What Is Your Diagnosis?

Holly A. Phelps Georgia Veterinary Specialists, 455 Abernathy Rd, Sandy Springs, GA 30328.

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 DVM
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Gustavo Sepulveda Georgia Veterinary Specialists, 455 Abernathy Rd, Sandy Springs, GA 30328.

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 DVM, MS, DACVR
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Lisa L. Langs Georgia Veterinary Specialists, 455 Abernathy Rd, Sandy Springs, GA 30328.

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 DVM, DACVIM

History

A 3.5-year-old spayed female Miniature Pinscher was initially evaluated for acute abdominal pain. Just prior to admission, the dog had started whimpering, jumped off the couch, and started biting at its flank. Appetite was normal, and there was no history of vomiting or diarrhea despite recent garbage ingestion. Physical examination was unremarkable with the exception of signs of pain on palpation of the cranial portion of the abdomen. Blood parameters measured with a portable clinical analyzer were within reference limits. Radiographs of the abdomen were obtained (Figure 1).

Figure 1—
Figure 1—

Lateral (A) and ventrodorsal (B) radiographic views of the abdomen of a 3.5-year-old female Miniature Pinscher evaluated for acute abdominal pain.

Citation: Journal of the American Veterinary Medical Association 235, 5; 10.2460/javma.235.5.507

Determine whether additional imaging studies are required, or make your diagnosis from Figure 1—then turn the page

Diagnostic Imaging Findings and Interpretation

A large amount of ingesta in the stomach is evident (Figure 2). Vomiting was induced, producing only a small amount of bile. No other clinical signs were observed until 2 months later when the dog was evaluated for a 24-hour history of vomiting and diarrhea. Food was withheld by the owner at the onset of vomiting. Mild dehydration and fluid-filled loops of intestines were identified on physical examination. Hematologic values were within reference limits. Abdominal radiography was performed (Figure 3).

Figure 2—
Figure 2—

Same lateral radiographic view of the abdomen as in Figure 1. Notice the large amount of ingesta in the stomach (arrows).

Citation: Journal of the American Veterinary Medical Association 235, 5; 10.2460/javma.235.5.507

Figure 3—
Figure 3—

Lateral radiographic view of the abdomen of the same dog as in Figure 1 obtained 2 months later. The dog had a 24-hour history of vomiting and diarrhea. Notice the large amount of ingesta in the stomach (arrows) that is similar in appearance to that observed earlier (Figure 2).

Citation: Journal of the American Veterinary Medical Association 235, 5; 10.2460/javma.235.5.507

A moderate amount of gastric distention with material appearing to be ingesta is evident; gastric content is similar in appearance to that observed 2 months earlier (Figures 2 and 3).

Comments

On the basis of clinical signs and concern over similarities between the 2 sets of radiographs, the dog was hospitalized. Abdominal ultrasonography revealed persistent gastric distention. The material observed provided strong acoustic shadowing suggestive of a gastric foreign body (Figure 4). Exploratory celiotomy and gastrotomy were performed, and a large, firm, sponge-like material intermixed with food particles was removed.

Figure 4—
Figure 4—

Transabdominal ultrasonographic image of the stomach. The left side of the body is to the top, and cranial is to the left. Notice the acoustic shadowing distal to the gastric mucosa suggestive of a gastric foreign body (arrows).

Citation: Journal of the American Veterinary Medical Association 235, 5; 10.2460/javma.235.5.507

The gastric foreign body was identified as a material consistent with diphenylmethane diisocyanate adhesive, combined with ingesta. Household glues containing diphenylmethane diisocyanate as the active ingredient foam with application, expanding to several times the original volume.1 Upon consumption, the environment of the stomach augments polymerization of the adhesive, allowing rapid expansion of the product, resulting in a large gastric foreign body that may occupy the entire gastric lumen.2,3 Ingestion of as little as 2 ounces of adhesive has resulted in gastric foreign body obstruction.2

During expansion, the adhesive will incorporate and trap gastric contents in its matrix. Commonly, abdominal radiography reveals a mottled soft tissue opacity encompassing the entire lumen of the stomach, resembling a large amount of ingesta. Clinical signs are similar to those associated with gastric outflow obstruction, including vomiting, hematemesis, and abdominal distention, and signs of abdominal pain, lethargy, and anorexia. The adhesive foreign body is nondigestible, and surgical intervention is required. Exploratory celiotomy and gastrotomy, with retrieval of the foreign body, have been associated with an excellent prognosis for full recovery.2

The owners did state that there had been construction in an area where the dog was allowed to roam during the time of the initial admission. Similarities between the 2 sets of radiographs, in conjunction with the possible opportunity for ingestion of adhesive, suggest that the gastric foreign body was present at the time of initial admission. A gastric foreign body was not palpable on physical examination as a result of its location in the cranial portion of the abdomen; however, a gastric outflow obstruction as the cause of vomiting was suspected on the basis of radiographic findings and was confirmed with abdominal ultrasonography.

At the time of surgery, only minimal irritation to the gastric mucosa was observed. Immediate postoperative recovery was unremarkable. The dog had intermittent vomiting 10 days after surgery, despite a normal to voracious appetite. The dog recovered with medical treatment, and communication with the owners 3 months after surgery revealed no further problems.

  • 1.

    Gorilla Glue Web site. Available at: www.gorillaglue.com. Accessed Apr 4, 2008.

  • 2.

    Horstman CL, Eubig PA, Cornell KK, et al. Gastric outflow obstruction after ingestion of wood glue in a dog. J Am Anim Hosp Assoc 2003;39:4751.

  • 3.

    Lubich C, Mrvos R, Krenzelok EP. Beware of canine Gorilla Glue ingestions. Vet Hum Toxicol 2004;46:153154.

Contributor Notes

Dr. Phelps' present address is New England Animal Medical Center, 595 W Center St, West Bridgewater, MA 02379.

Address correspondence to Dr. Phelps.
  • Figure 1—

    Lateral (A) and ventrodorsal (B) radiographic views of the abdomen of a 3.5-year-old female Miniature Pinscher evaluated for acute abdominal pain.

  • Figure 2—

    Same lateral radiographic view of the abdomen as in Figure 1. Notice the large amount of ingesta in the stomach (arrows).

  • Figure 3—

    Lateral radiographic view of the abdomen of the same dog as in Figure 1 obtained 2 months later. The dog had a 24-hour history of vomiting and diarrhea. Notice the large amount of ingesta in the stomach (arrows) that is similar in appearance to that observed earlier (Figure 2).

  • Figure 4—

    Transabdominal ultrasonographic image of the stomach. The left side of the body is to the top, and cranial is to the left. Notice the acoustic shadowing distal to the gastric mucosa suggestive of a gastric foreign body (arrows).

  • 1.

    Gorilla Glue Web site. Available at: www.gorillaglue.com. Accessed Apr 4, 2008.

  • 2.

    Horstman CL, Eubig PA, Cornell KK, et al. Gastric outflow obstruction after ingestion of wood glue in a dog. J Am Anim Hosp Assoc 2003;39:4751.

  • 3.

    Lubich C, Mrvos R, Krenzelok EP. Beware of canine Gorilla Glue ingestions. Vet Hum Toxicol 2004;46:153154.

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