As mentioned in last weeks post, here is our very first case study!
Case Study #1
| Patient: Fiona | |
|---|---|
| Age: 2 yrs | Breed: Domestic Shorthair (DSH) |
| Species: Feline | Colour / Sex: Grey / Spayed Female |
At the physical exam..
| Subjective Findings |
| – 2 year old spayed female cat |
| – History of vomiting with blood present for past 2 days |
| – Not eating/drinking |
| Objective Findings |
| Bright, alert, and responsive (BAR) – This is a good sign because an animal in severe discomfort will often not present as BAR. |
| Pain on palpation of cranial abdomen – Indicator that there is discomfort in this region but still unsure what the cause is. |
| Temperature, Pulse, Respiration (TPR) were all normal – Depending on chronic vs acute stressors, we can see elevated TPR in response. |
| Mucous Membrane = Pink and Moist – Since patient is presenting with blood in vomit, pink mucous membranes are an indicator of sufficient blood circulation and decreases the risk of severe internal bleeding. |
| Assessment |
| Differential Diagnosis: Foreign Body / Obstruction / Bacterial Infection / Stomach Ulcer |
| Plan |
| 1. Full Blood Panel – Complete Blood Count and Biochemistry |
| 2. Thoracic and Abdominal X-ray |
The Results.
Blood Work results came back normal and nothing stood out as concerning.
On the other hand, x-ray images showed an opaque irregular foreign body in the cat’s stomach.
This mysterious object could have been a few things including: bone, dense plastic, metal, glass, etc.
So, what now?
After discussing with the owner, the best approach was to intervene with exploratory surgery. Fiona was clearly in discomfort and it would only continue to weaken if she continued to lack appetite.
On top of that, if we wait much longer, there is a very real risk the object could either pass the stomach and enter the small intestines, cause lesions to the surrounding tissue, or potentially both.
This would make a big problem even bigger. Surgery made the most sense and so we began prepping the patient.
Surgery Time.
First off – Surgery was a success.
The type of surgery performed is called a gastrotomy where a surgical incision is made along the side of the stomach.
After some poking around, we found a chunk of glass about 2 cm x 3 cm in size.
Relative to the cat’s size, this was a HUGE piece to swallow!
Examining the surrounding tissue and structures, the esophagus and diaphragm appeared normal and not affected by the sharp glass. The liver was also normal and unaffected.
The incision was sutured and stress tested to make sure the sutures hold. Recovery went well and the owners took Fiona home that night!
WHY did Fiona eat the glass?
We may never know for sure, but the owner thinks there is a good chance Fiona came across this from a recent kitchen accident and it must have smelt appetizing enough to eat.
Next thing you know, we’re doing an emergency foreign body surgery.
The Recovery Process
The next few days following surgery were the most crucial in the recovery process.
We needed to make sure the cat regained it’s appetite and started eating again, but not too much food at once!
It’s important to get food into the body, but we don’t want to overload the stomach after such an invasive procedure. Slow and consistent feeding is the best approach here. Also, we prescribed a moderate calorie gastrointestinal diet by Royal Canin to help minimize stress on the digestive system by giving a food that is easily digestible.
We called the owner and followed up the next few days and luckily things were going well. Within 24 hours the cat was eating again and in much better spirits! No more episodes of vomiting and bowel movements (poops) were a back to regular.
Classic case of a cat half full (of glass).
The End
I mention “We” a lot in this case study. I refer to We more so as a collective group of people involved in the healthcare of your beloved animals.
The credit in this case really goes to Dr. Harnoor Bhinder based out of Cambridge, ON, Canada.
Dr. Harnoor is a veterinarian who has been practicing small/companion animal medicine for the past 5 years. I have had the pleasure of working with him for 1.5 of those years.
We have become great friends, and soon, veterinary colleagues.
I will do my best to bring justice to some of the work that he and his team of dedicated staff perform at the clinic.
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