Case Study

04-00308 Bailey O Fabric foreign body——–NO IMAGES——

A 10-year-old MN Labrador was referred for abdominal ultrasound for evaluation of vomiting and hemorrhagic diarrhea. Abnormalities on serum biochemistry were elevated ALT and ALP activity and Chol (423). The patient had been treated with Cerenia, famotidine, and metronidazole. Abdominal radiographs revealed a dilated stomach with soft tissue opacity and no evidence of gas. There was some heterogeneity to the opacity in the stomach which could be due to a foreign object.

A 10-year-old MN Labrador was referred for abdominal ultrasound for evaluation of vomiting and hemorrhagic diarrhea. Abnormalities on serum biochemistry were elevated ALT and ALP activity and Chol (423). The patient had been treated with Cerenia, famotidine, and metronidazole. Abdominal radiographs revealed a dilated stomach with soft tissue opacity and no evidence of gas. There was some heterogeneity to the opacity in the stomach which could be due to a foreign object.

Sonographic Differential Diagnosis

Stomach with very strong shadow especially evaluated better once the dog was sedated. There is no gas in the stomach noted radiographically, therefore this very well be a foreign object that is resulting in a strong shadow. A foreign object may trail into the duodenum especially due to the strong shadowing in the proximal duodenum

Image Interpretation

The stomach was abnormal in appearance in that there was a very strong shadow with complete obstruction of ultrasound waves within the stomach. In the proximal duodenum there was one area in which there was very strong shadowing but as the duodenum was assessed more distally there appeared to be ingesta within the lumen that was more normal in appearance.

Outcome

An abdominal exploratory was performed. It was noted that the liver was homogenous and the gall bladder was distended. The stomach contained a large amount of soft material. A gastrotomy was performed and three pairs of underwear were removed from the stomach. Bailey recovered from surgery uneventfully. While hospitalized he was treated with ampicillin, buprenex, famotidine, and carafate. Bailey was released from the hospital with tramadol and clavamox. He returned to the hospital 14 days later to have the sutures removed. At that time the owner reported that he was doing well.

Clinical Differential Diagnosis

GIT – foreign body, neoplasia, ulceration, dietary indiscretion, toxins Pancreas – pancreatitis, neoplasia Liver – acute hepatitis (infectious/toxins), neoplasia, abscessation Gall bladder – cholecystitis, mucocele Focal peritonitis

Sampling

None

Patient Information

Gender : Male, Neutered

Species : Canine

Type of Imaging : Ultrasound

Clinical Signs

Diarrhea
Vomiting

Blood Chemistry

Alkaline Phosphatase (SAP), High
ALT (SGPT), High
Cholesterol, High

Clinical Signs

Diarrhea
Vomiting