The patient is a 5 year old neutered male Boxer. The dog was presented to the clinic by a rescue organization. He was emaciated, vomiting, and anorexic. Bloodwork was unremarkable. Physical exam revealed a mid abdominal thickening potentially of intestinal origin. Lateral radiograph revealed a mid-cranial abdominal mass with mass effect upon the intestinal tract displacing the mesentery caudally. A volume-contracted heart was also visible (Image 1).
Obstructive foreign body with likely underlying mural disease and minor regional omental inflammation.
Exploratory surgery with enterotomy, gastric and intestinal biopsies were recommended. Guarded prognosis depending on underlying histopathology whether concurrent intestinal neoplasia is present (versus inflammatory-related mural hypertrophy).
Upper GI stasis is evident in both the stomach and duodenum (image 2). A distinctly shadowing intestinal foreign body is seen (arrow) with mural thickening and loss of layering of the affected intestinal wall (Image 3). The 6 cm shadowing foreign body is visible with adjacent stasis followed by empty small intestine finalizing the obstructive pattern defined in our prior study (Video 1 and 2) (see: Sonographic Criteria for the Diagnosis of Gastrointestinal Obstruction in 39 Dogs and Cats, ECVIM 2009, http://www.sonopath.com/resources/articles). A minor amount of ill-defined surrounding fat is noted adjacent to the intestinal wall in the near field indicative of an active transmural disease process, which classifies this case as a surgical emergency before further breakdown of the intestinal wall occurs.
The patient recovered well and is gaining weight readily (Image 8).
Special thanks to Dr. Harvey Hummel and Head Technician Diane McFadden & staff at Andover Animal Hospital, Andover, NJ, USA (http://www.andoveranimalhospital.com/) for their wonderful management and care for Jonah, the curious Boxer that just wanted to play with a monkey.
Neoplasia, intestinal obstruction, intestinal torsion, abdominal abscess or cyst, pancreatitis or pancreatic necrosis.
Patient had exploratory surgery with solid foreign body removal (Image 4) that revealed an underlying monkey toy (plastic monkey from barrel of monkeys, image 5). Intestinal biopsy revealed fibrosing enteritis/peritonitis adjacent to the intestinal wall without evidence of neoplasia.
