This week we have a 1 year old female Miniature Schnauzer who has been lethargic and anorexic for two days. Take a look at the images and post your comments and questions.
1 year old Miniature Schnauzer
Teaching and learning about veterinary diagnostic imaging.
There is a radiopaque FB in the pyloric antrum. On the left lateral view it does not fall to the dependent side, which suggests that it is lodged in there.
The SI loops are distended with fluid, but still measure within normal limits.
I am not sure, but the peritoneal details may be increased, which may indicate pneumoperitoneum.
There is a metalic object in the pyloric antrum that has the appereance of a coin or a washer. Given the history of dark urine I would be suspicious of a zinc toxicity. Does blood work show any suggestion of hemolysis? Regardless, the patient will benefit from a endoscopy in an attempt to remove the foreign body. The metalic object appear to have a soft tissue halo on VD view but I believe that it is gastric wall inflammation (please correct me if I am wrong). I would try to palpate the object if I am not able to do so I would still do endoscopy first ( if i have the resources) and if unsucessful I will consider exploratory laparotomy. All pending on the clinical picture of the patient.
In reference to suggestions about our weakness I believe that the abdominal foreign bodies are the most challenging cases for me. In the last 2 months the clinic where I work had 3 cases that were manage pretty conservative and patient end up death due to peritonitis. In order words I would be really interested in picking up small details in plain radiography that would be suggestive of a linear or an obstructive foreign body (mostly on early stages).
Right, there is a gastric foreign body that looks like a coin. The center of it has been dissolved by the gastric acid creating a radiolucent area. Zinc toxicity is particular to American pennies post 1983. There is a clue in the history given within the case that might help you with the diagnosis.
I agree that gastrointestinal obstructions take some practice to recognize. I’ll see if I can put something together for improving your skills.