ACUTE VOMITING

Treatment: The decision was taken to not risk waiting for the screw to transit through the gut and cause a possible obstruction/perforation.

History: A 6 month old French Bulldog presented for acute vomiting. Patient was active but not as hyperactive as normal. All vaccines and prevention were up to date and there was no sudden change in diet.

CLINICAL EXAMINATION: There was no evidence of fever, no dehydration and heart and lung auscultation was normal. Slight discomfort was noted on abdominal palpation. Overall, nothing remarkable.

Plan: Despite nothing obvious being detected on clinical examination, it was clear the patient was not quite herself and our veterinarian recommended some routine diagnostic tests to ensure nothing was missed.

DIAGNOSTICS: A full blood panel was ordered and came back with all values within normal limits. Standard 3 view abdominal x rays were also performed. These radiographs clearly showed the presence of a screw in the stomach

The patient was anaesthetized, prepped for surgery, a gastrotomy was performed and the foreign body was successfully removed. The rest of the gastrointestinal tract was also inspected and found to be in normal condition.

The patient woke up quickly after surgery, received adequate analgesia and showed minimal signs of pain or discomfort.

The following day the patient was bright and active, no longer vomiting and was already eating by herself. Due to her great progress the decision was made to discharge her on oral medication

The patient returned at day 3 and day 10 post-op for a routine check up. The incision healed fine and the patient had a full and straightforward recovery.

Note: The above case study is of interest as the patient could just as easily have been sent home with some anti-vomiting meds. She would have failed to improve and would have been much weaker by the time surgery was performed. This is the advantage of “evidence based medicine” that we practice here at ADI vs the standard “treat and see how it goes” approach.

Lexicon:

acute = sudden/short
auscultation = the action of listening with the aid of a stethoscope
abdominal palpation = examination of stomach area by touch
diagnostics = tests that help identify cause of illness
values within normal limits = blood tests pick up markers in the blood that if high or low can
give clues as to the source of illness. In this case all these markers were within normal limits
(neither high or low)
radiographs = correct name of the image produced by an may
perforation = hole made by a sharp object
anaesthetised = induce loss of consciousness by medical means
prepped = surgically prepared in a sterile environment
gastrotomy = surgical incision into the stomach
gastrointestinal tract = stomach, intestines, caecum and colon
analgesia = relief from pain
incision = a planned surgical cut