24 hours of emergency surgeries: Part 2 - Frankie eats a rug
So if you read last week’s blog, you read all about my friend Holly and her crazy surgery. The next morning, she was doing well, and we all breathed a sigh of relief. She seemed to be recovering just fine from her surgery so far, and looked pretty bright and alert considering what she had been through! We planned to keep her the rest of the day for some support, and then send her home that night with her loving foster mom!
Going on in the background though, I haven’t mentioned yet what was happening with Frankie. Oh Frankie….Frankie is Alison’s large, adorable, and poor life choice making dog. He’s a mixed breed boy, some sort of staffie mix, and he weighs in at around 95lbs, and is 9 ½ years young – certainly old enough that he SHOULD know better. But as dogs often do, they make some poor life choices, just like we do, and he decided to munch on an area rug. Earlier in the week, they saw the rug and it looked like they had just pulled it apart, but on Thursday when Frankie was acting painful and not eating – we all feared it was something more. We started with some xrays and supportive medications for nausea – we couldn’t see an obvious foreign body in his abdomen, and he overall looked ok, just a little dumpy, so we started with supportive care. Hopeful that it was just that he ate something outside, or just picked up a little bug.
We left it that we would re-evaluate him on Friday morning to take recheck xrays, to make sure the gas in there was moving through, and try to decide if we needed to do more. Friday am came with a very concerned Alison as she messaged me first thing when he tried to have a bowel movement and passed some string. It appeared to be stuck, and they had to cut the piece that was sticking out so that it would get caught on anything or pull. Luckily, Alison knew to just cut it and not pull on it, as that can cause more harm than good! I knew at that point we had a bigger problem on our hands. They went back and looked at the trashed rug and found that there was a long piece that had appeared to be pulled off, and my fear was that it was sitting in his stomach, and trying to pass through his intestines – causing what is called a linear foreign body.
Linear foreign bodies are a tough surgery – they often are anchored in the stomach and as they pass through the intestines, they cause them to bunch up like an accordion, and that can lead to perforations, or tears, in the intestines as it gets tighter and tighter the more the body tries to pass it and it cannot. We knew we had to act quickly!
My team sprung into action, and we were able to move some of my house calls around so I could stay in the hospital and perform his surgery. Once I got in there, it was what I had feared. There was a large bunch of rug fibers wadded up in his stomach that was too big to pass out and into his intestines – but one end of it, had started to pass out and had worked its way through the ENTIRE intestinal tract and into his colon. This is not good.
After taking a few minutes to collect my thoughts, and think a few ‘oh shit’s, I came up with a plan. I started with an incision in the stomach, so I could explore the large amount that was anchored there – I was able to track it down to where it left the stomach and cut it so I could release the tension and remove the rug in the stomach. After massaging the intestines to release more tension and improve blood flow, I worked my way about halfway down them and made another incision. I cut the rug material again, and removed the entire piece in the first half of the intestines. In the lower half, it was still pretty tight and had worked its way down, so I had one of my nurses put on gloves and do a rectal exam to help find it at the back end! Sure enough, we got a hold of it, and were able to slowly, gently, fish it out! Whew – sigh of relief!
Once it was out, I closed up the incision in the intestine and checked the one in the stomach, flushed the heck out of the abdomen, and closed him up! He woke up like a champ, and spent the next 48 hours in the hospital on fluids and antibiotics, and lots of supportive care. I’m happy to report that Frankie did amazing – though I’m not sure I can comfortably say he learned his lesson, one can only hope. I think Frankie’s foreign body was the first time I had a linear foreign body that so dramatically spanned the entire intestinal track – he’s a very lucky boy that his mom acted quickly, so we could get it out before it caused even more damage! I’m very thankful he did so well, he’s such a love and deserves all the good things in life, even if he is foolish at times.
On that same fateful day, we had agreed to take a Frenchie into our rescue that was having an issue with a prolapsed rectum….this one was also fun – check back next week to hear the ending of this very epic surgery day, and to hear the story of Cricket.