In this retrospective study from a veterinary teaching hospital, the medical records of 138 dogs (1997-2000) with a surgically
removed gastrointestinal (GI) foreign body were reviewed to determine whether acid-base or electrolyte abnormalities were
related to the site or type of foreign body. All dogs were seen in an urban emergency clinic setting.
The mean age of the dogs was 3.8 years, and Labrador retrievers were most often represented (22 cases). The duration of vomiting
(median = 48 hours) was noted in 124 dogs. Imaging (plain abdominal radiography, abdominal ultrasonography, or upper GI contrast
study) was performed in all the cases.
The location of the foreign body during celiotomy was most frequently in the stomach (50%) or jejunum (27.5%), and the foreign
body was most commonly linear (36.2%). Resection and anastomosis were performed in 28% of the cases. After surgery, one dog
died, three dogs had complications requiring another surgery (peritonitis, dehiscence), and eight dogs had complications not
requiring surgery (pancreatitis, pneumonia, GI motility problems, seroma formation).
The most common biochemical abnormalities were hypochloremia (51.2%), metabolic alkalosis (45.2%), hyperlactatemia (40.5%),
hypokalemia (25%), and hyponatremia (20.5%). Nearly 75% of the dogs had pH values within the reference range of 7.36 to 7.47.
No significant association was found between any biochemical abnormality and the site of the foreign body. Linear foreign
bodies were significantly associated with lower sodium concentrations (possibly because of incomplete obstructions and continued
water intake) and with longer surgery times (possibly because of multiple enterotomies).
The authors concluded that because of the wide variability in biochemical abnormalities, electrolyte concentrations and acid-base
parameters should be measured in dogs with a suspected GI foreign body to optimize fluid therapy before surgery.
COMMENTARY
GI foreign bodies are frequently encountered in small-animal practice. This article focuses on the biochemical abnormalities
seen in patients with GI foreign bodies and reminds clinicians of the need for preoperative evaluation and selection of the
correct fluid therapy. While specific associations between the locations or types of foreign body and biochemical abnormalities
(other than sodium) are difficult to make, the reduced morbidity and mortality of the patients in this study should be noted.
This reduction is probably related to the early admission of patients and the exclusion of patients with complicated septic
conditions. The short duration of vomiting and aggressive medical and surgical interventions are probably responsible for
these results and should be noted by practitioners.
Boag AK, Coe RJ, Martinez TA, et al. Acid-base and electrolyte abnormalities in dogs with gastrointestinal foreign bodies.
J Vet Intern Med 2005;19:816-821.
 Joseph Harari, MS, DVM, DACVS
|
The information in "Research Updates" was provided by Veterinary Medicine Editorial Advisory Board member Joseph Harari, MS, DVM, DACVS, Veterinary Surgical Specialists, 21 E. Mission Ave., Spokane,
WA 99202.