Bandit
Bandit - named after the cartoon character "Johnny Quest's" canine companion (!) - is a 6 1/2 year old Lhasa Apso Mix - adopted from Woods Humane Society in 2005. He was named after "Bandit” because he looked like him, sounded like him and was also a little thief! He was adopted by the Gillette family for their young son Wes who had been begging for a little dog to sleep with as all their previous adoptees had been larger black lab mixes.
Demonstrating his "whirling dervish" antics during the adoption interview, the Woods Humane Society Coordinator described him as a "little gremlin" Bandit was a stray and had been out on the streets for some time prior to landing at WHS. He soon acclimated to adopted life and learned to play fetch, groom the companion lab Milo, bark at squirrels and most of all go "in the car" - and if you say it you better mean it, according to Jan Gillette. He got in the habit of stealing shoes (mostly size 12's from Wes's room!) And they would find single shoes strewn throughout the house so they decided to buy him some chew toys instead - and the rest is "his-story"!

Bandit had been to see us over the past few years for routine vaccinations and the occasional foxtail removal, but presented on a Saturday morning for ongoing vomiting over a 3 month period; however on this Saturday he had vomited more frequently than usual. Jan even brought a picture of the "evidence" on her phone - the new technical modality for the explanation and "sharing" of animal symptoms!

His physical exam was fairly normal and he had a normal body temperature so we discussed the myriad of possibilities related to "dietary intolerance” - causing ongoing gastrointestinal upset including gastritis, pancreatitis (an inflammation of the pancreas associated with high fat ingestion), foreign material and foreign body obstruction. He was having normal bowel movements at the time of presentation so it was decided to run baseline blood work and treat with famotadine (Pepcid) and a bland, low fat diet trial.
The "in-house” baseline panel was within normal limits except for mild hemoconcentration (mild dehydration) and a slight increase in a certain type of cell called "neutrophils" - which can indicate a mild inflammatory response. This helped us rule out conditions such as pancreatitis and the need for immediate hospitalization so he was treated with "SQ" fluids (Lactated Ringers Solution administered under the skin) and an "anti-nausea" injection.

On Sunday we called to check on the "B" - and were told that he had not vomited in the last 24 hours but still seemed slightly "punk". He had gone for his walk and had a normal bowel movement but they did state that his urine seemed slightly "darker" than normal - so again, we discussed a radiograph or ultrasound exam to further assess the abdomen.

On Monday, Bandit re-presented for ongoing lethargy and anorexia (lack of appetite) and even though his physical exam and abdominal palpation was again within normal limits, his abdomen did seem slightly distended. Based on the chronicity (approximately 3 months in duration) and presentation, an ultra-sound exam was performed. We could visualize a mass in the area of the pylorus which is the "aperture" by which the stomach contents enter into the duodenum = the first part of the small intestine. The remainder of the ultrasound exam was within normal limits so we knew the pathology (disease process) was limited to this one area of intestine. However, we could not discern from the ultrasound exam if what we were seeing was a mass, tumor or foreign body - so it was decided to stabilize him that night with intra-venous fluids and antibiotics and perform exploratory surgery the following day.
On Tuesday, Bandit was taken to surgery and Dr. Cherbinsky discovered a part of a KONG chew toy in the duodenum and was able to remove it through an enterotomy (incision into the intestines). Bandit made an uneventful recovery - which is the way we like it - and returned home to resume his daily activities and squirrel monitoring!

This case just goes to show the body’s ability to adapt as the foreign body had remained in the stomach for weeks but only became problematic when it became lodged in the duodenum - so dogs and cats can survive with gastric foreign bodies but once they enter the small intestine, may cause intestinal blockage and subsequent deterioration. The vast majority of offending agents that dogs and cats eat will pass in time but when they don't, we must surgically intervene. So for now we will let Bandit dream of chewing on shoes and offer him a safer, non-destructible alternative in the chew toy department!