Foreign Bodies – and where to find them

Husky shredding toy

It’s an odd phrase, ‘foreign body.’ It’s like something that a caricature of a 1960s Home Office worker might have found. But of course, when we use it medically, we mean something very specific: an object that has sneaked, or been put, into an inappropriate place in the body. It’s often a vet’s job to get it out.

 

Paws

It’s a good idea, if you can do it safely, to check the feet of a limping animal. I’ve pulled out drawing-pins and flicked out stones that have been caught between some poor animal’s pads, but problems can go far deeper than that.

The classic example is a grass seed. Some of them have very sharp ends and they penetrate the foot, sliding deep into the tissues with barely an entry point. Classically, the client might have noticed nothing at the time, until a lump or an abscess appears a few days later quite a long way from where it went in.

 

Ears

Typically, animals with aural (that is, ear-related) foreign bodies scratch their ears and shake their heads a lot. Sometimes they do this so enthusiastically that they fracture the cartilage of the ear-flap, causing it to bleed. The blood has nowhere to go, but to squeeze into the gap between the ear cartilage and the skin, creating a big, squishy lump we call an aural haematoma (or a ‘haematomato,’ as a nurse I once worked with used to say).

In my experience, aural haematomas are more likely to be caused by itchy skin than something actually stuck down there, but – and here’s the big but – it does happen. Your vet will always look down a dog’s ear in the case of being presented with one.

 

Mouths

If we have something stuck between our teeth, we might prod it out of there with a matchstick. But that’s not so easy without fingers. Neither is it always a good idea for owners to do this for their pets: it really wouldn’t be the animal’s fault if its reaction was to bite. An animal with something stuck in their mouth will often snap their jaws open and shut, or drool a lot, or eat on just one side of their jaw because it hurts to eat with the other. The author has removed huge wads of hair that have been wrapped around the teeth, plastic bottle-tops and also chicken-bones that have been wedged across the roofs of cats’ mouths. You’ve heard people say that one should always look up at a crime scene? The same is true for vets examining mouths. I once found a fishing-hook caught under a tongue as well.

 

Noses

It’s easy to imagine that a nostril is one long hole, but that’s not true. There are some very delicate bones in there that scroll round each other, creating complex passageways – and between them it’s possible for items to get stuck. It doesn’t happen as often as you might expect, because, of course, nostrils have their own protective mechanisms including snot, which flows outward carrying with it unwanted particles and bugs. Dogs, unlike human children, don’t ram things up there with their own fingers. On the other hand, if there are any swellings or strange discharges it can pay to be suspicious, especially if you have a child, and especially if the discharge comes only from one side.

 

Eyes

Eyes, also, have evolved to keep things out of them: the advantages of long eyelashes aren’t just visual and tears can carry small particles away from the face. There’s soft, ‘packing’ tissue around an eye (conjunctiva) to keep it protected and moist and if, for example, grit gets in there, it will produce more and more tears to try to get it out.

This is all very fortunate, because foreign objects can cause a lot of damage to eyes. It isn’t unusual to see erosions, or ulcers, on the surface, where objects have scraped the top-most layer – the equivalent to a cut on the skin. These are very painful and can cost an animal their sight; often a pet can do additional damage by rubbing. You probably don’t need me to tell you that chemical contact can be worse than foreign bodies. Basically, if an eye looks uncomfortable, it’s an emergency.

 

Bottoms

Yes! Sometimes an animal might eat something it shouldn’t which goes all the way through and dangles out of the back end. But beware: if you can only seen one end dangling out, what is keeping the other where it is? The author has seen fishing lines hooked high up in the intestine and the line dangling right along the length of the pet. It’s difficult to imagine the devastation that can be caused if someone pulls on this ‘string’.

As a general rule, if an object has passed all the way to the rectum and can’t get out of there, there’s probably something stopping it. Show it to your vet.

 

Oesophagus

The oesophagus (the ‘food pipe’ from the mouth to the stomach) is quite straight and wide, but things do get lodged in it. These animals tend to bring food back up after eating, often without so much as a retch. Should the blockage continue, the food-pipe can become quite stretched. This is known as a ‘mega-oesophagus’ and even after the blockage is removed, can have a long-term impact on the animal’s ability to swallow. The important thing about swallowing food is that the wind-pipe should be closed off at the same time; unfortunately, mega-oesophagus (whatever the cause) can prevent this, resulting in food particles going down the windpipe instead, causing secondary lung infections ( ‘pneumonia’).

 

Stomach and Intestines

These are very common places for foreign bodies. The stomach, being much bigger and roomier, can sometimes house objects for a while without actually blocking the digestive system. The author once pulled several parts of a deceased teddy-bear from a dog’s stomach before finding the real blockage – a raw potato – further down in the gut. Intestines are much more prone to blockage by virtue of their shape. Peach-stones, condoms, tights, conkers and plastic toys are not uncommon.

Hard or Pointy objects, like bone fragments, carry a great risk of forcing a hole in the wall of the gut, and stringy objects can ‘cheese-wire’ through. Tinsel is a common ‘linear’ foreign body and gives vets nightmares every Christmas; if it gets caught at the back of the tongue, it can cheese-wire holes along the whole length of gut.

Worse still is if the gut’s own blood supply is blocked, in which case the gut goes black and begins to break down. After a short time, the ‘dirty’ gut contents leak through into the sterile part of the abdomen, causing a life-threatening infection called peritonitis. Peritonitis is very common in the pointy-object and the linear-foreign-body cases, too. If the surgeons removing a foreign body feel that part of the gut wall might die off, they will remove the section of gut rather than risk leaving a leak. Where a length of gut has been removed, the two remaining ends are sewn together (anastomosis). These cases always carry an additional risk, and I never say everything’s going to be okay until at least a week later.

 

Conclusions

It can be a lot of fun at veterinary meetings comparing the list of things we’ve removed from animals (mine includes tennis-balls, elasticated knickers and various toys, while my editor has fond memories of a bathroom plug wedged, plug-like, at the exit to the stomach). However, sometimes these cases result in serious injury or death. Keep an eye on what your animal is chewing, eating, standing on, putting their nose into and to consider banning tinsel when it’s Christmas. The bottom line is that accidents do happen and never be ashamed to take your animal for a vet-check: foreign bodies do far less damage if we can see them straight away.

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