Tuesday, June 3, 2014

Mort's Bowel Obstruction And Peritonitis

by Jen deHaan 

This is the story of Mort’s third brush with death. 

Mort is a 3 year old Australian Kelpie mix (or so we think). My husband and I adopted him from a shelter when he was approximately 7 months old. He is an incredibly high-energy dog who regularly participates in dog sports. I have trained him in Flyball, a bit in Disc Dog (he’s trained, but I’m not!), and we do quite a bit of tricks and “stunt” training. Even Treibball, but he prefers to use giant balls for what we call “VolleyDog”.

He has made several people gasp at the height of jumps he takes. Leaps up a six foot vertical cliff, over fences, onto the counter from a stand still - you name it and in a blink of an eye before you have a chance to tell him it’s a bad idea!  In other words, he could run and jump at full speed all day long - a true adventure seeker! He’s rough and tumble, but agile and with a great sense of balance. He’s attached to my hip, ready to do whatever the day might bring.

An outstanding companion and the love of my life, to say the least!

He’s also an aggressive chewer, often of inappropriate things like socks, blankets, and cardboard - things he finds lying around because we’ve forgotten to pick them up. We’ve reduced this quite a bit over the years, but not entirely - I’m still watching him like a hawk, and we have a pretty solid “don’t eat it” (more commonly called a “Leave It”).

We would have never thought what would take him down was his breakfast.

The first signs of distress

Because Mort is such an energetic dog, any signs that something is wrong have so far been quite obvious. In this particular case, the first sign was a sudden vomit off the side of the couch. This is unusual (usually the rug is the favored spot), and was combined with “downward dog” or “playbow” stretches which indicate a stomach ache.

When this happens, we go into evaluation mode that includes an easy walk around the block to assess whether this is something to monitor closely or an emergency.

Mort puked one more time, but was still eager to walk and otherwise seemed OK. 

He was puking bits of bark from a stick he started pulling apart on our evening walk - I thought his stomach might be upset from that, he may have gotten a bit too much into his system. I was worried perhaps he got a sharp bit. We put him on “heightened alert” but didn’t think it was an emergency.

Because this occurred right before bedtime, this meant that we turned on an alarm for every two hours. I happened to be quite concerned about him, and this was based on not much more than he was watching more more than usual. I’m pretty hyper-paranoid about the dogs, after losing one quite suddenly to a disease, so I bounce a lot of my worry off of my husband. He felt it wasn’t time for the vets quite yet. We set the alarm and tried, somewhat unsuccessfully, to sleep.

The initial vet visit

Just before the first alarm, Mort puked again. 

I turned on the light, and it appeared like he was in more pain. He was slightly more hunched over, and looked at me in a way that suggested he just wasn’t well. He didn’t want to jump off the bed either, and for such an active dog that said a lot. It was time to head into the vets.

We are very lucky to have the option of going to a 24 hour emergency veterinarian that is also an open vet practice, which means that we get to stay with Mort the entire time he is being examined and treated (except for the operating room for obvious reasons).

The first vet visit included a general exam and a set of X-rays. 

The exam suggested abdominal upset and gas, and the X-rays showed two bone fragments. I forgot to tell the vet about Mort’s raw diet, because it was raw grind and large raw bones that could not be consumed to clean the teeth (it’s good to mention a raw diet that includes consumable bones because the fragments show up on the x-ray). The two fragments were from one of the teeth cleaning bones, served raw and of course never previously cooked or roasted. So we weren’t surprised because there is a small amount of meat, cartilage and bits of bone that dogs can chew off of the ends of the ones we receive.

The vet prescribed painkillers, antacid, and hydration. 

We were to return the following morning at 10am if Mort wasn’t eating and back to normal.

The next morning

Mort had slept through the night, but was not well the following morning. The first sign was that he, again, didn’t want to jump off the bed or go down the stairs. When my husband went to help him down the stairs, he nipped at his face.

This was a big signal that he was in pain.

We took him out to potty before taking him to the vet. I wanted to also evaluate what his situation was so I could communicate this to the vets. Although my head was in a panic, I did know this was quite important so they knew what to do first. Mort could walk, and was even well ahead of me on the leash at times, but appeared to be in a lot of pain by now. The poor guy wanted to go for his entire morning walk, but was slow, almost acting like he didn’t want to place weight on his back legs. I had to force him to turn around to head back home, despite being in such poor shape.

Back to the vets well before 10am.

The diagnosis and treatment

Mort was quickly assessed at the vets, and not long after was having an ultrasound. Apparently it wasn’t overly easy because he is so lean! The same bone fragment was found in his small intestine, and the vet noticed that it was about to perforate and some free fluid was found in the area. I’m not a professional, but even I could see that it was bad news on the ultrasound screen.

Mort was now a  “surgery candidate” and we were given the forms to sign to send him into the operating room.
We are very lucky to have such a fully featured clinic that Mort was in the OR in about an hours time. The vet outlined that there were several possible outcomes, based on the obstruction and how much damage had occurred - they wouldn’t know until they opened him up. We stuck around, watched him get a catheter, and left him to the expertise of the surgical team.

A few hours later we got a call from the vets.

Mort was unfortunate in that he required the most complicated and risky surgery. The bone fragment had actually perforated his small intestine, and the contents had leaked into his abdomen, causing peritonitis. This required six inches of his small intestine to be fully removed. As this is a risky surgery, 30% of dogs have complications afterwards.

The outcome

Mort was unlucky to have had the bone perforate his small intestine, but he was fortunate in that there were no complications after his surgery. Most complications occur in the first 3-5 days. He spent about 3 days in ICU before coming home, where we visited him several times a day. Sometimes he didn’t want to visit and other times he wanted belly rubs (which were chest rubs instead!)

Since returning home he has been largely crate bound, because he wanted to run and jump but had a lot of internal and external stitches that needed to heal. He’s in the clear now, on the last day of his antibiotics and ending his 14 days of “limited activity”. However, he has a lifetime of permanent damage ahead of him.

Dogs who lose part of their intestines become high-risk for future obstructions and perforations.

Items that wouldn’t cause distress in a normal dog can easily get stuck in their bowels because of the scar tissue that is left over from surgery. This is bad news for Mort, who wants to chew and destroy - and occasionally succeeds despite being watched closely. Only two days after he was home, he found a bone someone tossed in a hedge within 3 seconds as I scooped my other dog’s poop.

What this means

A raw diet is incredibly healthy for dogs, and consumable bones keep teeth clean. For most dogs, raw bones cause no problems at all. But they do carry a small but very real and life-threatening risk, as evidenced by what we experienced with Mort. The bone that caused the problem was very small, and from what I can tell it simply digested in a manner that exposed a small “hook” shaped fragment that hitched up on his bowel and caused the perforation.

There wasn’t something we could have done to reduce the risk apart from not feeding bones at all, it seemed to be simply bad luck.

Because of this, we are not feeding raw bones to either of our current or future dogs anymore, but will continue to feed raw grind. Even with my dog who does not have permanent damage, I personally cannot take the worry of this happening again.

It’s a matter of chance, how the bone happens to digest and pass. 

Since experiencing this, I have seen photos of even small chicken bones being passed with sharp ends, so it would be a never-ending worry. And of course, for Mort it isn’t an option. He’s already a high risk dog.

We truly lucked out by catching the perforation incredibly early, and living close to an excellent vet that was able to get Mort in for surgery right away. I hope that through this story you will be able to notice any early warning signs in your dog, so you can address the problem quickly so your dog has a great chance at a speedy recovery.


Jen deHaan is an animal advocate, volunteer, and dog person living in Bay Area, California. She likes to support local and national efforts for animal welfare and advocacy. Jen enjoys learning about dog training and behavior, and has taken several courses and seminars since 2010. It all started with a great dog called Mikey (aka "dude"), loved and lost but remembered forever.

Jen’s dog blog is at DOGthusiast.com, and she also runs a small business making handmade dog products called Stylish Canine. She is also a freelance graphic artist, and her digital work can be seen at FoundPixel.

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  1. I'm glad that Mort survived his life threatening ordeal and recovering well. Responsible pet parenthood is never easy and your taking notice of his symptoms and following up quickly saved your dogs life...:)

    1. Yes, this is scary and dangerous stuff! Taking signs seriously is so important.

  2. I give my dog raw turkey and chicken bones, and no other raw bones. He doesn't get raw bones for just chewing purposes. So, while I know raw chicken bones are generally safe, I'm still a little freaked out by them. Every now and then Ace will throw up a tiny piece of bone in the middle of the night, usually a piece of back (from a chicken quarter) that he apparently was having trouble digesting. And sometimes the piece if pretty sharp! That worries me quite a bit, enough to be considering switching to only giving him ground bones.

    Jen's story has had me thinking even more about this, obviously. I'm so glad Mort ended up OK. How awful.

    1. I'm quite scared of bones too. When I do give a bone for chewing, I generally supervise making sure they only gnaw off the meat and don't get into chewing of the actual bone.

    2. It definitely gave me a fright too. Not to mention in reaction to this the photos of chicken legs and the like that are passed right through by some dogs with sharp bits (which made me end chicken legs/backs/necks for our other dog! She's only getting grind too now). The chunk that came off was pretty much nestled in the meaty bit on the ends - I didn't even know that it was in there. If feeding raw, the only thing I can think of is to make sure all the meat is removed and there are no potential loose bits on any bones to avoid what's described here. Marrow bones, for example, I would think of as quite safe - if I was still feeding them, that's what I would choose. They never have those bits, and at least for my dogs they've only been able to chew off tiny little bits off the end that aren't large or sharp in the least. I've always been pretty paranoid, but this definitely sent me over the top ;) I'm not going to try with any lottery tickets, lets just say that!

      And thanks so much Jana for sharing my story - sincere appreciation indeed.

  3. This was so scary, but we are glad that Mort is on the mend and hope that he'll be back to his high-flying (safe) leaps! After this incident, I've definitely been a little more leery with bones in general...

    1. Very scary and dangerous indeed. Of course, so it's driving and everybody does that. It is always a balancing act between risks and benefits.