Intussusception calls for exploratory laparotomy

Intussusception calls for exploratory laparotomy

Oct 01, 2003

Signalment: Canine, Golden Retriever, 6 months old, male, 46 lbs.

Image 1 and Image 2.
Clinical history: The puppy first presented three weeks ago for intermittent diarrhea, weight loss and being very thin. The puppy was eating acceptably. The puppy was treated with metronidazole, Albon, bland food, Drontal, Rimadyl and amoxicillin. The puppy presented last night for worsening diarrhea, vomiting, and not eating. The puppy was admitted for intravenous fluids and radiographs.

Physical examination: The findings include rectal temperature 102.8° F, heart rate 160/min, slightly pale mucous membranes and normal capillary refill time. Normal heart and lung sounds are heard. The puppy is quiet, alert and responsive, and is extremely thin, wasting muscle mass, fluid-filled abdomen and segment of thickened bowel.

Table 1: Results of laboratory tests
Laboratory results: A complete blood count, serum chemistry profile, and urinalysis were performed and are outlined in Table 1.

Radiograph examination: The thoracic radiographs are normal. The abdominal radiographs show multiple gas-distended loops of bowel and fluid filled abdomen.

Ultrasound examination: Thorough abdominal and right ocular ultrasonography was performed.

Image 3 and Image 4.
My comments: There is a small amount of free fluid accumulated within the abdominal cavity. The liver and gall bladder are not seen. The spleen shows a uniform echogenicity in its parenchyma - no masses noted. The left and right kidneys are similar in size, shape and echotexture. No masses or calculi were noted in either kidney. The urinary bladder is distended with urine and contains some urine sediment material - no masses or calculi noted. There are what appears to be bowel loops seen inside bowel loops.

Case management: In this case, most likely intussusception or lodged foreign body with intestinal obstruction is the clinical diagnosis. No matter what, an exploratory laparotomy needs to be done. It is possible that these latest signs shown by this puppy have just happened in the last 24 hours.

Review of intussusception An intussusception is a telescoping of one segment of the intestinal tract into an adjoining segment of intestinal tract. Intussusceptions are seen in all dog breeds. It is seen in all age animals, but it is more common in young dogs, with the exception of intussusceptions secondary to tumors, which are more common in older dogs.