my canine patients and I have no doubt that I will continue to do so. I have removed pantyhose and a ladies bra; I have taken out tennis balls, stones, pieces of seaweed, plastic toys, matchbox cars and many other items of little nutritional value. I have also removed foreign objects such as bones and toys from the oesophagus of some of my patients. I once used a snare and an endoscope and a lot of patience to remove a dummy from the stomach of a poodle, but what stands out the most in my memory is the case of the dog that swallowed a steel sosatie stick.
At the time I had a job at a veterinary hospital in the east of London in the UK and had been there for about three months. The work was routine stuff and included all the usual itches, lumps and bumps, cuts and broken bones – common injuries and ailments that do not tax one’s diagnostic or surgical skills. Amidst all the everyday procedures I got a most unusual case – one that challenged not only my skills but also my imagination.
The practice had late consulting hours and we closed only at 10.30 pm. During the course of the evening a client came in with his male Labrador, Jake, and with a quickening pulse I listened to him describe how his dog had just swallowed a sosatie stick. He’d been bar-b-queuing sosaties on the fire and Jake had helped himself. In his haste to make sure he got to devour this treat, he swallowed the whole lot in one gulp. I told the client that while sticks can potentially be a problem, they are more often than not broken up by the acidic digestive juices in the stomach. Jake was looking singularly unconcerned. I could see that the stick had not pierced his throat and so I assured his owner that the stick would probably not cause any problems. Close observation for a couple of hours but I felt sure that he’d be fine. ‘No, no,’ said the client. ‘You don’t understand. It wasn’t a wooden stick. It was stainless steel – look!’ He produced a long stainless steel skewer that must have been thirty centimetres long and five millimetres in diameter.
I looked at it in disbelief and dismay. ‘Are you absolutely sure?’ I asked. Surely he must be mistaken. But Jake’s owner was adamant. He knew exactly how many sosatie sticks he had ordered and was convinced that the missing skewer was in Jake’s tummy as he had actually seen Jake tucking in. Talk about a sword swallowing act. I told him that the easiest way to make sure was to take an abdominal x-ray. If there really was a steel sosatie stick in his stomach, it would be pretty easy to see. I silently had my doubts. I was convinced that if the owner went home and had a better look, he would find the sosatie stick and then we would all be able to relax. Jake’s owner agreed to the x-ray and we wasted no time in taking the image.
But even as the x-ray was coming out of the processor I could see, to my horror, a large steel skewer with a loop at one end and a sharp point at the other. I took the x-ray to the light box and beckoned the owner over to have a look. He was absolutely right. But how on earth did the dog actually swallow the thing without skewering himself? I don’t think I’ll ever know the answer to this question, but swallow it he did because there it was, clear as daylight, in his stomach. There was no way it was going to be neutralised by his digestive juices and it certainly was not going to pass through. The only way that I was going to get it out was through surgery.
My big concern was that the steel spike could perforate his stomach at any time and this would certainly cause major problems. My other concern was that Jake had eaten. An empty stomach before surgery safeguards the patient against gastric reflux, which is when semi-digested food is vomited into the patient’s mouth and then breathed into the lungs before it can be ejected. This can cause foreign body pneumonia, which can be very serious. However, I felt that surgery was the lesser of the two evils.
Once the consent forms were signed, I anaesthetised Jake and prepared for surgery. I had another good look at the x-ray and noticed that the end of the loop was open; it looked almost like a question mark. I wondered if this might help me in retrieving the skewer.
I always like to have more than one plan before surgery. In this case I had two plans. The first was to open up the stomach and take out the skewer, and the second one was a thought that I had just in fact formulated. I was going to try and push the skewer, sharp end first, through the wall of the stomach without first making an incision into the stomach. I would then try and feed the skewer through and when I got to the loop end, I would manipulate it through the small stab incision made by the sharp end of the skewer.
The instruments were laid out and the nurse and I were ready. I grasped the scalpel and forceps and made a bold incision into Jake’s abdomen. Once I had a big enough incision, I was able to grasp the stomach and believe it or not, I could clearly feel the steel sosatie stick through the stomach wall. I located the looped end of the sosatie stick. I then felt for the sharp end and, using one hand to guide the sharp end and the other to push the looped end, I pierced the stomach wall. Pushing gently, I gently manipulated the steel skewer through the stomach wall. It was working beautifully. When I got to the looped end, I managed to continue to feed the skewer through by wiggling it and allowing the stomach wall to follow the loop. Goodness, there it was, in its entirety. I had removed it without making an incision. There was just a tiny puncture wound in the stomach and I closed this off with a single suture. With a sigh of relief I looked at my handiwork and then glanced at the clock. The entire procedure had taken not much more than thirty minutes.
Jake recovered quickly and was ready to go home after two days. Carefully packed in a plastic bag, the sosatie stick was given to his owner as a souvenir of Jake’s most expensive meal to date. The x-ray of Jake’s sosatie stick was framed and to the best of my knowledge still hangs proudly in the surgery – a memento of one of the strangest items ever taken out of a dog’s stomach.
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