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Upset Stomach?

Unfortunately our canine friends can be indiscriminate eaters and may swallow anything they can get their paws on. It is hard to know what they may have quickly gobbled into their mouth at times and thus, we may need to watch them carefully for signs that they may have eaten something they should have. Typically we call any material or items that our pets eat that are not food, a “foreign body.” These may cause mechanical problems, or be toxic, sharp, or irritating – causing a veterinary emergency!

The effects of eating things may be drastically different. Some things may easily pass and not cause any harm. Some things may pass although cause extreme inflammation/damage to the stomach or intestines…. and some things unfortunately, may get stuck. It is not always easy or even possible to determine which one of these outcomes will occur, however our emergency and urgent care team can guide you through the best way to figure it out.

If you did not notice them eating anything specific, the first signs you may see that there is a problem may include, lethargy, anorexia, vomiting, or simply being uncomfortable or stretching/laying in the “prayer position.” Unfortunately these may also occur for many other cause of stomach upset, and as emergency veterinarians, it is our job to figure out if we have a foreign body or one of the other many causes.

Physical exam may reveal a painful or distended abdomen, however some patients are very stoic and will not show any signs on physical. The next step includes testing. We will typically recommend blood work or X-rays of the abdomen as the first step. Changes in blood work may reveal an alternate cause, or changes in electrolytes that may be consistent with a blockage.

X-rays are usually the most useful modality to locate a foreign body. Unfortunately, most things that could be causing an obstruction may not “show up.” This means that a small piece of fabric and even many plastic toys or other objects will blend in with the organs and other tissue in the abdomen and be hard to see. Of course, rocks, bones, and other very dense objects will be much easier to see. If we cannot see an exact object, the next step is to look at the gas patterns and width of the intestines. Typically gas and fluid will build up behind something that is stuck.

If clinical signs, physical exam, and progress are all consistent with a foreign body obstruction but we cannot see anything exact and the gas pattern is not severe enough to be sure, the next step will either be a surgical “explore” or an abdominal ultrasound. Many times we can confirm foreign bodies on ultrasound, however, sometimes it is still unclear whether the object is completely obstructive and the only way to know for sure is to perform a surgical explore.

If all diagnostics are inconclusive, we will discuss options to perform surgery or to start medical treatment for gastrointestinal upset and repeat diagnostics in 8-12 hours.

In summary, an upset stomach and a foreign body can have similar or the exact same clinical signs, and it requires diagnostics and clinical progress to confirm which cause it may be. Our best advice is to bring your pet in immediately with any concerns, so that we can help you step by step to figure out what may be going on and how to solve it as well as possible.

Author: Dr. Edward Aller

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