Outcomes of dogs undergoing immediate or delayed surgical treatment for gastrointestinal foreign body obstruction: A retrospective study by the Society of Veterinary Soft Tissue Surgery

Abstract

Objective: To evaluate gastrointestinal injury and outcomes between dogs treated with immediate surgical intervention vs those treated with delayed surgical intervention for gastrointestinal foreign body obstruction (GIFBO). Study design: Retrospective cohort study. Sample population: Client-owned dogs (n = 855) from five referral hospitals. Methods: Medical records of dogs in which GIFBO had been diagnosed between 2007 and 2017 were reviewed for preoperative management, timing of surgery, intraoperative findings, postoperative management, outcome, and survival. Surgical intervention was classified as immediate when it occurred within 6 hours of presentation and delayed when it occurred >6 hours after presentation. Results: Outcomes did not differ between dogs treated immediately (n = 584) or over 6 hours after presentation (n = 210). Intestinal necrosis and perforations were more common when surgery was delayed (P = .008; P = .019) but became nonsignificant after controlling for preoperative differences. Risk factors for necrosis and perforations included duration of clinical signs, increased lactate, linear foreign material, and timing of surgery. Enterectomies (P = .004) as well as the duration of surgery (P = .004) and anesthesia (P = .001) were increased when surgery was delayed. Immediate surgery was associated with earlier return to feeding (P = .004) and discharge from the hospital (P < .001); (5%) dogs in each group (n = 33 immediate; n = 11 delayed) either had a negative explore or the foreign body was milked aborally into the colon at the time of surgery.

Surgical removal of intestinal foreign bodies using a laparotomy‐assisted endoscopic approach in dogs and cats and comparison with enterotomy

“…Manoeuvring the FB into the colon during laparotomy was also cited (Maxwell et al . 2020). Complications inherent to an enterotomy or gastrotomy are the risk of gastric or intestinal dehiscence, peritonitis by spillage of digestive content and prolonged surgical time.…”

“…2019, Maxwell et al . 2020). No complications were reported after laparotomy‐assisted transoral FB retrieval using a grasping instrument, but there was no follow‐up or endoscopic evaluation of the oesophagus and stomach (Power et al .…”

“…2014, Maxwell et al . 2020). Most major complications are related to the intestinal incision, which was not performed in the LAEA group and can explain our absence of major complications.…”

“…Mechanical FB obstructions affect the integrity of the bowel by causing alterations in gastrointestinal blood supply with luminal distention and subsequent increases in intraluminal pressure (Maxwell et al . 2020). If untreated, intestinal obstruction can progress to intestinal wall oedema, mucosal ischaemia, necrosis and eventual perforation.…”

“…2014, Maxwell et al . 2020). Dehiscence of full‐thickness intestinal incisions and subsequent leakage of intestinal contents into the abdomen results in septic peritonitis (Grimes et al .…”