A foreign body is an object that, once swallowed, is likely to get stuck in the gut and cause a blockage.
Some dogs are notorious offenders when it comes to eating foreign bodies — and certain breeds, such as Labrador retrievers who snack first and ask questions never, being especially at risk.
This does not mean cats never get foreign bodies, but they are more likely to swallow string or ribbon, which then travels into their intestine and causes the bowel to accordion into pleats.
Left untreated, a foreign body can be fatal.
If your pet swallows something they shouldn’t, it’s always best to seek veterinary advice.
If you are lucky, the object may pass out the other end without a problem, but there are times when surgery is necessary to remove the errant object.
The symptoms range from the subtle to the dramatic, depending on the foreign body’s location.
If your Labrador has a piece of chewed toy lodged in his stomach, this forms an intermittent plug at the stomach exit. Thus the dog may be able to drink water and keep that down, but food is vomited back up.
In this case it is difficult to predict the outcome because the dog might vomit the toy up, but equally the toy may pass into the intestine and cause a full-blown blockage farther down.
If the intestine is blocked, things quickly become serious.
Taking our Labrador example, if the toy enters the small intestine it becomes like a cork in a bottle, and nothing else (food or fluid) can get past this intestinal foreign body in the dog.
- Initially, the dog vomits profusely, including fluids.
- If the bowel wall is damaged, it starts to die off and release toxins.
- The dog becomes unwell and is lethargic to the point of collapse.
- Left untreated, the dog gets dehydrated, the bowel may perforate and the patient could die.
Oh, that sneaky snack or tempting toy that a dog yaffles down in the quiet of the night. Be vigilant for anything and everything, from windfall apples and acorns to the tinsel on the Christmas tree.
Anything that fits into the bowel and is indigestible can potentially get stuck with devastating consequences.
As I was preparing to write this article, I jotted down a brief list of dogs I’d operated on recently to remove foreign bodies. Out of the 9 dogs who came to mind, 4 were Labrador Retrievers.
Even this doesn’t give a true picture because I counted each dog only once, even if they were a serial offender:
- One of the Labs repeatedly ate golf balls (3 surgeries).
- A French Bulldog swallowed toys whole (2 surgeries).
- A Golden Retriever had a sock fetish (2 surgeries).
If your pet has a history of eating foreign bodies, don’t let down your guard. The dog doesn’t link surgery (and a large veterinary bill) with eating that yogurt cup, and they’re never going to learn his lesson.
What’s the Big Deal?
The first problem: Foreign bodies block the bowel and don’t let food pass.
At best, this means the dog slowly starves. But more likely, complications set in.
If the blockage stretches the gut wall, it can cut off the blood circulation. This causes that piece of bowel to die off. And we haven’t even mentioned yet the risk of a sharp object piercing the gut and causing potentially fatal peritonitis.
Diagnosis can be a thorny issue — it’s a matter of not only seeing if a foreign body is present, but also working out if surgery is necessary.
Sometimes a vet can feel the blockage through the tummy wall.
However, it’s typical to have to hunt for it. This is done through imaging:
- Radiographs: X-rays are great at showing dense foreign bodies such as stones, but they are not so great at less distinct ones such as yogurt cups. Certain objects, such as rubber balls and cloth toys, can be the same density as soft tissue of the abdomen, and thus radiographs may not be particularly helpful.
- Barium X-rays: For those less-clear cases, the vet may give the dog a barium dose and follow the contrast agent as it passes along the gut. The barium should pass specific landmarks at set times, and failure to do this could indicate a foreign body.
- Ultrasound: In the hands of a skilled operator, ultrasound is arguably the best means of detecting a foreign body. As well as spotting the obstruction, the operator can look for changes in the way the bowel moves that hint at trouble.
Some signs do flag that emergency surgery is necessary, such as distended loops of bowel or dense foreign bodies, like stones, causing a complete obstruction.
A firmly wedged foreign body is a definite case for surgical removal.
Most foreign bodies are removed by laparotomy, which means an anesthetic and the surgeon opening up the dog’s abdomen.
The surgeon makes a cut in the gut to remove the object and carefully sutures the wound back together. This also allows the surgeon to check the health of the bowel wall and remove any badly damaged sections.
Unfortunately, bowel surgery comes with more complications than other forms of surgery. This is because the bowel is delicate and swells as part of the healing process.
This means an increased risk of the sutures pulling through and gut contents leaking out. Although this risk can be reduced with good surgical technique, it never goes away altogether.
This video shows Clover the dog after swallowing a stone (warning: minor graphic surgical scenes after the 1:00 mark):
Leaving a foreign body in place, however, carries a much higher risk of bowel perforation, peritonitis and death.
Sometimes if the object seems like it is slowly making its way out, then close monitoring of its progress is appropriate until it is safely passed or stops moving and becomes critical.
Repeat Offenders — And the Complications of Multiple Intestinal Surgeries
I want to tell you a story about a repeat offender, and why vigilance is so key.
Bradley Cooper was my latest ICU challenge. Not the actor, but a gorgeous young dog with doe eyes and a shy face that made you forgive him any action, no matter how stupid.
Today, he was recovering from complicated abdominal surgery prompted by a tube sock he had eaten. Problem was, last year he had done the same exact thing. Multiple abdominal surgeries put Bradley at risk for more complications.
When his family had returned from a skiing vacation, Bradley frolicked in the kids’ dirty laundry. He treated himself to a dinner of stinky, moist ski sock, tasty with toe sweat and ripe with the sweet scent of evergreens edging cold snow. If they wouldn’t take Bradley on their trip, he would eat some of it.
Last year’s intestinal surgery was rather straightforward. We took Bradley to surgery, found and removed a sock, and sewed him up. He went home on a recommended SF (sock-free) diet.
Bradley followed his SF diet with resolve until the temptation became too overwhelming and he ate another sock, thereby losing his 12 months of SF-living recovery.
Any bowel surgery for removal of a foreign body in a dog carries risk. Even with perfect surgical technique, you are cutting into a compromised intestine filled with fecal material and suturing up that bowel (enterotomy), or cutting away bowel and suturing 2 pieces of bowel back together (anastomoses).
Now think about the dog or cat who has to have multiple intestinal surgeries because they continue to eat foreign objects that obstruct the bowel. One of the biggest challenges a surgeon faces on a 2nd or 3rd surgery is dealing with the presence of abdominal adhesions.
OK, so what are abdominal adhesions?
They are a type of scar tissue. Bands of fibrous tissue can form between abdominal tissues and organs after any surgery. This means you can find a loop of intestine adhered (attached) to another loop of bowel, to an organ, to other abdominal tissue or to the body wall itself.
Any time an intestinal surgery is performed, there is inflammation.
Bradley’s intestine was angry and inflamed because it was harboring a sock. Once it was removed, the incision had to heal. This healing process doesn’t happen without more inflammation. A certain degree of scarring or adhesion formation occurs throughout the abdominal cavity.
In a study of human patients undergoing abdominal surgery, 93% developed abdominal adhesions. Most of the time, these adhesions do not cause people or pets problems. If, however, that patient needs a 2nd surgery, the surgeon may encounter scarring and adhesions that make the surgery much more difficult.
Bradley Cooper’s Complicated Surgery
In Bradley’s case, when I went in to retrieve this year’s sock, it was lodged in the same place as last year’s sock. The intestine had adhered to another loop of intestine amid a whole bunch of other adhesions. Think of sausage links stuck together and caught up in sticky cobwebs.
To make matters worse, whenever a surgeon breaks down these adhesions, more inflammation and adhesions are created. The order of the day is to remove the obstruction, try to create as little turmoil as possible in the surrounding bowel and get out of there.
Brad’s initial surgery was as routine as possible. A simple incision was made in the intestine, the sock removed and the intestine sutured closed (an enterotomy). Think of cutting into a sausage casing vertically, removing some of the contents, and sewing it back up.
Brad’s next surgery, because of the adhesions, required the removal of a section of the damaged intestines. Think of cutting 2 sausage links right down the middle horizontally and then sewing them back together end-to-end (called an anastomoses).
Long story short, Bradley’s family has learned the hard way that he must be carefully watched. He looked on with those adorable, devilish, twinkling Bradley Cooper eyes of his as his people had a family meeting about never leaving socks on the open floor again.
Preventing Foreign Body Obstruction
Vigilance is the answer!
- Get your kids to clear up their toys and put them into a dog-proof toy chest.
- Supervise your dog with small toys.
- Throw chewed toys away.
- Be vigilant with trash. Use trash cans with a locking top so a clever dog can’t help himself to packaging and trash.
- Some dogs have a bizarre addiction to socks and even underwear, so keep the laundry room out of bounds. (Here’s another important reason to keep pets and kids out of the laundry room.)
Unfortunately, some dogs never learn their lesson and become repeat offenders.
For his own protection, the only solution for the Lab who swallowed golf balls was to wear a muzzle on walks because in his case, his eyes were bigger than his belly.
Check your garden for hazards such as stones or fruit. Don’t leave your pet unattended with a toy (in case they chew and swallow pieces) unless it is designed to be indestructible.
If you suspect your dog has eaten something they shouldn’t, check with your vet.
The sooner a blockage is found, the sooner it can be corrected — let’s hope it’s before serious complications develop.
- Fossum, Theresa Welch, DVM, MS, PhD, DACVS. Small Animal Surgery. 4th edition. Mosby.