Stomach not contracting

Hello, I have an almost 2 year old cockapoo, a couple of weeks ago she vomited then she was fine for a few days then vomited again, this went on for about a week and we did take her to the vets when the last time there was speckled blood in her vomit. We were given pain relief and omeprazole to try, we brought her home and a couple of days later she was sick again so back she went. They did blood tests which came back clear and an ultrasound which showed no obstructions but did show that there was something in her small intestine kind of slopping back and forth and wasn’t passing through like it should, she was given an injection to help pass it. A few days later she vomited again so back into the vets she went, she was rescanned and that stuff still hadn’t passed. They suggested surgery so we went ahead. They found that her stomach was still and wasn’t contracting like it should, they found no obstructions or foreign bodies, she came home with pain killers and a medication to help her stomach start contracting as normal again. I can’t help but feel the surgery was unnecessary and am worried the meds aren’t going to fix the problem. If she doesn’t improve and the meds don’t work, what would the next steps be? And do you think the surgery was rushed or it was necessary to do? Thank you so much to anyone that takes the time to read this and reply.

Hello - I hear your frustration and trust that your vet was equally as frustrated.  The answer, of course, is a quibbly one:  what did you mean when you say that the surgery felt unnecessary?  If you mean that your dog would have been no worse off if they hadn't have had the surgery in this case, then from the information that you have given me, I am inclined to agree.  However, the real question is, whether your vet could have predicted as much before the exploratory laparotomy took place, or whether they needed to carry out the surgery in order to know that your dog was safe. If the exploration had found a foreign body and thereby saved your dogs' life, then you would all have been very pleased that it took place.  I was an emergency surgeon at one stage in my career and have attended whole lectures on the subject:  'to cut (operate) or not to cut.'  The  decision is regrettably not always clear cut and if all foreign bodies are to be found in good time, then it may be inevitable that some 'negative' exploratory laprotomies (ie surgeries that dont help anything) take place.   Now, I cannot see the scans and may be no more experiencd in this area than your veterinary surgeon, so I am not the person to judge the decision that your vet made.   You could ask the vet retrospectively about their decision, or ask an ultrasonography or surgical expert to review the notes and say how they would have called it.  Your vet may already have asked the same of their colleagues, because in my experience, vets are perfectionists and put a lot of pressure on themselves to 'call it right' every time.  The bottom line is that I would always rather explore the gut and find nothing than fail to explore the gut and miss something.  The reality is that a GP vet acts at hospital-consultant level in a number of different disiplines (your human GP would never have to make such a call) and that in order to at peace with themselves, vets have to accept that we probably do more negative ex-laps than our human medical colleagues.   I hope that something here helps.

You asked about the next stage of proceedings;  I suspect that this is another question for your vet.  It may help communications to establish 'What did the exploratory laparotomy successfully rule out?' and 'What is left that could still be going on?' and 'what can you do to tell the difference between these possibilities?  What is our first step?'  After that, if the problem doesn't resolve, you may want to ask, 'How can we tell the difference between the various things that could still be going on here?'  and 'Would it help to refer this case to a medical or gasterointestinal expert?'

Some Posts from our blog that may be of interest.  You may have to cut or paste the links into your browser, or search for the key-words using the search-function of our blog. Vomitig in dogs  - when is surgery indicated?  https://vethelpdirect.com/vetblog/2021/05/26/vomiting-in-dogs-when-is-surgery-needed/#h-when-might-surgery-be-necessary What happens when your vet does an ex-lap? https://vethelpdirect.com/vetblog/2020/09/02/what-happens-when-your-vet-does-an-ex-lap/ I have also reread your first post and seen that a potential positive finding did come out of the surgery; that the gut wall was less motile than expected.  This may inform future treatment or investigations. Wishing you and your dog all the best from here.