Important to Know: When things get Stuck! Intestinal Obstructions
Dogs and Cats eating the wrong things is a constant worry for any pet parent. This can cause problems as minor as an upset tummy but also as severe as a full intestinal blockage. Intestinal obstructions, also referred to as a “Foreign Body” are frequent emergencies seen in veterinary practices.
To diagnose a foreign body, we use a combination of an examination, palpation, and most importantly X-rays and Ultrasound imaging. Read below to find out what to look out for and what steps we take to find the cause.
Key Points:
Any object has the potential to get stuck and block the intestine
It is important to rule out (or in) an obstruction as quickly as possible as time blocked has an impact on success
Cats and Dogs can both be affected
Vomiting is the most frequent symptom seen, but it is not always present
X-rays and Ultrasounds are essential to identify obstructions before surgery is undertaken
What is an Intestinal Obstruction?
In veterinary healthcare, an intestinal obstruction is most commonly referred to as a “Foreign body”, i.e. something that should not be in the intestine!
Foreign bodies occur when your pet eats a non-food object that then gets stuck in the intestines. Foreign bodies can be pretty much anything; We have removed pieces of toys, underwear, socks, baby wipes, hair bands, stones, string and even some bones from pets!
Where can obstructions occur?
Foreign bodies can occur anywhere in the intestines, including being under their tongue, in the oesophagus, stomach, small intestines or even as far down as the large intestine.
The most common site however is the small intestine, as this often forms the longest and narrowest elements of the intestinal tract.
What are the symptoms of an obstruction?
Both cats and dogs can be affected by foreign bodies and intestinal obstructions. Sadly, it is not always obvious and symptoms can resemble minor ailments in the early stages with vomiting being the most common presenting sign.
Decreased appetite
Straining to pass faeces or producing small amounts of faeces
Lethargic
Changes in behaviour such as biting or growling when being picked up/ when touching the stomach (abdomen)
Pawing at mouth
Drooling
Choking or gagging
Any obstruction is a serious condition and even if only mild symptoms are showing, it can easily progress to a critical emergency if left un-treated as conditions such as perforated intestines, peritonitis and aspiration pneumonia can all occur as consequences of obstructions.
How is a foreign body diagnosed?
An obstruction needs to be ruled out fast. If there is any suspicion that your pet has swallowed something (e.g. breed – Labrador! Or other risk factors – Children and their toys…!) then we will often look sooner in our investigations, than if there is no suspicion.
General Examination
We will always examine your pet with an open mind. Early signs could suggest another cause of vomiting, with an intestinal obstruction being one of the possible causes.
Palpation
Feeling your pet’s abdomen is the first step. Can we find any solid lumps? This is not a very sensitive test as we do not have eyes in our fingers, but if a hard lump in present, it shouldn’t be there.
X-rays
If we are suspicious of a foreign body, we will advise x-rays be performed on your pet whilst under general anaesthetic. X-rays are a method of getting images of inside of the body by passing a small amount of radiation through different parts of your pet’s body.
Fat, body tissues, bone and air all absorb different amounts of x-rays which gives us an image and allows us to visualise what is going on inside. Sadly it is not a perfect tool, for example, a garden stone shows up bright white, but wood, a plum stone (or a sock!) does not look any different to a kidney or slightly thickened intestine. This limitation can be the difference between detecting or missing a foreign body obstruction. As a result, we always combine the test with an Ultrasound.
Ultrasound
Ultrasound imaging involves subjecting part of the body to high-frequency sound waves to produce images of the inside of the body. With an ultrasound we area able to look directly into organs!
Frustratingly, like X-rays they have limitations. Sound waves cannot pass through air or bone, or stones…! Equally, whilst we can create a real time image, the window being examined is limited by the size of the ultrasound probe and as a result, certain items can be missed.
So What Next?
If at this stage we do not find anything obstructing the intestine then we all can relax a little and be pleased that we have avoided a large surgery. We then treat for vomiting, or other illnesses and investigate a medical cause for the symptoms.
However, if we identify a clear obstruction, then surgery is our only option. To cause symptoms that require investigation, a blockage is not going to shift of its own accord.
Can I do anything to prevent an obstruction?
Yes and no! Some pets are impossible to stop their chewing habits. In extreme cases, a basket muzzle can be used to prevent ingestion of unwanted items, in addition to constant vigilance by owners.
Conclusion
A suspected foreign body causing an intestinal obstruction is a common severe emergency that is dealt with at our clinic. Ruling out an obstruction is really important, and if we can do this without operating then we have saved a surgery and the challenges associated with this. X-rays and Ultrasounds are essential in finding out of the blockage is real and guiding surgery making it quicker and safer for everyone involved.