Wednesday, June 2, 2010

Case of the Week - Lilly

One of the great aspects of a veterinary clinic is the interesting cases that come through our doors. In a new blog series, we will be presenting a case of the week.

Lilly is a two-year-old grey tabby that likes to play with ribbon. On a recent Friday, she actually swallowed some and started to vomiting it up, and not eating anything else. By Monday, she was still not eating so her mom brought her into the clinic. A radiograph (x-ray) of her abdomen showed an abnormal air pocket that could be an indication of an obstruction in her i
ntestine. We fed her a contrast liquid and took periodic radiographs to watch it move through her stomach and intestines.

In a normal cat, the contrast liquid should pass through the entire intestinal tract in three hours. In Lilly, after four hours, the contrast had traveled through her small intestine but was not yet moving into her colon. We gave her a little food which she ate then vomited up. The vomiting and the slow transit of the contrast liquid were a good indication that Lilly had an obstruction and needed surgery.

As soon as we finished our afternoon appointments, we anesthetized Lilly and prepared her for surgery. A four-inch incision was made into her abdomen and the stomach and intestines were evaluated. Her stomach appeared normal but there was something firm in both ends of her small intestines. After making a one-centimeter incision into the beginning of the small intestine, a black ribbon was removed. It had frayed at the end and a thin thread went further into the intestine.

A thread or string th
at enters the small intestine is called a linear foreign body. Typically, part of the linear foreign body will get stuck at the start of the small intestine or in the stomach but the rest will continue passing through the intestines. This can create an accordion of the intestines, even leading to tearing of the intestines. Multiple incisions are needed to cut and remove the foreign body while minimizing the trauma and pulling on the intestines themselves. Lilly needed five incisions to completely remove all of the thread. Her intestines did show some evidence of trauma from the thread pulling but fortunately it was only light bruising.

Lilly did very well through the surgery and recovery period. She was transferred to an emergency clinic for continued monitoring throughout the night. By the next afternoon she was lively and eating small amounts. Eight days after surgery, she is eating well and back to her normal self.
Her family is now very vigilant about any thread or string-like objects in the house, having learned how quickly something of that nature can be swallowed. Be sure to keep any thread, ribbon, string, yarn or floss out of your cat's reach.

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