Diagnosis and Treatment of Gastric Foreign Bodies in Samoyeds

Gastric foreign bodies are a common occurrence in dogs, characterized by the ingestion of indigestible materials that become lodged in the stomach, leading to various gastrointestinal disorders and impaired gastric function. Samoyeds, known for their playful and inquisitive nature, exhibit a particularly high incidence of this condition due to their tendency to ingest foreign objects. This article will comprehensively explore the diagnosis and treatment of gastric foreign bodies in Samoyeds, expanding upon a previously reported case to provide a more complete understanding of this prevalent issue.

I. Case Presentation:

A three-year-old, 30kg male Samoyed presented with a history of severe vomiting for the past day. Initially exhibiting appetite, the dog gradually developed anorexia, with all ingested food being vomited. The patient displayed lethargy, recumbency, and retching after water ingestion. Defecation had ceased for two days.

II. Diagnostic Evaluation:

1. Physical Examination:

Visual examination revealed conjunctival and gingival hyperemia. Body temperature was 38°C. Abdominal palpation elicited restlessness and significant abdominal distension, along with a pronounced vomiting reflex.

2. Hematological Examination:

Complete blood count (CBC) revealed leukocytosis with significantly elevated lymphocyte and monocyte percentages, coupled with decreased erythrocyte count. This indicated an inflammatory response and potential infection.

3. Biochemical Examination:

Serum biochemistry analysis showed elevated albumin (ALB) and amylase (AMYL) levels, along with decreased glucose (GLU), suggesting pancreatic metabolic dysfunction.

4. Radiographic Examination:

Radiographs revealed irregularly shaped, high-density projections within the stomach, strongly suggestive of foreign bodies. Further imaging confirmed the presence of multiple, dense foreign objects.

5. Ultrasonographic Examination:

Ultrasound imaging demonstrated strong, circular echogenic rings within the stomach, accompanied by acoustic shadowing, confirming the presence of high-density, suspected foreign material.

III. Surgical Intervention:

Based on the clinical examination, laboratory findings, and imaging results, a diagnosis of gastric foreign bodies was established, necessitating surgical intervention. A large area of hair was clipped and disinfected from the xiphoid process to the umbilicus. A midline incision was made through the skin, subcutaneous tissue, abdominal muscles, and peritoneum. The stomach was exteriorized, and moistened gauze pads were used to surround the incision site, preventing contamination. A gastrotomy was performed at the greater curvature, avoiding major vessels. Gastric contents were suctioned, and the foreign bodies were retrieved. Thorough lavage with warm saline solution followed.

The stomach was closed using a two-layer closure: a Connell continuous inverting suture for the mucosa and submucosa, and a Cushing inverting suture for the seromuscular layers. The exteriorized stomach was thoroughly rinsed with saline, and the pre-placed sutures were removed. The stomach was repositioned, and the abdomen was lavaged with metronidazole and saline solution. Excess fluid was removed, and the greater omentum was placed over the gastrotomy site. The peritoneum, muscles, and skin were closed in layers.

Post-operative management included the administration of cephalosporin antibiotics and analgesics for six days, along with a one-week period of fasting. Following suture removal, easily digestible food was gradually introduced, supplemented with vitamins and minerals to ensure adequate energy supply and metabolic function. At a ten-day follow-up, the dog had recovered well.

IV. Discussion:

This case highlights the importance of thorough pre-operative laboratory investigations to accurately assess the patient’s condition and guide surgical planning. In cases of confirmed gastric foreign bodies, especially large ones, surgical intervention is often the preferred treatment after stabilization and anesthesia. Conservative management alone cannot guarantee foreign body expulsion and may delay treatment, potentially leading to serious complications or death. Surgical intervention is generally safer and more effective than solely relying on medical management.

V. Prevention and Management of Gastric Foreign Bodies in Samoyeds:

A. Prevention:

Environmental Control: Remove potentially ingestible objects from the dog’s environment. This includes small toys, bones, fabrics, and any other items that the dog could swallow.

Supervised Play: Closely supervise playtime to prevent ingestion of foreign objects.

Enrichment Activities: Provide a stimulating environment with appropriate chew toys and puzzles to reduce boredom and the likelihood of destructive chewing.

Nutritional Considerations: Ensure a balanced diet to prevent nutritional deficiencies that might lead to pica (eating non-food items). Consult your veterinarian for guidance on appropriate dietary choices.

B. Management of Suspected Gastric Foreign Bodies:

Prompt Veterinary Attention: If you suspect your Samoyed has ingested a foreign body, seek veterinary care immediately.

Diagnostic Imaging: Radiographs and ultrasound are crucial for confirming the presence, location, and number of foreign bodies.

Treatment Options: Treatment options range from conservative management (e.g., inducing vomiting with appropriate medications) for small, non-obstructing objects, to endoscopic retrieval or surgery for larger or obstructing objects. Surgical removal remains the gold standard for large or sharp objects that pose a significant risk.

Post-Operative Care: Post-operative care includes pain management, antibiotic therapy, and a gradual return to a normal diet, as determined by the veterinarian.

This detailed approach underscores the importance of prompt veterinary diagnosis and appropriate treatment for gastric foreign bodies in Samoyeds. Proactive preventive measures can significantly reduce the risk of this potentially life-threatening condition. Regular veterinary check-ups can also help identify and address underlying conditions that might predispose Samoyeds to pica and ingestion of foreign bodies.