Sunday, April 19, 2009

Gastrointestinal Obstruction in Pets

Due to Clif Richard, our beautiful kitty whom was featured last blog, we are featuring a special blog on the diagnoses of Gastrointestinal Obstruction which he suffered from the past few weeks- read the April Adventure for more information

Clinical Findings:
Clinical signs of small-intestinal obstruction may include lethargy, anorexia, vomiting, diarrhea, abdominal pain, abdominal distention, fever or subnormal body temperature, dehydration, and shock. Gaseous bowel distention develops within the initial 12-35 hr after obstruction and is followed by the loss of fluid into the intestinal lumen. Without treatment, death due to hypovolemia ensues within 3-4 days.

Upper or duodenal obstruction tends to present as frequent vomiting. In general, the closer the obstruction to the pylorus, the more severe the vomiting. Obstruction of the lower small intestine (eg, distal jejunum and ileum) is infrequently associated with vomiting. Lethargy, anorexia, weight loss, and ultimate starvation in untreated dogs lead to death within 3 wk or longer.

A careful history including information about the animal’s eating habits is important. Many animals with a history of dietary indiscretion continue that practice even after having experienced discomfort in the past. Access to string or sewing needles or missing objects (eg, toys) may be important historical facts. Examination of the oral cavity and, in cats, the base of the tongue is vital. Linear foreign bodies most often lodge at the base of the tongue in cats and at the level of the pylorus in dogs. Careful abdominal palpation examining for evidence of pain (ruptured bowel, peritonitis), organomegaly, thickened bowel loops (intussusception), and tympany (dilatation-volvulus), and a rectal examination for evidence of dietary indiscretion or blood (suggestive of strangulation) are important components of the physical examination.

Plain abdominal radiographs may demonstrate the presence of foreign objects, masses, obstruction, or abdominal fluid. Barium-impregnated polyethylene spheres are capsules containing radiopaque plastic spheres. They are being used for the diagnosis of GI obstruction and motility disorders in dogs and cats. Flexible endoscopic examination is useful in the identification of foreign objects, mass lesions, and ileocolic intussusception.

If an obstructive lesion is documented and it cannot be resolved via endoscopy (eg, removal of a foreign object), the animal should be stabilized and an exploratory laparotomy performed. Similarly, animals with acute abdominal signs of unknown etiology, and those that continue to deteriorate clinically, should also have an exploratory laparotomy.

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