Playthings and small household articles are especially taken by puppies through mere wantonness. Rubber balls, pieces of metal, thread, cord, cloth, bits of leather, sponge, horse hair, human hair, corks, bits of wood and everything obtainable of small size may be swallowed and found in the stomach.
Pigs swallow pieces of wood and other objects.
Birds habitually swallow pebbles and ordinary objects are ground down in the gizzard. They also readily vomit feathers, bones and other offensive matters that have proven indigestible.
Symptoms. In horses there are no especial symptoms, though the foreign bodies sometimes cause gastric catarrh, and in other cases produce wounds and ulcers or block the pylorus causing violent colic. Most commonly the foreign bodies pass on into the intestines, where they may directly wound the walls, form nuclei for the deposition of earthy salts in the form of calculi, or in case of fibrous materials (cords) roll into firm balls.
In dogs the foreign bodies may cause gastric catarrh, or puncture or abrasion of the mucosa, and they may be rejected by vomiting. The more rounded, smooth bodies may lie for a length of time in the stomach without doing any manifest injury, as in the case mentioned by Nichoux in which a dog carried in its stomach for twelve years a four franc piece and a large sou. Sometimes the objects block the pylorus. Then the subject is dull, depressed, inclined to lie on the right side but continually changing his position, gives a stifled yelp when he lies down or occasionally when he stops walking. He carries the back arched, and the abdomen tucked up, and drags his hind limbs. Vomiting, is frequent and accompanied by violent and painful retching. The vomited matters may be mixed with blood. The epigastrium is tender to pressure. Death may ensue in twenty-four hours or not until after weeks or even months.
In other cases there is gastro-enteritis with vomiting, colic, anorexia, trembling, hyperthermia, constipation or diarrhœa, and finally the passage of the offending agent per anum, when recovery ensues.
In other cases sharp pointed bodies perforate the walls of the stomach, and determine the formation of abscess or fistula opening at any point around the abdominal cavity. This may be followed by recovery, by gastric or intestinal fistula, or by chronic disease of some important organ like the liver.
In dogs, diagnosis is often possible by manipulation of the stomach through the walls of the abdomen. If the belly is very lax it may be compressed between finger and thumb, or between the two hands; if more tense, pressure with both hands just behind the sternum may detect the resistance of a solid body.
Treatment. In the horse this is hopeless.
In the dog much may be expected from the use of emetics, (ipecacuan, tartar emetic, apomorphine, tepid water, tickling the fauces). In some cases of sharp pointed bodies an exclusive and abundant diet of well boiled potatoes proves successful. The object is to pass much of the starchy matter through the small intestines undigested, so that it may envelop the sharp body and protect the mucosa. When it reaches the colon, the ingesta as a whole becomes more solid and invested by this, the body is often passed without danger. Other methods failing laparotomy remains. The dog is stretched on his back on a table with the forelimbs held well apart. The skin of the epigastrium is denuded of hair and washed with antiseptics (mercuric chloride solution 1:500). Hands and instruments are also made aseptic. Then an incision is made in the epigastrium or in the situation where the offending body has been felt, and the finger is introduced to locate the body. At this point a thread is passed through the walls of the stomach, and these are drawn well out through the abdominal wound and incised to the extent of an inch or more. Through this orifice the foreign body can be easily felt and extracted. Then in case the stomach is over-filled it may be emptied, and the edges washed with the antiseptic and carefully sutured with sterilized catgut. The usual care must be taken to turn the mucosa inward and bring the muscular and serous coats in accurate opposition. Finally the abdominal wound is closed by a continued suture of silk or catgut.