Efficacy of intravenous administration of apomorphine for removal of gastric foreign material in dogs: 495 cases (2010-2015)

OBJECTIVE

To evaluate the efficacy of IV administration of apomorphine for removal of gastric foreign bodies in dogs.

ANIMALS

495 dogs with gastric foreign bodies.

PROCEDURES

Records of a veterinary hospital were searched to identify dogs that received an injectable formulation of apomorphine between January 1, 2010, and July 30, 2015. Dogs with a gastric foreign body that received an IV injection of apomorphine were included in the study. Information extracted from the record of each dog included signalment, type of foreign material ingested, duration between foreign material ingestion and emesis, dose and number of doses of apomorphine administered, and whether emesis occurred and did or did not result in successful removal of the foreign body. Descriptive data were compared between dogs with and without successful foreign body removal.

RESULTS

Emesis with successful foreign body removal was achieved in 363 and 11 dogs after administration of 1 and 2 doses of apomorphine, respectively. Successful removal was more likely for young dogs and dogs that had ingested fabric, leather, or bathroom waste. Successful removal was less likely as the duration between foreign body ingestion and emesis increased and for dogs that received opioids, sedatives, or antiemetics before apomorphine administration. Minor adverse effects were recorded for only 4 dogs.

CONCLUSIONS AND CLINICAL RELEVLANCE

IV administration of apomorphine was a viable alternative for induction of emesis and removal of gastric foreign bodies in dogs. Dogs should be examined as soon as possible after foreign body ingestion and should not receive any medications that might affect apomorphine efficacy.

Zinc toxicosis - Associated hemolytic anemia and pancreatic disease in 2 dogs

Two cases of canine zinc toxicosis with pancreatic disease are reported. Both dogs had pigmenturia, pallor, regenerative anemia, an inflammatory leukogram, hyperbilirubinemia, hyperamylasemia, and hyperlipasemia. Zinc toxicosis was diagnosed post-mortem in patient 1 based on the discovery of a metallic gastric foreign object, pancreatic necrosis, nephrosis, and high tissue zinc concentrations. Survey radiographs of patient 2 allowed identification and prompt removal of coins from the stomach with resolution of anemia, hyperamylasemia, and hyperlipasemia 3 days post-gastroscopy. Plasma zinc concentration was markedly elevated in patient 2. Zinc toxicosis should be considered in dogs with concurrent hemolytic anemia and pancreatic disease.

Laparoscopic retrieval of a hepatic foreign body in a dog

A 4-year-old female pointer dog was presented with a 10-day history of tensed abdomen. Migration of a metallic foreign body to the liver was diagnosed using radiography and ultrasonography. Surgical retrieval of a sewing needle was successfully performed by laparoscopy using a 3-trocar technique, thus avoiding laparotomy. No intra- or post-operative complications occurred. The dog was discharged 24 hours after surgery. Ten months after surgery, the dog was in excellent physical condition with no recurrence of clinical signs. This is the first reported case of laparoscopic retrieval of a hepatic foreign body in a dog.

Extrahepatic biliary duct obstruction secondary to duodenal foreign bodies in 2 dogs

Two dogs, a 5-year-old neutered male boxer dog and a 2-year-old neutered male Australian cattle dog, were evaluated for vomiting and inappetence. Both dogs were icteric on physical examination, and had hyperbilirubinemia, elevated liver enzymes, and inflammatory changes on diagnostic blood analysis. A proximal duodenal obstruction causing extrahepatic biliary duct obstruction (EHBDO) was suspected in both cases after diagnostic imaging was performed. Exploratory laparotomy confirmed duodenal foreign bodies in both cases. This case report defines duodenal foreign body as a differential diagnosis for EHBDO in dogs.

Likelihood and outcome of esophageal perforation secondary to esophageal foreign body in dogs

OBJECTIVE To determine the likelihood and outcome of esophageal perforation secondary to an esophageal foreign body (EFB) in dogs. DESIGN Retrospective observational study. ANIMALS 125 dogs evaluated for EFB at 2 veterinary teaching hospitals from January 2005 through December 2013. PROCEDURES Data were retrieved from the medical record of each dog regarding variables hypothesized to be associated with esophageal perforation, whether esophageal perforation was present, and survival to hospital discharge. Variables were examined for associations with various outcomes. RESULTS Bones (55/125 [44%]) and fishhooks (37/125 [30%]) were the most common types of EFBs. Fifteen (12%) dogs had an esophageal perforation (10 with a fishhook EFB and 5 with a bone EFB). No association was identified between dog body weight and esophageal perforation. Esophageal perforation was more likely in dogs with a fishhook EFB (10/37 [27%]) versus other EFBs (5/88 [6%]; OR, 6.1; 95% confidence interval, 1.9 to 9.6). Median interval from fishhook or bone ingestion to initial evaluation was significantly longer for dogs with (12 and 96 hours, respectively) versus without (1 and 24 hours, respectively) perforation. Thirteen of 15 (87%) dogs with esophageal perforation survived to hospital discharge, including all 10 dogs with perforation secondary to fishhook ingestion. Eight survivors with esophageal perforation required no surgical intervention. CONCLUSIONS AND CLINICAL RELEVANCE Esophageal perforation was uncommon in the evaluated dogs with an EFB, and no surgical intervention was required for a large proportion of them. Fishhooks and delay between EFB ingestion and initial evaluation were risk factors for perforation.

Effects of a surgical checklist on decreasing incisional infections following foreign body removal from the gastrointestinal tract in dogs

Two similar populations of dogs were evaluated in either a retrospective or prospective manner for 2 weeks after gastrointestinal foreign body surgery to determine the impact of a surgical checklist on the surgical site infection (SSI) rate. The medical records of 201 gastrointestinal foreign body surgeries were reviewed to determine the SSI rate without the use of a surgical checklist (SC-) and 101 consecutive gastrointestinal foreign body surgeries were performed using a surgical checklist (SC+). The SSI rate had a significant decrease from 19.9% to 11.9% with the use of the surgical checklist. When combining the cohorts, statistically significant predictors for development of an SSI following gastrointestinal foreign body removal included: a combined gastrotomy and enterotomy, an enterotomy, and known self-trauma.

Retained laser fiber in the nidus of a recurrent cystine urolith in an intact male English bulldog

A lithotripsy and percutaneous cystolithotomy (PCCL) were performed on a 5-year-old intact male English bulldog. The composition of the uroliths was 100% cystine. When a second PCCL was performed 2 months later, the nidus of the largest urolith was a segment of an optical fiber broken off during laser lithotripsy.

Pathologic findings and causes of death of stranded cetaceans in the Canary Islands (2006-2012)

This study describes the pathologic findings and most probable causes of death (CD) of 224 cetaceans stranded along the coastline of the Canary Islands (Spain) over a 7-year period, 2006-2012. Most probable CD, grouped as pathologic categories (PCs), was identified in 208/224 (92.8%) examined animals. Within natural PCs, those associated with good nutritional status represented 70/208 (33.6%), whereas, those associated with significant loss of nutritional status represented 49/208 (23.5%). Fatal intra- and interspecific traumatic interactions were 37/208 (17.8%). Vessel collisions included 24/208 (11.5%). Neonatal/perinatal pathology involved 13/208 (6.2%). Fatal interaction with fishing activities comprised 10/208 (4.8%). Within anthropogenic PCs, foreign body-associated pathology represented 5/208 (2.4%). A CD could not be determined in 16/208 (7.7%) cases. Natural PCs were dominated by infectious and parasitic disease processes. Herein, our results suggest that between 2006 and 2012, in the Canary Islands, direct human activity appeared responsible for 19% of cetaceans deaths, while natural pathologies accounted for 81%. These results, integrating novel findings and published reports, aid in delineating baseline knowledge on cetacean pathology and may be of value to rehabilitators, caregivers, diagnosticians and future conservation policies.

Silicon Foreign Body in the Cerebrum of a Rhesus Macaque (Macaca mulatta)

A male rhesus macaque with a cephalic chamber implant for neurophysiology recording presented with hemiparesis affecting the left thoracic and pelvic limbs at approximately 5 wk after craniotomy surgery. MRI indicated a 1×2-cm ovoid cerebrocortical cystic lesion immediately subjacent to the right hemisphere craniotomy and recording chamber. Transdural aspiration of sterile transudate and resultant decompression resolved the hemiparesis, and follow-up MRI at 1 mo indicated resolution of the lesion. Subsequently, necropsy at study end revealed a cerebrocortical foreign body composed of silicon. The atypically slow cure rate of the lot of silicon used and the unique recording chamber configuration were underlying factors that contributed to the formation of this foreign body. To our knowledge, this report is the first description of iatrogenic intracerebral foreign body in a macaque.

Comparison of the use of fresh-frozen canine cadavers and a realistic composite ex vivo simulator for training in small animal flexible gastrointestinal endoscopy

OBJECTIVE To compare the usefulness of fresh-frozen canine cadavers (FFCCs) and a validated canine simulator model for training veterinary students in basic gastrointestinal endoscopic procedures. DESIGN Randomized trial. SAMPLE 48 veterinary students in their final year of training. PROCEDURES Students were randomly assigned to receive basic gastrointestinal endoscopic training on a canine simulator or FFCC. All students were trained as assigned in esophagogastroduodenoscopy, endoscopic gastric biopsy, and gastric foreign body removal for 2 h/d for 5 days. They then performed each procedure on a live dog, and procedure completion time and performance ability were compared between groups. Two experienced endoscopists used a validated Likert-type procedural rating scale to rate the students' performance. Students completed a survey to rate their training model. RESULTS No significant differences were identified between groups in quality of performance of the 3 endoscopic procedures on a live dog. Students required significantly less time to complete the procedures on a live dog when trained on an FFCC versus canine simulator. Although both training models were considered equally useful by students, training on the simulator was significantly more stimulating. CONCLUSIONS AND CLINICAL RELEVANCE Students showed the same skill level in performing basic endoscopic procedures on live dogs regardless of the training model used, although students who trained on the FFCC completed these procedures faster than students trained on the canine simulator. Use of the simulator appeared to be a viable alternative to use of FFCCs for veterinary endoscopic training, providing students with a good level of proficiency before performing endoscopic procedures on live dogs.

Endoscopic Removal of Gastrointestinal Foreign Bodies in Two African Grey Parrots ( Psittacus erithacus) and a Hyacinth Macaw ( Anodorhynchus hyacinthinus)

Two African grey parrots ( Psittacus erithacus) and one hyacinth macaw ( Anodorhynchus hyacinthinus) were examined because of varying clinical signs ranging from general lethargy to seizure-like episodes and regurgitation. Radiography and fluoroscopy in the 3 birds demonstrated variable degrees of gastric abnormalities, suggesting the presence of foreign material or stricture-like defects. Upper gastrointestinal rigid endoscopy by ingluviotomy revealed foreign bodies that were removed endoscopically. Minor postoperative complications were pulmonary congestion or mild aspiration and cardiac arrhythmia, both of which resolved, and no serious deleterious effects were associated with endoscopy in the short or long term. Endoscopy is recommended for examination and removal of foreign bodies from the upper gastrointestinal tract because it is less invasive and traumatic than traditional surgical approaches.

Diagnosis and treatment of massive porcupine quill migration in a dog

A 5-year-old spayed female Boston terrier mixed breed dog was presented with porcupine quill migration. The quills were difficult to detect directly using computed tomography and magnetic resonance imaging. This case highlights difficulties faced in detecting porcupine quills with current diagnostic imaging modalities and describes surgical and medical management of a patient with massive quill migration.

Tracheobronchial foreign bodies in cats: a retrospective study of 12 cases

Objectives The aim of the study was to evaluate age, sex, breed, clinical signs, time between onset of signs and presentation, diagnostic procedures, method of extraction, location and nature of foreign bodies (FBs) in confirmed cases of tracheobronchial FBs in cats. We hypothesised that bronchoscopy was effective in extracting tracheobronchial FBs in cats. Methods A retrospective study was performed using clinical reports from three private practices in France between May 2009 and November 2014. Cats were included if an intraluminal tracheobronchial FB had been identified and extracted (either by bronchoscopy or surgery). Results Twelve cats (six male, six female) were included. Mean age was 3.75 ± 2.5 years. Coughing was the main complaint and was present in 9/12 (75%) of the cats. Thoracic radiographs were obtained in 12/12 cats (100%) and a FB was suspected in 11/12 (92%). Bronchoscopy was performed in all of the cats and enabled FB extraction in 10/12 (83%) of them. In 2/12 cats (17%), an additional surgical approach was required. In 6/12 (50%) cats, FBs were located in the trachea, while in 6/12 (50%) cats FBs were in the bronchial tree, particularly in the right caudal bronchus (4/6; 66%). Seven of 12 (58%) FBs were vegetal in nature, 3/12 (25%) were mineral and 2/12 (17%) were undetermined. All the mineral FBs were extracted from the trachea, while the majority of the vegetal ones (5/7; 71%) were found in the bronchi. Conclusions and relevance Feline respiratory FBs can be found in the trachea and in the bronchial tree, particularly in the right caudal bronchus. Vegetal FBs tend to migrate through the bronchial tree, whereas mineral ones tend to lodge in the trachea. Bronchoscopy seems to be a highly effective procedure for the extraction of tracheobronchial FBs in cats.