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The Case of the Missing Garbage…

Chase is a 3 year old Welsh Terrier who always comes in to see us with a smile and a wag, despite having to see us often for recurrent allergic skin disease. Earlier this year, however, he wasn’t so bright-eyed. His parents noticed he wasn’t himself. He had become lethargic and was trembling and panting. There didn’t seem to be any change in his appetite, he wasn’t vomiting and his stools had been normal although he hadn’t produced one oChasen the day he was brought in. They did note that he had gotten into a garbage can a couple days earlier. On exam he was quiet (aka – Not our Chase!), had a normal heart rate, appeared hydrated and had a normal temperature. His belly was painful to touch and he didn’t want to stay standing. There were many possible things that could be causing these symptoms in Chase including: gastroenteritis from eating garbage; pancreatitis; intestinal blockage from ingesting something that doesn’t break down and gets stuck in the intestine; intestinal intussusception (a problem caused by the telescoping of one section of intestine into another section); and a twisted loop of intestine among a variety of other problems. In order to help Chase feel better as quickly as possible, we needed to find the cause of his symptoms so he was admitted to the clinic for abdominal x-rays and bloodwork, including a special test specific for pancreatitis. He was administered pain medication right away to give him relief while we ran these diagnostic procedures.

Thanks to our in house laboratory and radiology suite, our amazing registered veterinary technicians had Chase’s labwork and abdominal radiographs ready for us to assess in less than 1 hour. Chase’s complete blood count including checking red blood cells, white blood cells and platelet numbers was normal. His biochemistry profile including checking glucose, electrolytes, blood proteins, liver enzymes and kidney functions was normal as well. We had to wait for the results of his pancreatitis test as this special test needs to be run at an external animal laboratory in Mississauga.

The x-rays of Chase’s abdomen showed gas throughout the intestinal tract but no evidence of a foreign body. As this was concerning for something more serious going on in the intestines, an abdominal ultrasound was recommended. While waiting for the results of the ultrasound, Chase was kept in intravenous fluids to maintain his hydration, pain medication, anti-nausea medication and antibiotics. There was no improvement in his symptoms by the next morning despite the care he received from our overnight care technician. He hadn’t vomited, he had eaten and was one of the most polite patients in the hospital but there just wasn’t a light in his eyes. When we received the results of his ultrasound, we had our answer – the reason Chase just wasn’t himself – there was a foreign body lodged in his intestines that wouldn’t show up in the x-rays. His owners agreed for us to proceed with surgery to remove this blockage.

By staying in the clinic overnight, Chase had already been stabilized for surgery and we were able to proceed right away.   The obstruction was detected quickly into surgery and was removed through an incision in the intestine. Unfortunately the intestine around the foreign material was not healthy and could not be saved. Leaving it in would result in continued pain for Chase and eventual leakage of intestinal content into the abdomen – an often fatal condition. This section of intestine was removed and the remaining intestine sutured together.   The rest of the intestines were thoroughly examined to ensure there were no other abnormalities that could be contributing to Chase’s symptoms. When none were found, his abdomen was sutured closed and Chase was continued on strong medication to ensure he wouldn’t be painful as he was recovering.

As any employee at a veterinary clinic will tell you, major emergency surgeries most often happen near a weekend and Chase’s was no different. It was performed on a Friday afternoon. As the first 48 hours after intestinal surgery are the most crucial for healing of the intestines, Chase stayed with us over the weekend for continued supportive care. Without proper care, healing is delayed and may not be successful. He was fortunate to have our overnight technician attending to him the night after his surgery and the Saturday night after our day technicians and veterinarians had left. He slowly improved over the weekend and was discharged to the care of his amazing owners on Monday for them to continue his supportive medications in pill form.

Now Chase is back to his usual self, causing trouble and unfortunately even incurring a visit to the local emergency clinic for a recurrence of his allergies (ear infection). He still bounced in happily to see us on his latest visit for us to recheck his ears!

One of the take home messages we took from Chase and his parents was that we were able to provide optimal care for him because of the support his parents received from their pet insurance company. You may also notice that I mentioned Chase’s recurrent bouts with allergic skin disease. This is a very frustrating disease as it is incurable and usually requires frequent vet visits (more than 1 annual visit). Pet insurance is helping Chase’s parents with the costs to manage this stubborn condition as well as the major illness he just experienced.