The Risks and Dangers of Foreign Body Ingestion.
John R. Pisciotta D.V.M.
When an animal eats food, it normally travels from the mouth through the esophagus and into the stomach. Food is then stored in the stomach and mixed into a gruel where it is slowly pushed into the intestines. This gruel easily weaves its way through the narrow lumen of the small intestines while being digested and absorbed. What is left over ends up in the large intestines in the form of stool. The colon adsorbs water and electrolytes and stores the stool before it is expelled as feces.
It normally takes 10-24hrs for food to make its way through the entire gastrointestinal system of a dog. A swallowed object or "foreign body", as it is called, can have problems following this path normally reserved for food. Problems can occur in any area of the gastrointestinal system, although stomach and small intestines are most common. By the time an object makes it to the large intestines, the difficult part of the journey has passed. Large intestine/colon foreign body problems are rare. Foreign bodies are more common in dogs than cats while puppies have more problems than older dogs.
In the mouth, objects can get caught between the teeth or across the palate. When this happens, animals usually salivate, paw at their mouth and act in distress. Bones and sticks are the most common foreign bodies in this area.
Less frequently, foreign objects can cause problems in the esophagus. When an animal tries to swallow an object that is too large, especially one with an irregular surface it can get caught in the esophagus. Bones and fishhooks are commonly found in dogs, while cats are often seen with needles. Salivating (potentially bloody), gagging and regurgitating are signs often seen in animals with esophageal foreign bodies.
Stomach foreign bodies are common. Occasionally a foreign object, depending on its size and shape, uneventfully stays in the stomach for an extended period of time. Objects such as smooth balls can literally bounce around the stomach without ever being "pushed" into the intestines. I recall a basset hound with a golf ball in its stomach. It was an incidental finding causing no problems. Eventually it broke apart enough to pass through the intestines without causing a problem. My client noticed pieces of the ball in the stool years later.
Foreign objects in the stomach can cause vomiting, anorexia, lethargy, depression, decreased appetite and weight loss. Objects I have removed from the stomach of dogs and cats include: coins, bones, rocks, bottle caps, pacifiers, erasers, hair bands, balls, corn cob, wood, peach pits, socks, underwear/panty hose, toys, t-shirts, towels, zippers, string, sponges, gloves, shoe parts, baseball leather, stuffed animals, a fully intact bird, and a mostly intact Nerf football.
Intestinal foreign bodies are also common. Here the concern is blockage- when an object gets stuck and can't move. Clinical signs can include vomiting, diarrhea, anorexia, depression, and pain. Damage to the intestines can result in leakage. This is life threatening and a surgical emergency. Smaller objects with irregular surfaces and objects that expand in the intestines are problematic. Peach pits, corncobs, sponges and cloth products are common in dogs, while string is most common in cats. Erasers seem particularly common in ferrets.
Diagnosing a foreign body can sometimes be difficult. Your veterinarian will perform a physical exam and usually recommend an x-ray. Some foreign bodies are obviously seen on x-ray and the diagnosis is easy. These objects are described as radiopaque. Your veterinarian may recommend additional test if a foreign body is suspected but not obvious on physical exam or x-rays. Further tests may include a barium swallow, ultrasound, endoscopy, and blood tests.
Treatment of gastrointestinal foreign bodies depends on location and severity. Bones and sticks in the mouth can usually be removed with an animal under light sedation. A flexible endoscope can retrieve objects caught in the esophagus or push them into the stomach. Small objects in the stomach or beginning of the intestines can usually be retrieved with an endoscope. Most larger stomach foreign bodies and intestinal foreign bodies will require surgery to remove. This usually involves a few days of hospitalization.
The perfect toy doesn't exist. Any object an animal puts in their mouth and chews could possibly cause a problem. One should never offer a toy that is potentially toxic. Avoid toys made of materials that are easily compressed and swallowed only to re-expand in the stomach. This would include any foam or sponge types, as well as some materials and certain kinds of rubber. Stay away from hard plastics or composites that are easily broken up into irregular, jagged, or sharp pieces and swallowed. These can get caught in the smaller loop of intestines. Its also important to avoid any toys with long string or rope attachments. Even certain materials can be chewed, torn or shred into strips that can act as a string or "linear foreign body". Intestines tend to bunch up on these type products when swallowed. A linear foreign body can actually "saw" through and severely damage the intestines during routine peristalsis (intestinal contractions). As noted earlier, string problems are particularly common in cats.
The benefits our pets gain from appropriate toys can far outweigh the risks posed by unsafe options. Always offer your pet the safest products you can find. In an attempt to minimize problems with foreign body ingestion in your pets, try to avoid the more obvious and common objects that cause problems. New items should only be offered under supervision. Offer appropriately sized toys that fit your pet's activity level and chewing style.
Aggressive chewers will require harder objects less likely to be easily destroyed. Other animals have softer chewing styles satisfied with more plush items. Routinely examine toys for damage or missing parts and replace as necessary. By offering a variety of toys and rotating them on a regular basis, you can help keep your pet interested in safer chewing alternatives.
