To Cut or Not To Cut: Foreign Body in a Cat?

Signalment: 1-year-old castrated domestic shorthaired cat.

History: Vomiting of 4 days’ duration. SC fluids and antiemetics initially administered at referral veterinarian. Presented to emergency clinic for anorexia and severe lethargy.

Physical Examination: 5%-7% dehydrated and painful on deep abdominal palpation

A) Right radiograph, B) Left radiograph, and C) Ventrodorsal radiograph

Should this cat go into surgery or not?

Abdominal radiography: Left/right lateral and VD views.

Radiographic Findings: The stomach (St) and duodenum (D) are severely distended with fluid and gas, suggesting intestinal obstruction or possibly pancreatitis with secondary ileus.

There is a 1.5-cm rounded opaque structure (arrows) in the caudal abdomen, to the left of the descending colon on the VD view. It is partially obscured by feces in the colon (C) on the left lateral view. The remaining organs and serosal detail appear normal.

C**omments:** We often perform left and right lateral radiographic views of the abdomen in cases of suspected GI foreign bodies and obstructions since the fluid and gas disperse into different portions of the GI tract. For example, any gas in the stomach rises to the pylorus (P) in left lateral recumbency and may outline a foreign body anchored to this region; this is particularly useful in suspected linear foreign bodies, which typically anchor to the tongue or pylorus and subsequently plicate varying degrees of small intestine.

A brief abdominal ultrasound was performed and the foreign body was confirmed in a small intestinal lumen.

O**utcome:** This patient was cut! He was treated for dehydration and taken to surgery, where a rectangular plastic foreign body was “milked” from its location in the jejunum, backwards into the stomach, where a single gastrotomy was performed to remove the object. The severe gastroduodenal distension was secondary to complete obstruction. The patient recovered quickly and ate that same evening.

To Cut or Not to Cut is intended as a forum for those with specialized expertise to share their case experiences. As such, the content reflects one expert’s approach and is not subject to peer review.

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