VIDEO ENDOSCOPIC RETRIEVAL OF FISH BONE FROM OESOPHAGUS OF A DOG WITH SUBCUTANEOUS EMPHYSEMA

G. Vijayakumar1, B. Sudhakara Reddy, S. Kathirvel, R. Ezakial Nepolean and P. Sankar
1Professor & Head, Department of Veterinary Clinical Medicine, Veterinary College and Research Institute, TANUVAS, Namakkal – 637 002(T.N.). [Received: 28.4.2018; Accepted: 29.10.2018]
{DOI 10.29005/IJCP.2018.10.2.104-105}

A ten months age old non descriptive bitch was referred to the Veterinary College and Research Institute,
Namakkal Hospital with subcutaneous emphysema all over the body. It was reported to have been fed with fish four
days earlier. The animal had cough, dysphagia and vomiting. Thoracic radiographs showed diffuse subcutaneous
emphysema, along with presence of the radiolucent foreign body in the cervical oesophagus. Video endoscopy revealed presence of the fish bone in the cervical oesophagus. Fish bone was retrieved using endoscopic snare without any complication. Dog was administered with the amoxicillin – cloxacillin, pantoprazole and dextrose normal saline twice daily for three days and had uneventful recovery following treatment.
Keywords: Dog, Endoscopic retrieval, Fish bone, Subcutaneous emphysema, Oesophagus.

Oesophageal foreign bodies caused trauma to the thoracic oesophagus which might result in pleuritis, mediastinitis, pyotho -rax, pneumothorax or oesophageal stricture (Jankowski et al., 2013). Generalised subcutaneous
emphysema may occur traumatically, iatro -genically or spontaneously (Malliari et al., 2014). The most common causes of subcutaneous emphysema are rib fractures, parenchy -mal lung wound and oesophageal trauma
(Thompson et al., 2012). Perforation of the cervical oesophagus may result in local abscessation, subcutaneous emphysema, pleuritis, mediastinitis, pnemothorax, bronchoesophageal fistula formation or aortic oesophageal fist
ula formation. Subcutaneous emphysema had been reported in dog, cat, horse and human due to tracheal perforation. This article report s subcutaneous emphysema in a dog subseque -nt to choke due to oesophageal foreign body.

Case History and Observations
A ten months aged non descriptive bitch was referred to Veterinary College and Research Institute, Namakkal, Hospital for subcutaneous emphysema throughout the body. It was reported that dog was fed with
fish and cooked rice four days earlier and it developed subcutaneous emphysema over the body approximately 3 – 4 hours following ingestion of fish. Emphysema was initially involving thoracic region and later on it
spread over to abdominal region and extremities. The dog was treated for the emphysema by veterinarian in their home town without success. Clinical examination revealed cough and dysphagia. Haematobioch -emical parameters were within the normal limits except for elevated PCV. Thoracic radiographs showed presence of the radiolucent foreign body in the cervical oesophagus (Fig.1) and diffuse subcutaneous emphysema (Fig.2).

Treatment and Discussion
Dog was subjected to video endoscopy under general anaesthesia using propofol (@ 4 mg/kg body weight I/V after glycopyrrolate premedication (0.02 mg/kg body weight, S/C). A piece of fish bone in the cervical oesophagus, stretching the wall of the oesophagus was appreciated through endoscopy (Fig.3). While, tracheal collapse
was also noticed as an incidental finding. Under endoscopic guidance, fish bone was retrieved using foreign body retrieval snare without any complications. Retrieved bone was irregular shaped and was about 4cm in
length (Fig.4). Bitch was administered with amoxicillin – cloxacillin (@ 20 mg/kg body weight, BID), dextrose normal saline (10 ml/kg body weight, I/V.) and pantoprazole (@ 0.5 mg/ kg body weight) twice daily for
five days. The dog recovered uneventfully following therapy.

In the present study, pneumomediastenum and pneumoretroperitoneum were detected in radiograph. Pneumomediastinum was characterised radio-graphically in lateral view by visualization of mediastinal
structures that were not normally seen, such as oesophagus and great vessels of cranial mediastinum, because the presence of air within the mediastinum, provided excellent contrast to adjacent soft tissue structures.
With the smaller amounts of mediastinal gas, the changes were less dramatic and the only abnormality might be visualisation of the adventitial surface of the trachea as also reported by Thrall (2013).

References

Jankowski, M., Spuzak, J., Kubiak, K., Glinska-Suchocka, K. and Nicpon, J. (2013). Oesophageal foreign bodies in
dogs. Pol. J. Vet. Sci., 16(3): 571-572.

Malliari, H., Ntasenos, E., Chatziavramidis, A., Printza, A. and Konstantinidis, A. (2014). Cricotracheal separation with multiple cricoids fractures after blunt neck injury: A case report. Hippokratia, 18: 65-66.

Thompson, H.C., Cortes, Y., Gannon, K., Bailey, D. and Feer, S. (2012). Esophageal foreign bodies in dogs: 34
cases (2004–2009). J. Vet. Emerg. Crit. Care., 22: 253–261.

Thrall, D.E. (2013). The mediastinum. In: Thrall, D.E. (Eds.) Text book of Veterinary Diagnostic Radiology. 6th edn., Saunders/Elsevier, St. Louis, Missori, U.S.A. Pp. 550-571.

 

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