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Aug 03 2013

Kendra’s exploratory surgery

Do you remember Kendra?

She is a 14 week old lab mix who is learning to be a CCI service dog. On Monday, September 20 she presented for occasional diarrhea, her appetite was a little less than normal and she had vomited twice. Her owners were concerned, but Kendra was still running around and acting fairly normal. Well, it was a good thing that they were concerned. During Dr. Tate’s physical exam he palpated a firm mass in Kendra’s belly. When he palpated the mass Kendra reacted because it was extremely painful. Dr. Tate was immediately concerned about a foreign body (Kendra eating something she wasn’t supposed to) or an intussusception.

An intussusception is when one part of intestine telescopes inside another part; creating a tube within a tube. This still allows some fecal material that is really watery to pass around the intussusception causing diarrhea. The intestinal piece that goes within the other piece can actually become necrotic (tissue dies) because the intestine swells and blood supply can be cut off.

Kendra2

Dr. Tate took radiographs or x-rays of Kendra’s abdomen. This showed an area of suspicion in her colon that could indicate a blockage. Kendra was placed on intravenous fluids to hydrate her. She was given several enemas to try to help her pass the possible foreign material. This was unsuccessful and an exploratory surgery was needed.

Dr. Tate made an incision into Kendra’s abdomen and checked the entire length of the intestines. When he reached the area where the small intestine meets the colon he found the problem. Her small intestine had telescoped inside her colon creating an intussusception. Dr. Tate and Dr. Ware gently pulled the small intestine out of her colon, but too much damage had been done to leave that piece of small intestine in her body. Therefore, they performed a resection and anastomosis. This is where the damaged piece of intestine is actually cut out and the two ends of the healthy intestine are sutured back together. The procedure went well and she was placed on a highly digestible, low fat diet. Kendra was also started on a broad spectrum dewormer. Although her fecal exams had been negative, intussusceptions are commonly associated parasites and/or diarrhea. Kendra is continuing to do well after surgery, however there is a 3-5 day window where dehiscence of the sutures can occur. If this happens Kendra can get peritonitis (infected abdomen) and become very sick.

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