Outcomes of esophageal and gastric bone foreign bodies in dogs
Nanelle R. Barash, Erin Lashnits, Zachary T. Kern, M. Katherine Tolbert, Katharine F. Lunn
Abstract
Abstract Background Bone foreign bodies are commonly encountered in small animal practice. Esophageal bone foreign bodies (E-bFBs) warrant removal, whereas gastric bone foreign bodies might not. Objectives Describe management and outcomes for dogs with esophageal or gastric bone foreign bodies. Animals One hundred twenty-nine dogs with esophageal (n = 45) or gastric (n = 84) bone foreign bodies. Methods Retrospective review of medical records. Results Dogs with E-bFBs were younger than dogs with gastric bone foreign bodies (median age esophageal, 4 years [IQR 2-8]; median age gastric, 6 years [IQR 3-10]; P = .03), and had a higher bone cross-sectional area relative to body weight (median esophageal, 98.21 mm2/kg [IQR 48.25-142.6]; median gastric, 28.6 mm2/kg [IQR 17.25-64.28]; P < .001). Forty-two of 45 esophageal foreign bodies were resolved non-surgically and 3 by esophagotomy. Esophageal erosions were more likely with distal entrapment (OR 12.88, [95% CI 31.95-129.29], P = .01) and longer duration (OR 18.82 [95% CI 2.22-273.97], P = .01). Sixty-two of 84 bone gastric foreign bodies were left in situ. Endoscopic removal was successful in 20 of 22 (91%; 95% CI 70-99) attempts. Conclusions and Clinical Importance While all E-bFBs were dislodged either by advancement into the stomach, endoscopic removal, or esophagotomy, the majority of gastric bone foreign bodies were left in situ for dissolution, with no reported complications. Gastric advancement of E-bFBs should be considered when oral removal is not feasible, and dissolution can be considered even with large bones.