and left sides of the abdomen. Necropsy was carried out on six female and three male camels where the thoracic and abdominal organs were examined with special attention to the digestive system. Results: The affected animals had a history of gradual loss of body conditions, eating foreign objects, decreased or total absence of feces, and regurgitation of stomach content. Using ultrasound, the foreign body was imaged occluding completely or partially the intestines. Foreign bodies within the rumen could not be visualized with ultrasound. In cases where the rumen is impacted by sand, small pin-points revealing acoustic enhancement were imaged. Foreign bodies were removed from the rumen at exploratory rumenotomy (n = 11), laparotomy (n = 3), or at necropsy (n = 8) in the form of plastics, cloths, sand, mud, wool balls, robes, glasses, or even metallic objects which may be blunt or sharp. Sixteen (64%) of the camels were recovered while the remaining 9 (36%) did not survive. Conclusion: The syndrome of pica or depraved appetite is an important condition in dromedary resulting in the ingestion of objects other than normal feed. Substantial economic losses are expected as a result of this syndrome. Ultrasonography of the digestive system may help the clinician in some cases to localize of occluding foreign bodies in the intestines, while in the transabdominal scanning of the stomach is valuable only in cases of sand impaction.

Clinical manifestations, endoscopic findings and outcomes of tonsillar fossa foreign bodies in dogs: seven cases (2020-2023).

OBJECTIVES: Clinical presentation and outcomes of dogs with tonsillar foreign bodies are not described in the literature. The objective of this case series is to describe the presence, clinical manifestations, endoscopic findings and outcomes of foreign bodies in the palatine tonsillar fossa of dogs. MATERIALS AND METHODS: Medical records of dogs in which tonsillar fossa foreign bodies were removed by endoscopy between 2020 and 2023 at a referral centre were reviewed. Dogs were included if complete medical records were available. RESULTS: Seven dogs were included. Among all clinical signs reported, acute onset of throat clearing occurred in all dogs. Palatine tonsil enlargement and protrusion from the tonsillar fossa were observed in four of seven dogs. Foreign bodies were removed under endoscopic guidance in all dogs; a vegetal foreign body was found in all but one dog (6/7). Complete resolution of clinical signs was reported in the five dogs for which follow-up information was available. CLINICAL SIGNIFICANCE: The tonsillar fossa is a rare but possible location for foreign bodies in dogs and should be explored even in the absence of macroscopic lesions of the tonsils, since some dogs could have a normal palatine tonsil appearance. Acute throat clearing should raise the suspicion of tonsillar fossa foreign bodies. The prognosis appears good after removal.

Computed tomography of a canine omental torsion secondary to a chronic abdominal gossypiboma and concurrent incidental broad ligament torsion.

A 5-year-old female spayed Dogue de Bordeaux was referred for concerns of an abdominal mass and peritoneal effusion. Abdominal radiographs identified a mid-ventral abdominal soft tissue opaque mass containing a radiopaque marker consistent with a gossypiboma. Contrast-enhanced abdominal CT identified two whirl signs associated with the abdominal gossypiboma. Exploratory laparotomy confirmed an omental torsion with encapsulated gossypiboma and concurrent incidental torsion of the remnant of the right broad ligament. Based on a literature review, omental torsions are an unreported complication of gossypibomas in canids.

Endoscopic Removal of Gastric Foreign Bodies with a Bottle Liner in 12 Dogs (2020-2023).

Endoscopy is widely used to remove gastric foreign bodies using grasping forceps and loop snares to manipulate and retrieve the foreign material. However, as not all foreign bodies can be removed using conventional endoscopic techniques, this case series describes the use of bottle liners for the removal of gastric foreign bodies in 12 dogs between 2020 and 2023. A 4 oz bottle liner (Drop-Ins) was placed at the end of the endoscope and pushed into the stomach. With the help of forceps introduced into the operating channel, the foreign body was pushed into the bottle liner. The bottle liner containing the foreign body was then extracted with the help of traction threads. The technique was used as the initial retrieval method in 5 dogs because of smooth (i.e., difficult to grasp) or sharp (i.e., that may damage the digestive tract mucosa during removal) foreign bodies and as a rescue procedure in 7 dogs. Foreign body retrieval was successful in all 12 dogs, with minor complications reported in 5 dogs (erosions and bleeding of the gastroesophageal sphincter). The use of a bottle liner represents an affordable alternative to gastrotomy when foreign bodies cannot be grasped with forceps or snares.

Jejunal perforation and septic abdomen resulting from a choristoma in a dog.

A 4.6-year-old spayed female German shepherd dog was admitted to a specialty hospital emergency service upon referral for suspected gastrointestinal foreign body obstruction. Free abdominal fluid was collected, and results of cytologic evaluation were consistent with a septic abdomen. An abdominal barium study revealed free gas and intraperitoneal barium, along with an obstructive gas pattern within the small bowel. Ultrasonography revealed a full-thickness jejunal perforation. On exploratory laparotomy, the perforation was noted to be located mid-jejunum with no associated mass or foreign material. A resection and anastomosis were completed. Histopathologic evaluation of the affected jejunal tissue showed aberrant gastric glandular epithelium consistent with a gastric choristoma, or heterotopic gastric tissue. Key clinical message: Clinicians should consider gastric glandular choristoma as a differential diagnosis in cases of seemingly idiopathic small intestinal perforation with no known cause (i.e., foreign body penetration, neoplasia, NSAID use), and histopathologic evaluation should always be done to obtain a definitive diagnosis.

Perforation jéjunale et abdomen septique résultant d'un choristome chez un chien. Une chienne berger allemand stérilisée âgée de 4,6 ans a été admise dans le service d'urgence d'un hôpital spécialisé après avoir été référée pour une suspicion d'obstruction gastro-intestinale par un corps étranger. Du liquide abdominal libre a été prélevé et les résultats de l'évaluation cytologique étaient compatibles avec un abdomen septique. Un examen abdominal à l'aide de baryum a révélé du gaz libre et du baryum intrapéritonéal, ainsi qu'un patron de gaz obstructif dans l'intestin grêle. L'échographie a révélé une perforation sur toute l'épaisseur jéjunale. Lors d'une laparotomie exploratoire, il a été constaté que la perforation était située au milieu du jéjunum, sans masse ni corps étranger associé. Une résection et une anastomose ont été réalisées. L'évaluation histopathologique du tissu jéjunal affecté a montré un épithélium glandulaire gastrique aberrant compatible avec un choristome gastrique ou un tissu gastrique hétérotopique.Message clinique clé :Les cliniciens doivent considérer le choristome glandulaire gastrique comme diagnostic différentiel dans les cas de perforation de l'intestin grêle apparemment idiopathique sans cause connue (i.e. pénétration d'un corps étranger, néoplasie, utilisation d'AINS), et une évaluation histopathologique doit toujours être effectuée pour obtenir un diagnostic définitif.(Traduit par Dr Serge Messier).

USE OF HYSTEROSCOPIC MORCELLATION WITH A MYOSURE® DEVICE FOR REMOVAL OF UTERINE FOREIGN MATERIAL IN AN ORANGUTAN (PONGO SP.).

A 36-yr-old female intact hybrid orangutan (Pongo sp.) presented with evidence of chronic bacterial cystitis with no response to treatment with multiple systemic antibiotics. Abnormalities were identified within the reproductive tract on CT scan, and hysteroscopy was pursued based on the recommendation of an obstetrician-gynecologist. Hysteroscopic examination revealed a large amount of intrauterine foreign material consistent with wood wool from the orangutan's bedding. A hysteroscopic morcellator (MyoSure®) was used to remove the foreign material. Histologic examination of endometrial biopsies showed severe suppurative to pyogranulomatous endometritis with intralesional foreign (wood) fibers and bacteria. The orangutan was treated with antibiotics, but evidence of bacterial cystitis persisted. After 15 wk, additional wood wool was identified within the uterus by hysteroscopic examination and was removed similarly. Five months later, there was no recurrence of foreign material on hysteroscopy or CT. This report describes the first documentation of intrauterine foreign material in a nonhuman primate. Hysteroscopic morcellation is a useful technique for noninvasive removal of intrauterine foreign material in great apes.

Minimal adverse events occur when inducing emesis with apomorphine in brachycephalic, mesocephalic, and dolichocephalic dogs.

OBJECTIVE: To determine risks of complications with emesis induction and whether facial conformation is associated with the frequency of complications. ANIMALS: 1,788 client-owned dogs that presented immediately or by referral from a primary care veterinarian following ingestion of toxic or foreign materials. METHODS: Patients with emesis induced with apomorphine for removal of toxic or foreign materials were retrospectively identified. Collected data included patient factors, routes of apomorphine administration, other therapies, adverse events, and patient outcomes. RESULTS: 2 types of complications were identified in a very small number of patients (11 [0.6%]), with 3 (0.17%) having regurgitation postemesis and 8 (0.44%) having prolonged vomiting. No significant difference was found in the rates of repeated vomiting or regurgitation between brachycephalic dogs and nonbrachycephalic dogs (P = .375 and P = 1.00, respectively). Brachycephalic dogs had 1.6 times greater odds of having emesis induction due to toxin ingestion compared to foreign material ingestion. The presence of clinical signs of toxicity at the time of emesis induction was associated with regurgitation (P < .001), and the development of regurgitation was associated with admission to hospital (P = .001). CLINICAL RELEVANCE: This study found no increased risk of complications when emesis was induced using apomorphine in brachycephalic breeds compared to nonbrachycephalic breeds, regardless of indication for emesis induction. Facial conformation is not a reason to withhold emesis induction.

Clinical findings, surgical treatment and outcome in dogs with parotid duct ectasia: 14 cases (2010-2023).

OBJECTIVES: To describe the clinical presentation, diagnostic findings, surgical treatment and outcome of dogs diagnosed with parotid duct ectasia. MATERIALS AND METHODS: Medical records of dogs diagnosed with parotid duct ectasia between 2010 and 2023 at six small animal referral hospitals were retrospectively reviewed. Outcome was assessed by contacting the owners or referring veterinarians. RESULTS: Fourteen dogs were included. Lateral facial swelling was the most common clinical presentation. CT revealed a tortuous cavitary tubular fluid-filled structure consistent with a dilated parotid duct in all dogs. Surgical treatment included marsupialisation of the parotid duct papilla, surgical exploration of the duct alone, parotid duct marsupialisation with surgical exploration of the duct, parotidectomy or en-bloc parotid duct resection. The aetiology of parotid duct ectasia was not established in 13 of 14 dogs. In one case, a foreign body was retrieved from the duct. No recurrence of clinical signs was noted during the follow-up period (range 21 to 2900 days). CLINICAL SIGNIFICANCE: Parotid duct ectasia should be considered for dogs with a lateralised fluctuant non-painful tubular facial swelling. Surgical management was associated with a favourable prognosis without evidence of recurrence in all cases reported in the case series.

Aspectos gerais do retículo peritonite traumática em bovinos / General aspects of traumatic reticulum peritonitis in cattle / Aspectos generales de la peritonitis del retículo traumático en ganado

A Retículo Peritonite Traumática está diretamente ligada à ingestão de objetos metálicos perfuro cortantes, como pregos e pedaços de arame, que podem penetrar ou perfurar a parede do retículo. Embora a ocorrência de corpos estranhos de alumínio seja rara, outros elementos, como fios de pneus usados para fixar lonas em silagens e até cerdas de arame de escovas utilizadas em pequenos aeroportos, têm sido registrados como causas dessa afecção. A ingestão desses objetos pode resultar em lesões no retículo, desencadeando episódios de retículo peritonite traumática e suas sequelas, como pericardite traumática, inflamação do fígado, abscessos no baço e muito mais. Os sinais clínicos podem variar, mas incluem comportamento anormal, motilidade reduzida do rúmen, fezes mal digeridas, febre e sinais de dor. O diagnóstico baseia-se na avaliação dos sinais clínicos do animal, juntamente com exames complementares, como hemograma, bioquímico, ultrassom e radiografia. É importante considerar as alterações hematológicas, como leucocitose e hiperfibrinogenemia, como indicadores-chave desta afecção. O diagnóstico também envolve testes de dor ao corpo estranho. O tratamento pode ser conservativo ou cirúrgico. A abordagem conservativa envolve a administração de antibióticos, anti-inflamatórios e soluções intravenosas, além do tratamento de deficiências nutricionais subjacentes. A opção cirúrgica exige a remoção do corpo estranho do retículo, seguida de cuidados pós-operatórios.

Traumatic Reticulum Peritonitis this directly linked to the ingestion of sharp metallic objects, such as nails and pieces of wire, which can penetrate or pierce the wall of the reticulum. Although the occurrence of aluminum foreign bodies is rare, other elements, such as tire wires used to attach tarpaulins to silage and even wire bristles from brushes used in small airports, have been recorded as causes of this condition. Ingestion of these objects can result in damage to the reticulum, triggering episodes of traumatic reticulum peritonitis and its sequelae, such as traumatic pericarditis, liver inflammation, spleen abscesses and more. Clinical signs may vary but include abnormal behavior, reduced rumen motility, poorly digested feces, fever and signs of pain. The diagnosis is based on the evaluation of the animal's clinical signs, together with complementary tests, such as blood count, biochemistry, ultrasound and radiography. It is important to consider hematological changes, such as leukocytosis and hyperfibrinogenemia, as key indicators of this condition. Diagnosis also involves foreign body pain testing. Treatment can be conservative or surgical. The conservative approach involves administering antibiotics, anti-inflammatories and intravenous solutions, in addition to treating underlying nutritional deficiencies. The surgical option requires removal of the foreign body from the reticulum, followed by post-operative care.

La peritonitis traumática del retículo esto directamente ligada a la ingestión de objetos metálicos punzantes, como clavos y trozos de alambre, que pueden penetrar o perforar la pared del retículo. Aunque la aparición de cuerpos extraños de aluminio es rara, se han registrado como causas de esta afección otros elementos, como los alambres de neumáticos utilizados para fijar las lonas al ensilaje e incluso las cerdas de alambre de los cepillos utilizados en los aeropuertos pequeños. La ingestión de estos objetos puede provocar daños en el retículo, desencadenando episodios de peritonitis traumática del retículo y sus secuelas, como pericarditis traumática, inflamación del hígado, abscesos del bazo y más. Los signos clínicos pueden variar, pero incluyen comportamiento anormal, motilidad ruminal reducida, heces mal digeridas, fiebre y signos de dolor. El diagnóstico se basa en la evaluación de los signos clínicos del animal, junto con pruebas complementarias, como hemograma, bioquímica, ecografía y radiografía. Es importante considerar los cambios hematológicos, como la leucocitosis y la hiperfibrinogenemia, como indicadores clave de esta afección. El diagnóstico también implica la prueba del dolor por cuerpo extraño. El tratamiento puede ser conservador o quirúrgico. El enfoque conservador implica la administración de antibióticos, antiinflamatorios y soluciones intravenosas, además de tratar las deficiencias nutricionales subyacentes. La opción quirúrgica requiere la extracción del cuerpo extraño del retículo, seguida de cuidados postoperatorios.

Retrospective evaluation of the clinical course and outcome of zinc toxicosis due to metallic foreign bodies in dogs (2005-2021): 55 cases.

OBJECTIVE: To describe the overall clinical course of zinc toxicosis in dogs including source, time to source control, incidence of hemolytic anemia, acute liver injury (ALI), acute kidney injury (AKI), and pancreatitis. DESIGN: Retrospective case series from 2005 to 2021. SETTING: Six university veterinary teaching hospitals. ANIMALS: Fifty-five client-owned dogs with known zinc toxicosis due to metallic foreign body (MFB) ingestion. MEASUREMENTS AND MAIN RESULTS: The most common source of zinc was US pennies minted after 1982 (67.3%). Forty-five of 55 (81.8%) dogs survived and 10 of 55 (18.2%) died or were euthanized. Median length of hospitalization for survivors and nonsurvivors was 3 days. The most common clinical sequelae of zinc toxicosis were anemia (87%), ALI (82%), coagulopathy (71%), thrombocytopenia (30.5%), AKI (26.9%), and acute pancreatitis (5.5%). Most dogs (67.3%) required blood products and 83% of dogs achieved a stable HCT or PCV in a median of 24 hours after MFB removal. The median duration of illness prior to presentation was 48 hours for both survivors and nonsurvivors and there was no impact of time to presentation on the incidence of ALI, AKI, or pancreatitis. CONCLUSIONS: Zinc toxicosis secondary to MFB ingestion should be considered a differential diagnosis for dogs with gastrointestinal signs, hemolytic anemia, ALI, hemostatic abnormalities, AKI, and pancreatitis. AKI may be a more common sequela of zinc toxicosis than previously suspected. Acute pancreatitis is a rare but potentially serious sequela to zinc toxicosis.

Foreign body ingestion due to detachment of pill dispenser tips in cats: a retrospective study of 13 cases.

OBJECTIVES: The aim of this study was to evaluate and describe 13 cases in which a pet piller broke during the administration of medication, and the tip was accidentally ingested by the cat. METHODS: A total of 15 presentations to the clinic were identified in a private practice database involving 13 cats in which the silicone tip broke. Two of these cats ingested foreign bodies on two separate occasions. Routine radiographic examination enabled the identification of silicone tips in all animals. On 2/15 occasions, the cats did not receive an emetic drug. Intramuscular xylazine (0.2 mg/kg) and dexmedetomidine (6 µg/kg) were administered to 12/15 and 1/15 cats, respectively. RESULTS: The cats were aged 3-17 years (mean age 11.00 ± 4.35 years). Vomiting occurred in 13 cats that received alpha-2 adrenoceptor agonists, although the silicone tip was recovered in only five occurrences. In 9/15 occurrences, endoscopy was performed under general inhalation anesthesia, and the silicone tip was successfully removed. Natural elimination occurred in only one case. CONCLUSIONS AND RELEVANCE: The use of pet pillers with detachable silicone tips increases the risk of accidental foreign body ingestion by animals. Therefore, guidelines regarding safety standards for manufacturing would be beneficial. No cat in this series developed clinical signs related to the ingestion of the piller tip, probably because of the quick presentation by the owners and early intervention, including endoscopic retrieval. Surgical intervention was not required in any case, including one in which the foreign body was lodged within the small intestine before being passed naturally by the cat.

Successful intraoperative ultrasound-guided retrieval of intracranial grass seed foreign body in a 4-month-old puppy.

A 4-month-old female-entire Vizsla dog was referred for progressive seizure activity, vomiting, lethargy, inappetence, and neck pain. CT revealed focal inflammation, a calvarial osseous defect, a possible foreign body within the brain, and associated vasogenic edema. A cerebrospinal fluid tap revealed marked septic neutrophilic pleocytosis. MRI findings supported diagnosis of a 1.7 cm foreign body within the brain. A right rostrotentorial craniectomy was performed, and intraparenchymal grass seed was removed in its entirety via intraoperative ultrasound guidance. The patient was discharged 2 days postoperatively, and long-term follow-up revealed no abnormal neurological signs.

Outcomes following combined median sternotomy and ventral midline laparotomy for bicavitary penetrating wooden foreign bodies.

Combined abdominal and thoracic pathology caused by extra-gastrointestinal migration of an ingested wooden foreign body (WFB) is an uncommon but serious injury. Presenting clinical signs are typically nonspecific and, in the absence of observed WFB ingestion, diagnosis is challenging. Treatment requires concurrent abdominal and thoracic surgical exploration to remove the WFB and address injuries caused by its migration. This case series describes perioperative characteristics and outcomes in 4 dogs following combined median sternotomy and ventral midline laparotomy (CMSVML) for bicavitary penetrating WFBs. Key clinical message: Treatment of bicavitary penetrating WFBs with CMSVML provided postoperative outcomes similar to those in previous reports; however, high-grade complications and prolonged hospitalization were commonly encountered.

Résultats après sternotomie médiane et laparotomie médiane ventrale combinées pour des corps étrangers en bois pénétrant bicavitaires. La pathologie combinée abdominale et thoracique causée par la migration extra-gastro-intestinale d'un corps étranger en bois (WFB) ingéré est une blessure rare mais grave. Les signes cliniques présentés sont généralement non spécifiques et, en l'absence d'ingestion observée de WFB, le diagnostic est difficile. Le traitement nécessite une exploration chirurgicale abdominale et thoracique simultanée pour retirer le WFB et traiter les blessures causées par sa migration. Cette série de cas décrit les caractéristiques peropératoires et les résultats chez 4 chiens après une sternotomie médiane et une laparotomie médiane ventrale combinées (CMSVML) pour des WFB pénétrantes bicavitaires.Message clinique clé:Le traitement des WFB pénétrants bicavitaires avec CMSVML a fourni des résultats postopératoires similaires à ceux des rapports précédents; cependant, des complications de haut grade et une hospitalisation prolongée ont été fréquemment rencontrées.(Traduit par Dr Serge Messier).

Infrared thermography is a novel tool to assess small intestinal surface temperature in dogs undergoing laparotomy for foreign body obstruction.

OBJECTIVE: To evaluate local temperature differences directly over and adjacent to small intestinal foreign body obstruction (FBO) using infrared thermography (IRT) in dogs. ANIMALS: 49 client-owned dogs were initially enrolled. METHODS: In a prospective, clinical observational study, IRT was utilized to compare median small intestinal (SI) surface temperature differences at the site of FBO and segments oral and aboral before and after surgical resolution from April 24, 2019, to July 19, 2020. These differences were evaluated for correlation with canine acute patient physiologic and laboratory evaluation fast (APPLEfast) scoring, lactate, foreign body material (hard vs soft), and blood pressure. RESULTS: There was not a significant surface temperature difference between SI segments at the site of FBO, oral or aboral. After resolution of obstruction, there was a significant decrease in median temperature directly over the FBO (2.4 °C; IQR, -2.55 to 10.6 °C; P = .0043). A decrease in surface temperature of the oral SI segment was appreciated with FBO due to hard material (-1.7 °C; IQR, -5.2 to 3.4 °C), whereas soft material had an increase in SI surface temperature oral to the FBO (+1.1 °C; IQR, 0.3 to 3.2 °C). This difference did not achieve significance (P = .08; Z = 1.75). No correlation was found between APPLEfast, lactate, or blood pressure and SI segment temperatures. CLINICAL RELEVANCE: IRT may be useful diagnostic modality to identify changes in small intestinal surface temperature relating to FBO. Further evaluation is warranted to determine if IRT may be a clinically useful to evaluate intestinal perfusion.

Ultrasonographic appearance of retained surgical sponges and gauzes in the acute postoperative period: a phantom and cadaveric study.

Retained surgical sponges or gauzes (RSS) are an uncommon complication of exploratory laparotomy surgery and pose a clinically significant risk to the patient. The purpose of this two-part, prospective, descriptive study was to describe the previously uncharacterized ultrasonographic appearance of RSS in phantom and cadaveric models of the acute postoperative period (24-48 h). For the first part of the study, a gelatin phantom containing a woven gauze with a radiopaque marker (radiopaque gauze), a woven gauze with no marker (nonradiopaque gauze), and a laparotomy sponge with a radiopaque marker (radiopaque sponge) was evaluated with ultrasonography. For the second part of the study, a total of 23 gauzes and sponges (of the aforementioned three types) were placed within the peritoneal cavity of 20 cadavers in one of three randomized locations during an exploratory laparotomy laboratory. The cadavers were imaged with ultrasonography 17 h later and still images and video clips were reviewed. The retained surgical sponges and gauzes in the gelatin phantom displayed multiple hyperechoic layers and variable degrees of distal acoustic shadowing. In cadavers, 100% (23/23) of the retained surgical sponges and gauzes displayed a single hyperechoic layer of variable thickness and distal acoustic shadowing. In 95.6% (22/23) retained sponges and gauzes, there was a thin hypoechoic layer noted superficially to the hyperechoic layer. An improved understanding of the ultrasonographic appearance of retained sponges or gauzes in the acute postoperative period may assist in the identification of these objects.

Delay of definitive care in cats and dogs with gastrointestinal foreign body obstruction following antiemetic administration: 537 cases (2012-2020).

OBJECTIVE: To determine whether administration of antiemetic medication to dogs and cats with gastrointestinal foreign body obstruction (GIFBO) delays time to definitive care (surgery or endoscopy) and increases the risk of complications. DESIGN: Retrospective study (January 2012-July 2020). SETTING: Private referral center. ANIMALS: Five hundred and thirty-seven (440 dogs and 97 cats). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records of dogs and cats with GIFBO were reviewed for antiemetic administration at the onset of clinical signs, time from onset of clinical signs to first intervention and definitive care, GIFBO-related complications, and length of hospitalization. Antiemetics were prescribed for 200 of 537 patients (158 dogs, 42 cats). Antiemetic administration was associated with an increased time between the onset of clinical signs and definitive care (3.2 days [95% confidence interval, CI, 2.8-3.5] vs. 1.6 days [95% CI, 1.4-2.0]; P < 0.001) but not with GIFBO-associated complications (P = 0.45). Antiemetic administration was associated with an increased length of hospitalization (1.6 days [95% CI, 1.4-1.7] vs. 1.1 days [95% CI, 1.1-1.2]; P < 0.001). A longer duration of clinical signs prior to intervention was associated with GIFBO-related complications (P < 0.001) regardless of antiemetic administration. CONCLUSIONS: Antiemetic administration in patients with GIFBO was associated with increased time to definitive care and length of hospitalization but not GIFBO-associated complications. Antiemetics are not inherently contraindicated in patients for whom GIFBO is a differential, but clients should be counseled to monitor for progression of clinical signs and follow-up accordingly.

Fluoroscopy-Guided Surgical Removal of a Microchip from the Spinal Canal of Two Cats.

Two cats were presented with acute left-sided paresis after implantation of a microchip at the referring veterinary clinic. Neurological examinations were consistent with left-sided lesions between spinal cord segments C1 and C5. Orthogonal radiographs of the cervical spine showed a microchip dorsoventrally oriented, partially embedded in the cervical vertebral canal. Fluoroscopy was used to localize and retrieve the foreign body from the cervical spinal cord in each case. Improvement in clinical condition and return to ambulation was observed in both cats within 48 hr of surgical removal of the implant. No significant perioperative adverse events were noted during the surgical retrieval of the microchip. Two previously reported cases of intraspinal canal microchip placement had been treated surgically by hemilaminectomy. This approach carries a risk of complications, including hemorrhage from the venous sinus, iatrogenic damage to the spinal cord, and improper identification of the surgical site, requires advanced surgical training, and typically has an extended surgical time. The use of fluoroscopy to assist intraoperative localization of a spinal canal foreign body may lessen the requirement for more invasive surgical procedures.

Postoperative injectable opioid use and incidence of surgical site complications after use of liposomal bupivacaine in canine gastrointestinal foreign body surgery.

OBJECTIVE: To compare postoperative analgesic use and postoperative complications between dogs that received liposomal bupivacaine (LB) during surgical gastrointestinal foreign body (GIFB) removal and those that did not. STUDY DESIGN: Retrospective study. ANIMALS: Two hundred five dogs. METHODS: Medical records for all dogs with GIFB removal at the Purdue University Veterinary Hospital between May 2017 and August 2021 were searched. Incomplete records and dogs with less than 2 weeks' veterinary follow up were excluded. Data collected included: patient information, time until surgery, intraoperative findings, surgical data (including perforation at time of surgery, linear vs. solid, enterotomy vs. enterectomy), use of LB (including time and manner of administration), time to extubation after surgery, in-hospital postoperative analgesic use and duration, and postoperative complications. Fentanyl was noted as used/not used, quantified as mean hourly rate over 12 h intervals. All analyses were performed using commercial statistical software with p < .05 as the significance level. RESULTS: Dogs that received LB were heavier (n = 65, median 28.5 kg) than those that did not (n = 140, median 24.4 kg) (p = .005). Postoperative fentanyl use (p < .05 between 13 and 72 h) and hourly rates (p < .05 between 13 and 48 h) were less, and postoperative time in the intensive care unit (ICU) (p < .001) and hospital were shorter (p < .001) in dogs receiving LB. Postoperative wound complications were seen in 7/65 dogs (10.8%, 95% CI = 4.4-21.0%) with LB and 4/140 (2.9%, 95% CI = 0.8-7.2%) without LB (p = .039). CONCLUSION: Use of LB was associated with reduced postoperative analgesic use, and shortened ICU and hospital stay but also with wound complications. CLINICAL SIGNIFICANCE: Caution should be used when using LB in (clean) contaminated surgeries.