Case Study: Angelica | Barium Study

Patient: 13-year-old Spayed Female Labrador Mix

Presentation: Patient was not herself at home, very lethargic, hiding from the owner, and had a decrease in appetite. There was a chance for possible poison ingestion as patient had been seen laying in a pesticide.

Barium study at 0 minutes

Problem List: Due to the history of possible poison ingestion and the patient having clinical symptoms it was recommended to perform in house blood work paired with clotting times to check for any abnormalities. We also needed to bind any toxins that could have possibly been in the patients system so as to minimize the amount of toxins absorbed by her body, thus the doctor recommended feeding the patient a specialized activated charcoal substance. It was also recommended to hospitalize the patient on IV fluid therapy to help rehydrate and assist her body in flushing out the toxins more effectively.

Potential Diagnosis/Rule Out: Due to the lack of severe abnormalities on blood work paired with patient continuing to provide clinical symptoms overnight (patient was regurging whenever offered water, she was producing water, stomach bile, and what appeared to be tissue/paper) our next concern was that she had a Gastro-Intestinal Obstruction.

Diagnostics: With having already run the initial blood work the next diagnostic tool available to our Doctors in a case such as this is a barium study. This is where the patient is fed a barium contrast and a series of timed radiographs are taken to watch the progression of the contrast through the gastrointestinal tract. We also recheck a CBC (complete blood count) to check hydration status and if any signs of infection were yet present. Both of these diagnostics came back with abnormalities. The CBC showed a lack of white blood cells as well as a low blood platelet count. The barium study showed that the patient’s stomach was not “emptying” completely or effectively given a set amount of time.

Barium study at ~30 minutes

Procedures: Due to the results of our diagnostics it is recommended by the doctor for this patient to undergo an “exploratory” surgery to check her gastrointestinal tract for any abnormalities or obstructions. The patient was anesthetized and placed under general anesthesia in order for the doctor to perform this procedure. Once the patient was sterilely prepped and the doctor “explored” her abdomen for any signs of disease, obstruction, or abnormalities. At this time the patient had no obvious abnormalities or obstructions present in her gastrointestinal tract.

Diagnosis: Unfortunately in medical cases such as this there is no definitive diagnosis. With the possible exposure to toxins it could be that this patient was sensitive enough to it for it to cause gastrointestinal abnormalities and general internal discomfort. This could also lead to gastrointestinal stasis (slow motility within the intestines which would explain the results of our barium study). The patient was placed on medications to suppress nausea, encourage appetite, and pain medications to ensure she was comfortable. She was also sent home on a prescription diet that would encourage her to continue eating at home.

Resolution: Patient was rechecked several times over the following 7-10 days and appeared to improve with the medications and prescription diet at home. The incision from her surgery was also healing very well.

Barium study at ~3 hours (180 minutes)

Summary of Condition: This patient presented for possible toxin ingestion. Through diagnostics and procedures our doctors were able to rule out any life threatening obstructions in her gastrointestinal tract, and dangerous abnormalities on bloodwork. The patient was placed on supportive medications and food to be continued at home and all clinical symptoms resolved in the following days.

Advice for pet owners/Quote from Doctor: If you do have pesticides, poisons, or medications in the home ensure they are stored in closed containers that the pet does not have access to. If you ever are suspect that your pet ingested a toxin call your veterinarian with haste and have the information of the possible toxin available so that they may offer you the best recommendation for your pet’s specific situation.