Sometimes, Foreign Bodies In A Pet’s Stomach Or Intestines Are Obvious On X-Ray Images—For Example, A Bright White Metallic Object, Or A Whopping Big Children’s Dinosaur Toy.

However, sometimes GI foreign bodies and obstructions are trickier to detect…

For example, certain fabric objects—like socks or pieces of a blanket—don’t show up well on radiographs.

Here’s a quick guideline for how to get the “whole picture” and diagnose GI foreign bodies with confidence…

Clinical Evaluation

If you suspect a foreign object in the stomach or intestines, there’s a good chance the patient presented to you with symptoms—may be protracted vomiting with a full obstruction, or milder GI upset if there’s an object in the stomach that’s not digestible but also not causing an obstruction yet.

You proceed by taking a thorough history from the owner and then performing a physical exam.

Then, based on your findings, you perform radiographs.

Radiographs

Be sure to take orthogonal views to get as much information as possible about the dog or cat’s digestive tract.

For some patients, this may be enough information to give you a clear answer. Maybe you see obvious signs of an intestinal blockage, such as plications or extreme fluid and gas retention that doesn’t move over time. Or, maybe you see a mineral-dense rock or other radiopaque objects.

If you don’t have an obvious answer, there are some additional tactics you can pursue, including…

• Repeating the radiographs later for comparison, if the patient is healthy enough to wait.

• Performing a barium contrast study. This is a good option for many patients, but something you may wish to avoid if the patient is vomiting a lot, due to the risk of barium aspiration.

• Performing an ultrasound evaluation. This is a quick and non-invasive way to get more information but may require a waiting period or referral if you don’t have an ultrasound in-house.

• Performing abdominal exploratory surgery. This may give you a definitive answer and allow you to treat right away if a foreign body is present, but is obviously more invasive and requires a thorough discussion with the client to set up expectations.

Ultrasound

An ultrasound is a great way to gain additional information about your patient’s digestive tract, and it can work hand-in-hand with x-rays.

Now that your radiographs have given you a good overview, the ultrasound allows you to “zoom in” on the finer detail of soft tissue structures.

For example, if there’s a radiolucent cloth or foam children’s toy stuck in the intestines, the ultrasound can help you locate and characterize the obstruction.

These additional details may help you decide what to do next, and determine whether or not the patient needs surgery.

If you don’t have an ultrasound in-house, you may need to refer to a specialist or emergency center, and there may be a short waiting period if you use a mobile ultrasonographer.

By having an ultrasound in-house, and gaining the training and confidence to use it, you can potentially have your answers sooner—for more peace of mind for you, and the ability to provide faster answers to your worried client.

Treatment

Based on your findings, you’ll use your clinical judgment to decide the next step—whether that’s surgery right away or a period of observation and supportive care followed by a recheck and a repeat of your images.

As you know, some GI foreign bodies are harder to diagnose than others…

However, the more tools you have in your toolbelt, the easier it is for you to make timely decisions about the best care for your patients.

Written by: Dr. Tammy Powell, DVM