Case studies
Zara - gets the point of Magnetic Resonance Imaging!
Zara the Weimaraner, was nearly 11yrs old, when she presented to Northwest Surgeon with a six month history of progressive lameness with a stiffness in the hind limbs. This was particularly associated with pain around her right hip joint.
On examination, Zara was certainly reluctant to extend her right hip, so a full orthopaedic investigation commenced. All joints were gently manipulated under anaesthesia and xrays of her lower spine and pelvis were taken. There were no abnormalities detected, so the use of MRI ( magnetic resonance imaging) was performed to look in more detail at the soft tissues of the body, particularly the spinal cord and nerve roots. MRI works by mapping out hydrogen nuclei in body tissues using a combination of magnetism and radiowaves. The jumble of radiosignals is converted by a computer into a 2 or 3-dimensional image.
No abnormalities were identified in the spinal cord, but to the edge of one of the images, there was a change in the MRI signal intensity indicating abnormality in the tissues near the right side of the pelvis and the right hip. More images were taken with MRI and to our surprise, these revealed evidence of a so-called “foreign body”. The phrase “foreign body” is the medical term for an object in the body that has been introduced from outside. The foreign body in Zara’s case was still partially within a loop of small bowel, suggesting it was something she had eaten, but on the MRI scans it clearly penetrated the wall of the bowel, crossed the body wall and terminated in an abscess-like cavity beneath the right wing of the pelvis. There were also signs of inflammatory changes radiating towards the right hip joint. This could certainly explain the discomfort and lameness that Zara was experiencing from her right hip joint.
An abdominal exploratory surgery was performed which identified the migrating foreign body which turned out to be an 11cm long plastic rod with a sharp point. It had embedded within the muscle beneath the region of the right hip joint. The body had cleverly and efficiently walled off the penetrating part of the foreign body, so that fluid from the intestine did not leak out into the abdominal cavity. The plastic rod was carefully removed, the intestine repaired and the abscess cavity opened up, flushed with sterile saline and surgically suctioned. The cavity was then packed with the ‘omentum’ a natural sheet of tissue within the abdomen which is extremely good at aiding drainage of fluid and preventing further abscess formation.
Zara recovered remarkably well from the surgery but was kept under strict observations at the hospital to ensure that there was normal intestinal healing without complication. Zara was reunited with her family approximately 10 days later. It was incredible to think that despite the consumption of an 11cm plastic rod, that had penetrated her bowel, Zara had shown no obvious signs of a gastrointestinal disturbance!
Zara was treated by Catherine Sturgeon BVetMed(Hons) CertSAS DipECVS MRCVS.
Our thanks to Fraser McConnell, specialist in diagnostic imaging for interpreting the MRI films and to Andrea Scott at Four Paws Veterinary Centre, Warrington for referring Zara to Northwest Surgeons
