Ozzy had not eaten for the past 48 hours and had already lost an appreciable amount of weight.

This week it was touch and go for Ozzy.  Ozzy is an eight-month-old Beagle/Tal-Kaċċa cross, very loving with his owners and even possessive of them. His eyes are usually very expressive but when he was brought to the clinic they were dull and he was lethargic. His young owner told me that he had been vomiting for the past two days and that medication was not having the desired effect. Ozzy − never one to refuse his dinner − had not eaten for the past 48 hours and had already lost an appreciable amount of weight. He had also not passed any stools for at least three days, was in obvious discomfort and was getting steadily getting weaker.

A physical examination revealed nothing untoward. The abdomen was palpated but although there was an increased amount of liquid and gas, no swellings or lumps could be felt. His temperature was normal; heart and lungs all sounded normal and all blood and urine tests checked okay. We took a closer look. An ultrasound revealed nothing that might suggest the underlying cause, while an X-ray taken of Ozzy’s abdomen showed some swollen intestinal loops, yet no sign of a foreign body that might explain what was going on.

We decided to give him barium sulphate, which is a substance that is administered orally and can be easily seen and followed through a series of X-rays as it works its way through the oesophagus, past the stomach, down into the intestines and right through to the rectum. This test unfortunately gave us no new information and in the meantime Ozzi’s condition was deteriorating fast.   There was only one approach remaining – abdominal exploratory surgery. And it had to be done soon before Ozzy became too weak to withstand the rigours of surgery.

Exploratory abdominal surgery in the true meaning of the word does not happen as often as it used to. In fact, with the much-improved imaging facilities of digital equipment today, it has become less common that veterinary surgeons perform abdominal surgery without knowing what they are going to find as well as the type of intervention thereafter needed to resolve the issue.

The decision to perform exploratory abdominal surgery is not a decision any veterinarian will undertake lightly

Indeed, the decision taken to perform exploratory abdominal surgery is not a decision any veterinarian will undertake lightly.  And in a pet whose health is already compromised, performing surgery which might potentially not resolve the underlying problem is never an attractive prospect. But sometimes it must be done to save the life of the animal.

And so it was with Ozzy, where all attempts to treat medically were futile, and all attempts to diagnose the problem using more conservative approaches gave us nothing of substance other than that he had some swollen intestinal loops. Having taken the decision to proceed, there was no time to lose. Not only had Ozzy already lost a considerable amount of weight and was consequently getting weaker, we knew that if any intestinal damage was happening, it could only get worse.

During exploratory surgery, every organ in the abdomen may be examined for abnormalities in, for example, the liver, spleen or kidneys. There may be abscesses or tumours growing on any of the organs – in which case the mass may be removed and a biopsy taken depending on the case.  The organs may also be checked for diseases such as inflammatory bowel disease.  Sometimes exploratory surgery is performed to retrieve suspected foreign bodies trapped in the intestines that cannot show up on X-ray or other digital imagery.

If an abnormality or foreign body is found, it is either corrected, removed or a biopsy taken. If surgery turns up nothing, it is referred to as ‘negative exploratory’ and a biopsy is then taken to check for microscopic bacterial or viral infections, or parasitic infestations which would not be visible to the naked eye.

In Ozzy’s case, the reason for his illness became evident once we’d breached the abdominal wall and checked the intestines.  Ozzy had an intestinal loop entrapped within a twist of another intestinal loop, resulting in the bloating that was previously felt by palpation and partially visible on X-ray. The abnormality was very gently corrected so as not to tear or damage the critically compromised intestine and surrounding tissues.  After recovery, Ozzy was sent home to rest and recuperate with all the necessary palliative care and instructionsassociated with this type of surgery.

It is understandable that pet owners would feel nervous about veterinarian surgeons’ recommendation to perform exploratory abdominal surgery. It is the fear of the unknown that is so unnerving. But sometimes, this type of surgery is all that separates a pet from certain death. Seeing Ozzy together with his young owner, it is clear that there is a very strong reciprocal bond. The surgery has now given Ozzy a new lease of life that they can both enjoy together.

thisweekwiththevet@gmail.com

Dr Martin Debattista is a veterinary surgeon.