Pont de Neuilly veterinary clinic

If your dog is trying to vomit without success , seems to be bent forward and has difficulty getting up, and his abdomen is tense, hard to the touch, contact your vet immediately : these symptoms potentially indicate a stomach twist. (also known as gastric dilation or volvulus), the second leading cause of death in dogs after cancer.

The animal's stomach is strained due to excess gas and therefore twists, which cuts off the blood supply. These twists are mostly seen in large breed dogs with large chests such as Saint Bernard, German Shepherd, and Danish Mastiff.

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Symptoms

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A twist commonly occurs after the dog has eaten a heavy meal, followed by strenuous activity. Here are the signs to watch out for:

• abdominal pain

• distended abdomen

• retching without vomiting

• hyperactivity

• accelerated breathing

If you see any of these signs, it is a veterinary emergency.

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What treatment?

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Once the animal is taken care of, the veterinarian will assess its condition. If the dog is in stable condition, the vet will try to relieve the pressure in the stomach. If this is not successful, surgery will be needed to stop the twist.

Even if the procedure goes well, there may be complications afterwards. Twisting of the stomach can disrupt blood flow, electrolyte levels, and body fluid balance. The dog may therefore need to remain hospitalized for at least a week.

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Other cases

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Without always talking about torsion of the stomach, your dog may show signs of swelling of the abdomen:

* Bloating : the stomach contains too much gas, but is not twisted. The causes and clinical signs, however, are the same as in the case of torsion, and can lead to it. It is therefore necessary to take the dog to the vet fairly quickly.

* Massive lesions : These can be enlarged organs, due to cancer or another disease, for example a swollen liver in dogs with heart failure or Cushing's disease.

* Loss of muscle mass : Cushing's disease can cause muscle loss, giving the impression of an enlarged abdomen.

* Accumulation of abdominal fluids : caused by heart failure, hypoprotidemia, or peritonitis.

* Pregnancy : If the owner is unaware of a female's gestation, an enlarged abdomen may suggest stomach twisting.

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What prevention?

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If your dog is too gluttonous and / or a thief between meals, take care to place his food out of his reach. Give her two or three small meals a day, rather than one large one. Sequence meals in several times if your dog tends to swallow everything at once. And don't give him intense exercise right after his meal.

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Foreign bodies stuck in the pharynx are common in cats and dogs; we find them more particularly among young people because they are very curious. They are usually ingested as a result of play, or when trying to swallow large or irregularly shaped pieces of food. Very large objects can obstruct the airways and cause suffocation. When a foreign body becomes anchored in the soft tissues of the pharynx, it often causes an abscess which will swell and sometimes even occlude the pharynx.

Differential diagnoses

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• Pharyngeal tumor, e.g. tonsillar carcinoma, polyp in the eustachian tube

• Pharyngeal wound

• Tonsillitis

• Malformation of the pharynx in predisposed breeds

• Upper respiratory tract disorder

• Fracture of a hyoid horn.

Clinical signs

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Although there are several diagnostic hypotheses to consider, when the problem appears suddenly and the animal appears in respiratory distress, the suspicion of a foreign body blocked in the pharynx will be the main diagnostic hypothesis. Sometimes the owner knows exactly what the problem is and / or the foreign body is easily visible on physical examination.

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The classic clinical signs of a foreign body in the pharynx are pawing towards the mouth, the impression that the animal is choking, and ptyalism, which is sometimes tinged with blood. If the nasopharynx is affected, the animal sneezes and produces loud noises and snores, especially in cats. It often happens that the animal refuses to eat, and when it tries, it almost suffocates.

Usually over time, the distress caused by the presence of a small foreign object subsides, and symptoms become more subtle. They include a refusal to feed, swelling, and pain in the parotid region or throat. If there is adenomegaly of the retropharyngeal lymph nodes, their increase in size may cause signs of confusion with a protrusion of a cervical disc. Migrating foreign bodies that are not removed (eg spikelet) can cause fibrosis affecting the masseters and making it difficult to fully open the mouth, even under general anesthesia. If the foreign body is large, eg a bullet, occlusion of the pharynx may cause severe dyspnea or asphyxia. Chronic nasopharyngeal foreign bodies can induce the development of a mucopurulent nasal discharge.

Specific diagnostic techniques

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It is sometimes possible to see the foreign body during the examination of the oral cavity without sedation. When there is a strong suspicion of the presence of a foreign body but it is not visible, or it is difficult to examine the oral cavity, a complete examination should be performed under general anesthesia. We can thus examine the oropharynx, the nasopharynx, and look for the presence of sores or pharyngeal fistulas. It is essential to have good quality lighting; you can use a headlamp, a laryngoscope or a flexible endoscope. It is necessary to linger on the examination of the tonsillar crypts and nasopharynx, reflecting the soft palate.

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X-rays will allow detection of the size and position of a foreign metal or bone body, as well as any displacement of soft tissue in the cervical region secondary to the formation of an abscess. ultrasound of the cervical region can help locate a radiolucent foreign body and determine the nature of swelling at the base of the neck. Imaging should always be used when a foreign body is suspected but cannot be seen, or when an entry point can be seen.

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Treatment

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Once the foreign body has been identified, it should be removed and then controlled for edema, pain or pharyngeal infection. It is sometimes possible to remove some oral foreign bodies without sedation, especially if it is accessible and has not perforated an oral structure. However, animals with a foreign body blocked in the pharynx usually need to undergo general anesthesia. The pharyngeal wounds must be explored well to remove all the debris of a foreign body and then flush them with lukewarm saline solution. Before flushing, you must put an endotracheal tube perfectly adjusted to the tracheal diameter and tilt the animal's head downwards to avoid any false route. Broad-spectrum antibiotics will be given if there are lesions in the pharyngeal wall. NSAIDs will be used to reduce soft tissue swelling and pain.

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Pharyngeal wounds usually heal very quickly. There are very few that need to be sutured, but if so, you should put as few stitches as possible. If it seems difficult or painful for the animal to swallow food, it will be offered a little softened ice, and once it has started to eat, it will ingest the soft food more easily.

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Specific treatment of the most frequent foreign bodies in the pharynx

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Fish bones, irregular bones (vertebrae): thin (cartilaginous) bones often get stuck in cats, they are typically found planted 1 horizontally in the pharynx and anchored in soft tissue. They can be easily removed with a hemostatic forceps, but general anesthesia is usually required. Oddly shaped bones are often found in dogs, they are easy to find and remove. Tissue damage is often minimal.

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Hooks: Cats are affected when they play with flies or eat the bait. Dogs can also eat the bait or catch a moving fishing line. Whenever possible, when there is a line attached to the hook, try to preserve it and prevent the animal from swallowing it. The barb of the hook makes its extraction very difficult when trying to pull it out, so it is easier to extract it by pushing it through soft tissue. If the hook eye is large or there is not enough room to handle it, it may be necessary to cut the hook in half before it can be removed. However, the majority of hooks are made of very strong steel and can only be cut with a suitable hacksaw (not a nail clipper). Hooks that have migrated from the pharynx will sometimes lodge in the esophagus or stomach. In this case, an X-ray and endoscopy should be taken to determine the exact position of the hook and assess tissue damage. Some can be removed by endoscopy, otherwise they have to operate.

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Threads and needles: the needle can go through the pharynx or go deep into the root of the tongue. Unlike hooks, they are usually easily removed with hemostats. It is useful to preserve the thread that can be attached to the needle in order to locate it more easily and to be able to move it during extraction.

Spikelets, blades of grass, burrs of certain plants: these foreign bodies are generally ingested when the animal licks itself or ingests plants. The spikelets often sink into the crypts of the tonsils, and the blades of grass will often lodge in the nasopharynx, behind the soft palate. The spikelets will start to migrate through the mucosa if they are not found and not removed quickly, making their location even more difficult and causing a sharp inflammatory reaction in the soft tissues.

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Balls: This usually happens when the dog catches a ball that is too small for its size. The bullet is then stuck at the back of the mouth above the root of the tongue. Breathing is then severely compromised and the risk of death from asphyxiation is very high. By the time the animal is presented, it is usually in severe dyspnea and everything should be done so that the animal is not stressed and calms down. The easiest way is to remove the bullet with short-acting general anesthesia, but all the materials needed for an emergency tracheostomy should be prepared before induction. Once the dog is anesthetized, we will fix the ball by manipulating the larynx from the outside, then we will catch it with a large clamp. It often takes a lot of effort to get the ball out. During this operation, the dog usually cannot breathe, so the ball should be extracted as quickly as possible if a tracheostomy has not been done. You can facilitate the removal of air-filled balls (eg tennis balls) by piercing them first, so that they flatten when caught.

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Wood splinters: they are found in dogs who play with pieces of bots or who have destructive behavior. Although the dog is sometimes presented with typical clinical signs of distress and suffocation, it is very common for these signs to have become chronic. Splinters are often the cause of abscess formation at the base of the tongue or in the upper cervical region, but are difficult to identify and locate. Since they are not radiopaque, ultrasound is more useful than X-ray in detecting them.

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Stick penetration injuries: These are common and occur when a dog catches a stick while playing. These injuries should always be fully examined under general anesthesia. Tissue damage can be significant and is often heavily contaminated.

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Follow-up and care

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If the diagnosis is made quickly and the foreign body is removed without general anesthesia, the cost will not be excessive and the animal will only need a few medications to recover. On the other hand, if the signs persist after the removal of the foreign body, one must quickly seek another cause.

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