Species: dog
Breed: Labrador Retriever
Sex: f, neutered
Weight: 19.2 kg
Birth date: 2021-02-12 00:00:00
Primary diagnosis: Jejunal foreign body
Situation: Post-surgery
Time since surgery: < 2 hrs
Recovered from anesthesia: Moderate sedation (2)
Medical history: The dog was presented to us on the 10.10.2024. The dog was playing with other dogs on Saturday (05.10), they bumped heads while playing but no reaction. Saturday evening Flocon might have eaten something during the walk but the owener is not sure as it was dark. On Sunday morning she started vomiting every 4 hours. On Monday they went to the private vet. X-rays were taken, blood analyses were done and an antiemetic (Maropitant) was given. The medication was also given at home until Tuesday (3 times a day). She showed no vomiting until Wednesday (09.10.2024) night, then around midnight she drank and 30 min later she started vomiting (greenish liquid, 5x in different places), then Wednesday morning she vomited again (greenish liquid with several mm large black-green shreds). Since Sunday (06.10) she doesn't eat amd doesn't pass feces, but she drinks and urinates normally. At our clinic x-rays were taken and an abodminal ultrasound was performed. X-rays report (10.10): Highly suspect small intestinal foreign material with segmental mechanical ileus --> The presence of two small intestinal populations strongly suggests the presence of a mechanical ileus due to a small intestine obstruction, likely jejunal; The fact that the presence of foreign material and the distended segment of small intestine could not be confirmed on the VD make an abdominal ultrasound may be recommended. Ultrasound report (10.10): Jejunal foreign body with focal dilation of the small intestines at the site of the foreign body but not either side; Focal steatopathy. The dog then went into surgery the same day and an enterotomy was perfomed to remove the foreign body. Flocon went home on the 15.10.
Medication: 9 & 08.10 (prescribed by the private vet): Maropitant. Before observation 1: Ondansetron 0.3 mg/kg IV. Shortly after observation 1: Methadon 0.1 mg/kg IV, Maropitant 1 mg/kg IV. 1h before observation 2: Dexmedetomidin 0003 mg/kg IV, Ampicillin 30 mg/kg IV. after surgery: Methadon 0.2 mg/kg q4h (before observation 3) then switch to Buprenorphin 0.015 mg/kg IV at midnight, Ondansetron (before observation 3), Ampicillin 30 mg/kg IV TID. 11.10.2024 (nothing given before observation 4): Ondansetron 0.5 mg/kg IV TID, Maropitant 1 mg/kg IV SID, Ampicillin 30 mg/kg IV TID, Methadon 0.2 mg/kg IV q4h. 13.10: Ondansetron 0.5 mg/kg IV TID, Metamizol 30 mg/kg IV TID, Maropitant 1 mg/kg IV SID, Ampicillin 30 mg/kg IV TID, Metoclopramid CRI 1 mg/kg/d, Prokolin according to weight PO BID. 14.10: Ondansetron 0.5 mg/kg IV TID, Metamizol 30 mg/kg IV TID, Maropitant 1 mg/kg IV SID, Ampicillin 30 mg/kg IV TID, Prokolin according to weight PO BID. 15.10: Ondansetron 0.5 mg/kg IV then PO TID, Metamizol 30 mg/kg IV then PO TID, Maropitant 1 mg/kg IV SID, Ampicillin 30 mg/kg IV then PO TID, Prokolin according to weight PO BID, Fortiflora PO on the food.
Anesthesia: Intervention on 10.10.2024: laparotomy with enterotomy, central venous catheter. Premedication: Methadon 0.2 mg/kg IV. Induction: Midazolam 0.1 mg/kg IV, Propofol 4.2 mg/kg IV. Maintenance: FiO2, Isofluran. Analgesia: IV infusion Fentanyl 0.005 mg/kg/h, IV infusion Lidocain-CRI. Antibiotics: Ampicillin / Sulbactam 30 mg/kg IV. Complications: bradycardia & arrhthmia --> Glycopyrrolate 0.01 mg/kg IV (2x?). Wake up phase: Bolus Methadon 0.2 mg/kg IV. Intervention duration: 110 min. Anaesthesia duration: 240 min.
Pain type: acute, inflammatory, somatic, visceral
Pain origin: abdomen, intestine
Pain duration: 24 hours to 7 days
Estimated pain severity: 23