Hello, thanks for your question today! I am Dr. Drew, and I am a licensed veterinarian. I'll be happy to help you in any way I can.
I am sorry to hear about Barkley's vomiting issue.
My first thought, when I read your first sentence of the question, is that this is a surgical case.
Persistent vomiting, after eating from the trash, means that there's still something lodged somewhere, until proven otherwise!
Go on, please
Just because it doesn't show up on x-rays or ultrasound, does NOT mean that there's nothing foreign in there.
I've seen many cases where something small, such as a bit of plastic, gets lodged in the intestine.
This won't appear on either imaging test
What should we have done.
and was only found when we went to surgery.
Exploratory surgery is needed, in my opinion./
Clearly, medical management is not resolving Barkley's issue.
When you say "in there" where is that?
... in the digestive tract.
So what is the procedure called?
Exploratory Laparotomy, basically going in to the abdominal cavity to examine all the organs.
Ok. Would you describe the surgery.
Is this dangerous? Is there a high success rate?
After cutting into the abdomen, each organ is viewed, palpated by hand, and evaluated for its condition.
the stomach or intestine may be cut into in order to look inside.
How can they "see" if something is there?
there's always a risk, but the longer you wait, the weaker Barkley becomes,
and the worse the prognosis.
He vomits water ( we make sure he doesn't over drink) after drinking. We even switched to bottled water
I don't think bottled water vs tap water is going to make a difference, to be honest.
We are trying everything we can think of. Can our vet (it's an animal hospital and we have been going there for ages) perform this or do we seek a specialist?
I'm honestly a bit surprised that your vet hasn't already suggested it... so that makes me question whether or not they feel comfortable performing the procedure -- but I'd still ask them about it first, since it may not have occurred to them that there's some foreign material present that isn't appearing on the x-ray or ultrasound.
a specialist is not needed for a typical exploratory laparotomy.
If he vomits within an hour or so of eating, how could he have this object further in his digestive tract? I don't know how quickly food travels from mouth to digestive tract, but that certainly seems quite quick to me.
the digestive tract includes the entire path that food takes. It's in the digestive tract as soon as it is swallowed.
esophagus, stomach, small intestine, large intestine.
So he could have hurt his esophagus?
possibly, but that would result in vomiting much sooner, I suspect.
based on your description I'd suspect the duodenum (first section of the small intestine).
So, as a general rule, how long does it take for food to pass from mouth before entering the duodenum?
generally within an hour, up to 4 hours
Oh, my husband says that Barkley has bowel movements.
that's great, so obviously some food is getting by
I guess I need to look at a diagram of canine digestive system. How certain are you?
Yes, I realize there are no certainities in the world
Certain about what? I can't make a diagnosis without ever examining Barkley. Certain about the anatomy? 100%.
It was a stupid question. Do you agree with the Rx he's been given?
well, those medications are reasonable to try, but I'd have re-evaluated my choices much sooner than 2 1/2 weeks in to treatment.
Cerenia is a potent anti nausea medicine. When vomiting persists even with the use of Cerenia, there's something significant causing it.
Okay. Any ideas of what we can feed him?
what to feed, is not the issue here, the issue is that the diagnosis needs to be re-evaluated, and the longer you delay in doing so, the worse his prognosis becomes.
If further evaluation is not an option,
ok. We will make an appointment immediately. Any last words?
then liquefied / blended foods, such as white rice and boiled chicken, would be worth a try.
If your vet is not sure where to go next, in this process, then asking for a referral to an Internist (internal medicine specialist) is entirely reasonable.
How long have you practiced vet medicine?
about 10 years.
I studied at Cornell University, Ross University, and University of Missouri... do you have any other questions related to Barkley's health today?
Oh, I do have one more question. When they do this laparotomy (spelling), how do they "see" the foreign object.
If anything unusual is seen or felt, the organ will be cut into.
Viewed under microscope or with naked eye?
naked eye. microscopes cannot be used inside a patient.
Thank you. I don't have any more questions. You have been very helpful. How can I keep you informed about Barkley?
You are very welcome, you can reply to give me an update if you wish anytime, after you provide a rating today, I can change the question into a Q/A format which can be re-accessed at any time.