Dogs seem to ingest things they shouldn’t all the time. Socks, balls, and an assortment of other objects can cause enough trouble. However, linear foreign bodies are an especially dangerous situation.
Linear foreign bodies in dogs are a disaster in making.
Further information: Linear Foreign Bodies in Dogs and Cats
Thank you, Dr. Karel Carnohan, for sharing Mango’s story.
Mango’s story
I arrived in Manhattan, Kansas in an RV filled with four dogs, seven cats, a house rabbit, and a parrot. I was excited about starting my new life as a vet student. My dogs included Flash, a 4-year-old shepherd mix who had been abused as a puppy, Parker, an 11-year-old Golden Retriever who I rescued from a life of neglect, Dougie a 5-year-old Chihuahua-pug mix, and Molly, an 8-year-old pug.
Parker, the Golden, was a sweet, gentle, wonderful dog. During my sophomore year in vet school, he died after surgery to remove a hemangiosarcoma in his abdomen.
To honor Parker’s memory, I rescued a one-year-old female Golden from the Topeka Humane Society. I decided to adopt Mango because she had a bad rap sheet.
Her previous owners were a couple with a young baby. They surrendered the dog because she “chewed through $350 worth of pillows and household items. She also crapped all over the floor”. Oh my, sounded much like a normal Golden puppy to me but with that record who would adopt her?
Mango arrives to her new home
I drove Mango home. She marched into the house, flopped down on the kitchen floor and calmly let the cats and the rabbit check her out. She was going to be just fine.
After treating her gastroenteritis causing the runs, never giving her the chance to chew the pillows by crate training her and giving her chew toys, Mango became a well-behaved member of the family.
I had always been a cat person and my dog experience was relatively new. Flash, Parker, Dougie, and Molly were never destructive chewers. My collection of Kongs, rope toys, stuffed animals and an assortment of rawhide chews seemed to be safely enjoyed by my pooches. Then along came Mango.
Mango was a chewer
She loved going at her toys with unabashed vigor; I was pleased she destroyed her toys and not the couch cushions, although one or two bit the dust. She quickly killed the stuffed squeaky toys. I bought new ones and within five minutes each one was dead. I had the common sense at that point to get rid of the plushies. But I didn’t suspect that the rope toys would cause any trouble – they were hard as rocks and indestructible. Little did I know.
As freshmen vet students, there were no classes Friday afternoon. We were encouraged to don our freshman scrub top, identifying us as a rank beginner. And we spent the afternoon in the clinic observing, learning and getting our first look at what to expect in three years. I never missed a Friday in the clinic and loved it. I loved watching surgeries.
My favorite professor was a wonderful man, a top-notch surgeon, named Dr. Dennis Olsen. He was a marvelous teacher. Whenever he was behind the glass in surgery and would see me, he would wave me in so I could observe first-hand. I would do the hair net, the mask, the booties, and the gown and watch this man perform what I could only think of as miracles for hours every Friday. I learned so much from Dr. Olsen and had the utmost respect for his passion for teaching.
Mango gets ill
One day, Mango began vomiting and stopped eating.
After multiple bouts of her vomiting and me seeing a young dog not looking very happy, I took her into the clinic. The clinicians, along with the 4th year students, worked her up.
Radiographs were taken and it showed something in her stomach…. a gnarly, amorphous blob filling it up.
I made every attempt to learn as I fretted about my dog’s fate and readily agreed that Dr. Moore, our expert with the endoscope, should attempt to pull out whatever was in Mango’s stomach, saving her from surgery. It was worth a shot.
Mango’s endoscopy
Mango was anesthetized and wheeled into the scope room where Dr. Moore began to guide an endoscope probe with a prong at the end into Mango’s throat.
This prong looked like one of those tools to grab light bulbs too high to change by hand. I was just smaller and stainless steel. The room was filled with technicians, students, interns, and residents. We were all intently watching the TV screen as the probe traveled down Mango’s esophagus. Everyone was taking bets as to what exactly the blob in Mango’s stomach was. A dishtowel had top votes, a sock, underwear (Oh, I really hoped it wasn’t that), a stuffed toy…..just what?
Dr. Moore arrived at the stomach and we all looked at the screen and saw a jumbled mass of …… no one could really tell.
What the probe discovered
There was some grass, we could see that. Dr. Moore grabbed the blob, made sure she had a good grip and began to gently pull. He was trying to guide the mass through the opening of the stomach and up the esophagus. She was having a difficult time; it wouldn’t budge. She tried re-gripping and pulling from different angles but no luck. Finally, she announced that the scope wasn’t going to work and started to remove the probe. Only, the probe wouldn’t come out…. it was stuck! She kept trying but she could not get the probe out.
Emergency surgery
A quick call to surgery….. get a surgical team ready to go and a suite ready….Mango was going directly to surgery!
Now, through all this, Dr. Moore is telling everyone how expensive that probe is. It needed to be protected from any damage. I am sweating bullets worried about Mango and now, the probe. It wouldn’t be a good start to my career to be the student whose dog destroyed an expensive endoscope probe.
So here I am, handed the end of said expensive probe sticking out of Mango’s mouth, now free of the endoscope, as the dog is wheeled through the clinic halls towards surgical prep, closely followed by Dr. Moore (continually exhorting me to be careful with the probe) and about a dozen students and doctors.
All eyes were on this entourage and I am dying, just dying.
As Mango is being prepped for surgery, who comes out of the scrub room but Dr. Olsen. If I hadn’t had both hands gripping the probe and he hadn’t been scrubbed and sterile, I would have given him a big bear hug. His kind eyes looked at me from behind his mask. Then he looked at the dog, then at me again and said: “You’re assisting me, right?” My stress and fear disappeared and I replied: “Of course”.
The entourage was still a buzzing mass outside the surgical suite looking in through the glass windows. Dr. Olson calmly instructed a technician to take over holding the probe as I gowned up. The first order of business was to open the stomach and carefully disentangle the probe’s fingers and gingerly hand it back to Dr. Moore. Whew, at least that was done. Now, we could focus on saving Mango.
What is that mess?
Dr. Olsen began to explore the blob in Mango’s stomach, now exposed.
He gently moved it and revealed a large, mass of cotton string intertwined with a great amount of grass. Mango had tried to resolve her stomach ache by eating grass. The grass had mixed with……. oh it dawned on me….it was the rope toy.
However, it didn’t look like the nice tight rope I remembered; it had expanded into a Medusa-like chaotic mess.
As Dr. Olsen explored further, he discovered that this mass of string continued its tangled chaos through the pyloris and into the small intestine. He couldn’t pull the mass out because it might do a lot of damage to Mango’s intestine. This is what is called a “linear foreign body.” It is very dangerous because it can do a great deal of damage to the intestines which are continually contracting to try and move its contents along.
Dr. Olsen ran the intestine (carefully examining the length of the intestine in a disciplined orderly way). He determined that this linear foreign body was potentially quite long. His first incision in the small intestine was a few inches below the pyloris and cut the “rope” to remove part of it. He proceeded to make eight more incisions before he announced that Mango’s gut was free of her rope toy.
With 9 incisions and a stomach to close, it took another hour to finish the surgery. We were exhausted.
Mango was lucky
Mango made a full recovery. I purged my house of rope toys, rawhides, and plushies, restricting Mango to large Nylabones, Kongs and beef knucklebones.
She went to surgery one more time a while later.
We were visiting my sister, who had small dogs with small toys. I didn’t think to pick them up before it was too late. But Mango lived another 11 years, healthy, happy and never again needed to go to surgery. Until last Summer when we discovered she had a mass in her abdomen. However this time it wasn’t her fault; it was cancer and she passed having lived a great life.
I learned my lesson the hard way about dog products and warn my clients about dangerous toys.
Each client knows his dog best and some dogs are fine with rope toys and plushies and never shred them. However, if they shred at all, consider the risk and think of Mango and me with the endoscope wheeling down the clinic hall.
My vet school experience with Mango also went a long way to forge my knowledge about handling abdominal symptoms.
Mango could have died
If I had waited much longer, Mango could have died.
It is important not to wait long before taking your dog to the vet when he shows signs of something wrong; vomiting, especially vomiting with nothing coming up, is a sign of several serious and life-threatening conditions including bloat and foreign bodies.
I have seen the sad result of clients who wait when the veterinarian suggests an exploratory abdominal surgery, only to have their beloved pet die.
Veterinarians’ diagnoses are limited to the information they have and radiographs and ultrasounds can only tell them so much. We were taught in school never to be afraid to suggest exploratory surgery if the patient can handle it.
Most of the time, surgery gives the surgeon a clear view of the problem and it gives him/her the option to take biopsies.
It sometimes exposes other problems that were not obvious.
With blood work and exams, a veterinarian can determine how safe it is to perform surgery and carefully weigh the risks involved.
The surgery option
It is often safer to do surgery than to “wait and see what happens”.
I had a client who brought in her dog on emergency for vomiting, lethargy, and inappetence. The exam, radiographs and the blood work didn’t tell us anything but the owner suspected a foreign body. I suggested an exploratory even though we really didn’t know what was going on. I explained my reasoning and the client agreed.
We opened the dog up to find massive ulcers in his stomach.
Not only did we get an immediate answer, we were able to take biopsies, check the rest of his abdomen, and best of all, we were able to directly place six to ten sulcralfate pills into the stomach (a medication that coats the stomach and goes a long way to help ulcers to heal). We sent the dog home on antacids and he made a full recovery.
The owner was very happy she made the decision. So was I.
Related articles:
Foreign Body Ingestion in Dogs: Levi Eats 200 Gauze Squares
Further reading:
Linear Foreign Bodies in Dogs and Cats