Medical Management of GI Foreign Bodies in Dogs

In the Literature

Carrillo AJ, McCord MA, Dickerson VM. Clinical features and outcomes of dogs with attempted medical management for discrete gastrointestinal foreign material: 68 cases (2018-2023). J Am Vet Med Assoc. 2024;262(9):1251-1258. doi:10.2460/javma.24.01.0050

The Research …

Treatment of GI foreign bodies in dogs traditionally includes cardiovascular stabilization followed by surgical intervention. Clinical course and interventions have been evaluated in dogs and cats with GI foreign body obstructions, but few studies include conservative management.^1-6

This retrospective study evaluated clinical features and outcomes of 68 dogs that received medical management for GI foreign body obstruction; comparisons and statistics based on the data were not performed. Management included fluid therapy, GI support medications, and analgesics. Serial abdominal radiography (n = 61), ultrasonography (n = 7), or both (n = 13) were performed to assess progression of foreign material.

Medical management was successful (ie, foreign body passed through the colon) in 32 dogs and failed in 36 dogs, resulting in surgery (n = 29), endoscopic removal of foreign material (n = 5), or euthanasia due to financial considerations and previous foreign body obstructions (n = 2).

Gastric dilation was diagnosed via radiography in 18 dogs and resolved in cases with successful medical management (n = 5) but did not resolve in cases with failed medical management (n = 13). Small intestinal dilation, measured as the ratio of maximum segmental small intestinal dilation to height of the midbody of L5 (SI:L5 ratio; normal, <1.6), was calculated on serial radiographs and resolved in all cases with successful medical management (median change in SI:L5 ratio, −25.6%) but progressed in most cases with failed medical management (median change in SI:L5 ratio, +8.8%).

… The Takeaways

Key pearls to put into practice:

• If surgical intervention is not an option, medical management (eg, IV fluid support, GI support medications, analgesics) can be attempted and may be successful.

• Failure of medical management resulting in surgical intervention occurred more commonly with linear foreign body obstructions compared with discrete foreign material obstructions. Dogs diagnosed with linear foreign body obstruction should undergo surgery for best outcomes.

• Serial radiography can monitor progression or successful migration of foreign material by assessing small intestinal dilation (SI:L5 ratio). Abdominal ultrasonography can be used when accessible.