April 20, 2011

Rookie's Foreign Body

Rookie waking up from anesthesia.
Rookie is a 2-year-old male domestic shorthair cat who was recently admitted to CUVS. Rookie's owner noticed a couple things that spurred her to bring Rookie in: he had started acting differently and dry heaving occasionally without bringing anything up. He was eating and drinking less than normal and his bowel movements were infrequent. As an indoor cat, Rookie normally doesn't get into much trouble (besides finding hair ties on the floor and batting them around). However, his owner also noticed a lump that had formed under Rookie's jawline, and at that point she decided to bring Rookie to CUVS.
Close-up view (inset) of the end of the needle (with black thread) embedded in Rookie's throat. Click to enlarge image.
Rookie was seen by emergency veterinarian Dr. Michael McCann, DVM, who performed a physical exam and found that Rookie had an elevated temperature, and that the composition of the submandibular mass was abnormal. Palpation of the mass revealed the suspected presence of a hard object within the swelling. Together, Dr. McCann and Dr. Melissa McDaniel, DVM, MPH, performed an exam of Rookie's mouth and throat. A sharp metal object was seen protruding from the right ventral oropharyngeal region, just caudal to the back of the tongue (behind the tongue, protruding from the bottom right side of the wall of the throat).
Two radiographic views showing the location of the foreign body.
Dr. McCann ordered two radiographs of the neck and head. A linear metal object of uniform thickness from end to end was visualized adjacent to the mandible. Rookie was then intubated and prepared for surgery to remove the foreign object. A hemostat was clamped onto the foreign object from within the oropharynx to prevent accidental loss of the object into the mouth upon removal. An incision was made in the skin just over the top of the mandible, not only to easily remove the foreign object, but to allow the wound to drain afterward. The incision revealed the foreign object to be a sewing needle with a few millimeters of thread still attached. The needle and thread were removed, along with some purulent debris (commonly called pus). The wound was cultured and sent out to the lab for analysis, and it was thoroughly irrigated with sterile saline.  The surgery went very well and Rookie recovered uneventfully.  Rookie spent the night at CUVS to continue to receive supportive care, pain medication and antibiotics. The next morning he was discharged back into the care of his observant and concerned owner with more antibiotics and pain medication. 

Close-up of the needle and thread removed from Rookie's throat.
While the above case sounds fairly simple and uneventful, it should be noted that this particular cat was very lucky: lucky to have an attentive owner, lucky to be seen quickly at a high-tech animal hospital, and lucky that he did not sustain more serious injuries from ingesting the needle. This is a great reminder to all of us: cats and dogs frequently play with and explore objects with their mouths. This is a natural behavior that can lead to big trouble if they find something dangerous. We should all take the time to pick up and put away anything potentially harmful to our pets so we can keep them safe.

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