Endoscopic removal of foreign bodies

Gastrointestinal foreign bodies(FB) are non-food objects that may not pass through the gastrointestinal (GI) tract. Some can be lodged in the esophagus ( esophageal foreign body) or trapped in multiple locations along the GI tract (linear foreign body). These can present as medical emergencies that require emergent intervention. Common foreign bodies Toys Corn cobs sticks Socks underwear bones string balls fishing hooks As a veterinary technician, you play a crucial role in the endoscopic removal of foreign bodies in dogs and cats. This minimally invasive procedure is becoming increasingly common in veterinary medicine, and your expertise is essential in ensuring that it is performed safely and effectively.

Foreign bodies can cause various problems in dogs and cats, from mild discomfort to life-threatening obstruction. Common foreign bodies include toys, bones, and other objects that pets may ingest accidentally or out of curiosity. Endoscopic removal involves using a flexible tube with a camera and specialized tools to locate and remove the foreign body without requiring invasive surgery.

Clinical signs

Vomiting, loss of appetite, nausea, diarrhea with or without blood, abdominal pain, and lethargy. Esophageal FBs can present with ptyalism, gagging, dysphagia, and regurgitation. Signs vary based on the location of the FB, severity (obstructive vs. nonobstructive), and duration. Severe cases can present in extreme pain and/or hypovolemic shock.

Diagnosis:

In addition to patient history ( owner observing ingestion of the foreign material) and clinical signs, radiographs, in many cases, can confirm the presence of a FB due to the radiopaque nature of the object. Contrast abdominal radiographs can evaluate material and signs of intussusception. FB can be on ultrasonographic evaluations. Dilated intestinal loops and large amounts of gas in the GI tract can also be identified. Contrast abdominal radiographs and endoscopic evaluation of the GI tract

Treatment

Patient stabilization, supportive care, surgery, or endoscopic removal are the mainstay treatment for foreign bodies. The patient must be stabilized and fluid, acid-base, and electrolyte abnormalities correct. Removal of the offending material is recommended via endoscopic or surgical removal. Removal via endoscopy is possible for most objects in the esophagus & stomach. Some larger objects ( like a tennis ball) may not pass retrograde through the lower esophageal tract, thus requiring gastronomy. Surgical intervention is also required for any object that there is a concern for additional damage via endoscopic removal (sharp object),

Surgical removal by laparotomy or laparoscopic-assisted exploratory surgery is indicated if the object is located in multiple locations (string FB in cats), there is a concern for an additional object(s), the object is in the small intestine or beyond the reaches of the endoscopic equipment if there is an intussusception, perforation, or the need for biopsies or resection.

Your role as a veterinary technician in the endoscopic removal process begins with a thorough review of the patient history and DVM physical evaluation and assessment. As a member of the patient care team, familiarize your self with the patient by performing a patient evaluation. You will ensure that the animal is appropriately sedated and monitored throughout the procedure. This requires a thorough understanding of anesthesia and patient monitoring techniques and the ability to identify and respond to any potential complications.

During the procedure, you will work closely with the veterinarian to assist with the endoscope placement and provide support as needed. Your expertise in animal handling and restraint will be critical in ensuring that the animal remains calm and still throughout the procedure.

After the foreign body has been removed, you will play a critical role in post-procedure care. This may include monitoring the animal's vital signs, administering medications, and providing post-operative instructions to the owner.

Prognosis/Outcome

The prognosis is good for patients with GI foreign bodies with intervention & removal. Patients presenting with obstructive FBs, esophageal Fbs, and in hypovolemic shock with severe electrolyte derangements are at a higher risk of complications, including perforation, surgical site dehiscence, short bowel syndrome, and peritonitis. Cases requiring surgical removal (versus endoscopic) are at a higher risk of postoperative complications.

In addition to your technical expertise, your role as a veterinary technician in the endoscopic removal of foreign bodies in dogs and cats involves communication and client education. You will need to be able to explain the procedure to pet owners and answer any questions they may have. You may also be responsible for scheduling follow-up appointments and providing ongoing support and guidance to the owner.

The endoscopic removal of foreign bodies in dogs and cats is an increasingly common procedure in veterinary medicine, and your role as a veterinary technician is essential in ensuring its success. Your expertise in anesthesia, patient monitoring, animal handling, and client communication will be critical in providing safe and effective care to patients and their owners.