2. ANIMAL
• Species – Canine
• Breed – Spitz
• Age – 4 years
• Sex – Male
• Color - Grey
3. HISTORY
• While administering a liquid dewormer in the metal cap of the bottle,
the cap accidentally fell into the opened mouth of the dog and it
swallowed it at once
• Immediately, careful examination was done by the owner and his
family in the oral cavity of the dog and later, he confirmed that the
dog swallowed the lid
4. • The incidence happened on the day before the day of presenting the
dog to the hospital
• After the incidence, the owner gave only water and was taken to the
clinic the next day morning.
• Luckily no attempts were made by the owner to extract the metal lid
by himself
5. CLINICAL SIGNS
• No specific clinical signs were observed
• The dog showed no sign of any GI disorder
• Appetite was there for the dog but since the aware owner did not
give any solid diet, the condition of the animal was exclusively
healthy. The dog was fed with ad libitum water
6. CLINICAL EXAMINATION
• Conjunctival mucosa normal
• No abdominal tenderness
• Had passed stool some time back
• Color of stools normal showing no GI bleeding
• No much of abdominal palpation was attempted due to fear of
Gastric tear / perforation or injury
7. SPECIAL TESTS
• Lateral plain abdominal radiograph in a single plain was taken to confirm
the presence of semi radiolucent round foreign body with the shape of a
metal bottle cap inside the lower gastric lumen
• Ultrasonography was done to locate the foreign body. As the metal cap
was seen located just proximal to the pylorus as hyperechoic round mass
with that shape
15. DECISION
• The owner was educated about the management and convinced that
with out a surgery the pet cannot be rescued
• With the consent of the owner, it was decided to extract the gastric
foreign body by Laparotomy followed by gastrotomy
• Gastroscopic transesophageal extraction and leaving into the
duodenum was excluded due to fear of GI injuries
16. HEMATOLOGY
• TEC - 5.8 mill / cmm
• TLC - 11400 cells / cmm
• Platelets - 2.3 lakhs / cmm
• Hemoglobin - 14.6 Gm %
• DC - N – 47%, L – 36%, E – 3%
• PCV - 35 %
• No microfilaria or other BP could be detected in smear as well as wet
film
17. BLOOD BIOCHEMISTRY
• ALT - 35 U / L
• AST - 46 U / L
• S. creatinine - 1.3 mg / L
• BUN - 48 mg / L
• S. cholesterol – 127 mg / L
18. ANESTHESIA
• Induction – Glycopyrrolate injection (COROLATE) @ 0.05 mg / kg i/m
followed by Xylazine (XYLAXIN) @ 3 mg / kg i/m
• After sedation, GA plain 3 was achieved by i/v administration of
Ketamine (ZOKENT) @ 5 mg / kg followed by Diazepam (CALMPOSE)
@ 0.5 mg / kg i/v
19. • Maintenance of Plain 3 GA was achieved by incremental
administration of 1:1 mixture of Ketamine 50 mg/ml and Diazepam
10 mg/ml intravenously till sufficient anesthesia and abdominal
muscle relaxation is maintained
• Maintenance anesthetic solution was infused through the i/v line of
DNS administered through out the surgery
20. SITE AND APPROACH
• The left paracostal site was chosen
• The prepared site was then sterilized as per routine procedure of a
laparotomy.
• The patient was placed on right lateral recumbancy
21. STEP 1
• A 2 inches long Laparotomy incision was put through the paracostal
area of left side
• Careful dissection of subctaneous facia and generous ligation of
bleeding vessels
• Incision extended into the peritoneal cavity by careful dissection of
abdominal muscles
22. STEP 2
• Stomach was grasped with the fingers and exteriorized and the
foreign body could be palpated and partially seen through the
delicate wall of the stomach
• The borders of the laparotomy incision was packed with sterile
cotton to avoid contamination of the peritoneal cavity with the
gastric contents while gastrotomy
23. STEP 3
• A 2 cm long incision was put on the gastric wall on the less vascular
area of the greater curvature over the foreign body grasped with the
thumb and fore finger of the left hand
• The metal lid was gently squeezed out through the gastric incision
• Excess gastric contents were wiped out
24. STEP 4
• The gastrotomy incision was closed with full length Connel’s suture
followed by a row of Lembert’s suture with 1/0 medium chromic
catgut to produce inversion
• The stomach was then irrigated with warm saline and gently and
carefully replaced into the left subhepatic region in the original
position
25. STEP 5
• Laparotomy wound was closed by simple continuous suture with No
0 medium chromic catgut with a second row of relaxation sutures
• Skin was closed by horizontal mattress sutures
46. POST OPERATIVE
• Ceftrioxone Tazobactum combination (INTACEF TAZO) 632 mg was
given i/m daily as post operative antibiotic
• Ketorolac injection 10 mg was given i/m on the day of surgery
• The recovery from anesthesia was uneventful
• The owner was advised to offer liquid diet only and after 24 hours
47. • Antibiotic ointment was prescribed for external application over the
skin incision
