Gastric FB vs. pills on sonogram

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Gastric FB vs. pills on sonogram

Response to a veterinarian that sent a GI case to me that had the presentation similar to the ones in these images:   They are likely foreign bodies but I don’t know what medications were given because some pills will hang in the pylorus without dissolving in light of gastritis. If scoping for bx then they should be easily retrievable should they be true FB and not whole and broken up meds. Full thickness bx surgically would be better though given the wall prominence. This is why i used this terminology as its a tough sell on a scope/sx for “FB” when the “FB” may be the carafate or baytril your tech gave earlier that day or even the night before. I saw a caraftate tab do this for 2 1/2 days in a gastritis case and the dog defecated it in tact once he was rehydrated and doing better. When going in on this type of case surgically or with a scope I would word that this is for BX of the stomach wall and remove the foreign matter but the foreign matter may just be undissolved meds. Chronic GI issues including ulcerative disease is frequent in emerging or subclinical addisons dogs and with mildly flattened adrenals I would hate to have you anethetize an Addisonian and have complications. So be sure to look at the adrenals as well in these vague GI cases and if not plump then get at least a baseline cortisol if not a stim entirely.

 

The first image here is a stomach lumen with a Baytril 60 tab embedded in the gastric rugae and had been there a few hours hence it is not shadowing owing to the fact it is dissolving. The second image is a view of avocado pits in the pylorus in an anorexic lab with no food for 48 hours. However if this lab had been given sucralfate or glucosamine or something similar prior to the sonogram it could have been those or similar medications. Makes for a fun conversation for the owner if you scope or cut a patient to retrieve the pills that Donna the technician gave 3 hours prior to the sonogram:).  Just measure out the shadowing structure in the image and match it with the medication and look at the history and you can usually figure it out.

BTW these are images off the pathology CDs on the home page.

Eric Lindquist DMV (Italy) DABVP
Cert./Pres. IVUSS
Director SE NJ Mobile Associates
Fonder Sonopath.com

Comments

Anonymous

Some good points here on how
Some good points here on how to talk this through with the practitioner!

Anonymous

Some good points here on how
Some good points here on how to talk this through with the practitioner!

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