Lola, the springer puppy and an intussusception
Meet Lola, a great Springer Spaniel puppy with a tale of puppy naughtiness and chewing that led to a stay at the Practice and surgery...
We saw Lola in December, when her owner brought her collapsed, unable to stand and refusing to eat. She had been sick since Friday, and today was Monday. Far from being a lively and crazy Springer puppy, Lola couldn't have cared less where she was or what happened next.
Our treatment plan for Lola was very much supportive from presentation and an intravenous fluid line was set up to start rehydration support, plus medication for toxaemia and infection.
Her vomiting was an important sign of an abdominal "catastrophe" and a puppy refusing food for several days added to our concern.
When we considered Lola's body signs were slightly improved with rehydration, we sedated her and performed 3 important further tests - radiographs of her abdomen, an abdominal ultrasound and gentle palpation of her abdomen – always a help to narrow down your suspicions.
Lola's x-rays were not conclusive – we were considering a foreign body – eating something she shouldn't - and hoping we would see a lot of trapped gas, or even something interesting like a stone or a ball. Suspicious? Not certain!
Feeling Lola's tummy gave more clues - we could feel a soft, long swelling, the shape and consistency of a soft "sock" or "bean bag". This wasn't right, since we would expect Lola's tummy to be so empty from all the sickness and refusing food.
Our biggest clue came from an Ultrasound Scan of her abdomen. Here, an ultrasound probe placed on her belly through some contact gel, showed a "lamellar" structure – a long cylinder with several walls layered on top of each other. Experience pointed to this being a severe , life threatening blockage called an intussusception.
An intussusception often forms when there has been an upset like diarrhoea, or the animal concerned has eaten something untoward that can't pass through the intestines. The intestines' desperate attempts to squeeze it through the bowel mean they override each other and create a blockage. Not only this, but the blood supply to the affected bowel can become cut off, resulting in complications like rupture of the intestine and peritonitis.
We had enough evidence to recommend immediate surgery and a look inside!
Lola was prepared for an operation to open her abdomen and look at this concerning piece of bowel. Lucky we did. The damaged bowel was confirmed as an intussusception sitting low down in the small intestine. It looked like a huge fat sausage, but was a horrid, dark red colour.
Our approach was to try to unravel the overriding bowel and check if it was still viable. Unfortunately the intestine tore in one place and our only option was to operate to remove approximately 15 cm of lower small bowel.
Things were a bit more complicated since we could feel a tight, thread- like structure pulling the bowel tight from within. We traced this further and and found the root of our problem and the intussusception. After operating upon another part of the bowel and then the stomach, we had removed our offending foreign body..
Not much you might think, some old woollen type thread and green plastic. The owner later identified this as part of a trowel handle and some fibre from a rug, but it had damaged Lola's bowel in a distinctive pattern.
This is what we call a linear foreign body and as such can cause complex internal damage. Its effects are made worse when one end anchors higher up in the intestines, but a long thread , which is still attached, continues to travel down the bowel until it can go no further. At that point , the intestines keep trying to move it and concertina up. Sometimes the linear thread can saw through the bowel like a cheese wire causing multiple sites for damage and peritonitis.
After all our repairs, Lola was allowed to wake up from her anaesthetic and get some rest.
Initial progress was good. With Lola up and about and wagging her tail and trying to eat. But over 2 more days she became a bit bloated , hadn't toileted and refused food.
We rechecked xrays , fearing bowel rupture or wound breakdown inside and peritonitis. Nothing could confirm this , so we continued nursing, hoping for better.
Lola's owners were great and visited their pet. They took her home overnight, but still she was a bit quiet. She had been through such a lot with 3 points of surgery to her bowel, not forgetting a piece being removed.
Back she came, looking sad and forlorn and losing more weight, but spirited enough to keep trying to get better.
As an exception to every protocol we are told to follow at Vet School and within the veterinary profession, the Owners kindly consented to Lola spending the weekend at home with one of our Vets and her family and dogs. It gave the owners a break, but also Lola could be amongst the sounds and activities of normal family life and we felt that a bit of canine company on dog walks may lift her spirits.
So Lola moved in for the weekend and what a pleasure she was to have at home. All her hosts welcomed her with friendly interest and tail wags. She gingerly made her way round the field on walks and these became of more interest and fun over the weekend.
She was the brightest little dog, following and walking to heel with little training. You should consider a springer perhaps as your next dog. We will!
Our biggest triumph was Lola turning the corner to appetite and interest in food. Even if we broke the rule of sensible convalescent diet and went for roast dinners and scrambled egg from the resident hens. But hey, at this point, we didn't care.
The weekend passed with slow improvement, and Lola packed her bags as quickly as she had arrived.
By Monday was on the way home with her proper family, after a rather tearful goodbye from the Surgery. We get very attached to some special patients when they survive against the odds.
Lola has since made a fine recovery. Apart from a bit of time to settle her surgical wounds, she has been brilliant and is back to full speed ahead. It took a while to get her off the home made dinners though!
And the moral of the story? Well, it's watching your pet, especially a youngster for signs of eating what they shouldn't, and learning how serious a linear foreign body can be. So be careful!
Poppy: a case of Rat Poisoning
Poppy is usually a very young energetic border terrier. Earlier this year her owner was very concerned that she wasn't her usual self. She was feeling down and not interested in anything, even her food, which was very unusual, so he brought her in for us to have a look at. She wasn't her bouncy self coming through the door and it was obvious something really wasn't right. Her gums were pale, she was breathing quickly and her heart rate was fast. We were concerned that she was very anaemic and a blood test helped to confirm the severity of this. One of our main concerns was that she had eaten rat poison. Being a Terrier they have a tendency to go and find things that are hidden in small spaces and it is also possible that they would eat dead rats. Rat poison causes bleeding by depleting the body of Vitamin K, which is needed for the blood to clot normally. Generally treatment is Vitamin K replacement alone but Poppy was too poorly for just that. We decided that Poppy's only option was a blood transfusion where we could directly transfer blood clotting components and Vitamin K into her system to help her blood clot.
Truman, Julie's Flat-coated Retriever was brought in to help, he was happy to donate as long as he got a few extra cuddles and a treat at the end! We took over a litre of his blood and gave it directly to Poppy who made a very rapid recovery. The next day she was a lot happier and eating well, and not long later she was back to her normal happy, bouncy self.
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