The Veterinary Centre

Henley and Twyford

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Case Notes: Henry - "Dogor Kebab"
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Henry was one of those mystery cases that are sent to baffle us every now and then. He saw virtually every vet in the practice over a period of two weeks, and had every diagnostic test we could think of, and was the subject of numerous discussions and theories but eventually he cured himself and presented us with the diagnosis in one dramatic gesture!

 

Henry presented with severe diarrhoea and vomiting in July of this year. He was subdued and running a temperature but his abdomen did not seem painful and we suspected that he had just picked up a gastroenteritis bug. He was treated for this with antibiotic and anti nausea drugs plus an electrolyte replacement fluid and then light meals. Later the same day he was still vomiting so we x-rayed his abdomen to check for any foreign body or other obstruction and could see nothing abnormal.

Photo: Henry

The treatment was continued. Over the next day or two he seemed to improve somewhat in that he vomited only occasionally and was brighter and livelier again. However, the owners brought Henry back to see us on day five because a hard lump had suddenly appeared on his left side spanning the last four ribs. He was admitted for further investigations.

Firstly a comprehensive set of blood tests showed only a markedly raised white blood cell count suggesting a severe inflammatory response was going on somewhere, quite possibly within the lump we could see.

Secondly we took some more detailed radiographs under general anaesthetic but, apart from the fact that the stomach and intestines were now rather empty and gassy after more than a week of intermittent vomiting and diarrhoea, there was still nothing abnormal to be seen. Certainly nothing to explain what was causing the soft tissue swelling over the caudal ribcage.

Finally we took needle biopsies of the swelling and sent these off to a pathology lab for interpretation. The dog went home while awaiting these results which were faxed to us three days later. The histopathology revealed only inflammation within the fat and muscle layers overlying the ribcage. At least we new it was not a tumour but we were no wiser as to what had caused this inflammation. Had he perhaps had a vicious kick in the ribs unseen by his owners? Or had a splinter or some other foreign body got in there somehow?? We reported this frustrating report to the owners who informed us that it looked as if the swelling was coming to a head now and had become quite tender if they tried to lift the dog. Henry was now quite well in himself with no more vomiting or diarrhoea so we decided to “wait and see”, a tried and tested diagnostic technique!

Sure enough, two days later the swelling burst releasing a lot of inflammatory fluid. The area was extremely tender and the dog was subdued with a temperature of 105 degrees Fahrenheit so he was given anti-inflammatory painkiller and long acting antibiotic and the owners were instructed to keep bathing the wound to keep it open. We were, by now, highly suspicious that the body was trying to eject a foreign body of some sort, perhaps one of the dreaded grass seeds that we have been removing from dogs ears and feet and noses all Summer.

Two days later the owners arrived at the surgery, one of them holding Henry and the other holding an 8” satay stick that had just emerged from his side!

Henry has been as right as rain ever since and we can only assume that he swallowed the satay stick (probably with its Tai chicken in place) and then, as the stomach contracted in the process of digestion, the stick pierced its way out through the stomach wall, migrated across the short distance to the adjacent abdominal wall and then out between the last two ribs.

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Photo: Hand holding satay stick

A point of interest:
Wood presents a particular diagnostic challenge because it has a very similar radio density to most body tissues and so does not show up on x-rays. We have similar difficulty with rubber, cloth, cork and many types of plastic.

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Henley Vets and Twyford Vets
The Veterinary Centre: 271 Reading Road, Henley-on-Thames, RG9 1EL - Phone 01491 574490
Also at Twycombe Lodge, Loddon Hall Road, Twyford, RG10 9JA - Phone 0118 934 0259