Linear foreign body in a domestic short-haired cat

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foreign body found in a cat
The foreign material that was removed.

A six-year-old female-neutered domestic short-haired cat presented to Canberra Veterinary Emergency Service for lethargy and inappetence after vomiting up a single hair tie. The cat had experienced several episodes of vomiting two days prior to presentation. The cat had been examined by its regular veterinarian the day before presentation, and at this time a single Maropitant injection was administered. 

The cat had a history of food intolerances and was only being fed Royal Canin® Anallergenic. There was no known history of eating foreign objects, and the owner thought it was unlikely that there would have been more than one hair tie ingested as she had not noticed anything missing. The cat was not allowed outside access. The rest of the history was fairly unremarkable, and the cat was considered to otherwise be normally healthy.  

On examination, the entire intestinal tract was extremely hard, thickened and painful. There was a mild hypothermia, significant dehydration and a mild gallop rhythm. All the rest of the physical examination findings were within normal limits. On radiograph examination, there appeared to be a linear foreign body/bodies in the stomach through much of the intestine, and several sections of distended intestine.

Preoperatively, Maropitant was administered at 1mg/kg IV to reduce nausea. Cephalexin was commenced at 22mg/kg intravenously to be given every 90 minutes from the commencement of surgery, for a total of three doses. The cat was premedicated with 0.2mg/kg Methadone IV, with the Medetomidine previously administered to facilitate imaging still being active. Intravenous fluids were provided throughout the procedure. 

Anaesthesia was induced with Alfaxan to effect and a 4.5 cuffed ET tube placed and lightly inflated, fortuitously prior to the cat regurgitating a moderate volume of green fluid post-induction. The cat was quickly and gently elevated to an angle to allow the fluid to flow out, and suction and cleaning of the oral cavity were performed. 

foreign body found in a cat
On radiograph examination, there appeared to be a linear foreign body/bodies in the stomach through much of the intestine, some sections of which were distended. 

A routine midline approach to exploratory laparotomy was performed. Upon initial exploration, moderate gastric distention was evident, and the entire length of the small intestine from proximal duodenum to distal ilium was completely plicated. Colour and mesenteric pulses of the small intestine were assessed to be good throughout. A minimal volume of serosanguinous free abdominal fluid was visible and there was no evidence of perforation.

A total of three enterotomy incisions were required. Each enterotomy incision facilitated the severance of a segment of the linear foreign bodies and removal of a portion of them. At all enterotomy points multiple different linear foreign bodies including fabric, ribbon, elastic hair ties and hair were noted to be entangled together, such that collectively they spanned the entire length of the small intestine. 

After severance and removal of the foreign material, the internal mucosa was assessed for pressure necrosis along the mesenteric border where the foreign material had run. Colour remained erythematous due to inflammation, with no necrotic discolouration evident. Each enterotomy was routinely closed with 3-0 Monosyn sutures in a simple continuous pattern prior to proceeding to the next. A gastrotomy incision was performed to remove the final portion of foreign material from the stomach and closed routinely in two layers with 3-0 Monosyn sutures, each in a simple continuous pattern. 

The entire length of the gastrointestinal tract was then examined proximal to distal to ensure no further evidence of foreign materials. The mesenteric border of the small intestine was palpably thickened and mildly inflamed due to the effect of pressure from the linear foreign body constriction, however, intestinal colour and mesenteric pulses remained very good.

An abdominal lavage and suction was performed with a large volume of warm sterile saline. The gastrotomy and enterotomy incisions were all omentalised prior to closure. Closure of the surgical site was performed in three layers, with 2-0 simple continuous Monosyn sutures used for the linea alba, 3-0 Monosyn sutures used in a simple continuous pattern for the subcutaneous layer, and an intradermal skin layer of 3-0 Monosyn sutures.

Further medical management included administration of Esomeprazole at 1mg/kg q12hrs to reduce the risks of both esophagitis post-regurgitation and gastro-intestinal tract ulceration potential from the linear foreign body pressure. Methadone was continued at 0.2mg/kg IV q4 hours. 

An Elizabethan buster collar was placed to ensure the cat was not able to traumatise the wound. IV fluids were continued overnight and the following morning the case was transferred to the owner’s regular veterinarian for ongoing management and subsequent discharge.


Dr Julie Boyle 

foreign body found in a cat

BVSc Cert AVP MRCVS 

Canberra Veterinary Emergency Service

Dr Julie Boyle recently moved to Australia from her home country of England along with her family after having worked throughout the world. 

With her post-graduate qualification in advanced veterinary practice, she has a wealth of knowledge from her 27 years in veterinary practice. 

Dr Kai Goyen 

foreign body found in a cat

BVSc

Canberra Veterinary Emergency Service

Dr Kai Goyen has been a veterinarian for eight years after graduating from the University of Queensland. She has worked in a variety of areas of medicine such as equine practice, rural mixed practice and emergency. 

Dr Goyen recently joined the Canberra Veterinary Emergency Service team to keep her hands in emergency after relocating to her coastal retreat with her husband. 

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