Of sick puppies and nasty surgeries: Intussusceptions 101

Patty Khuly, DVM
Updated: November 01, 2010
Published: January 16, 2008
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There’s no end to the havoc one’s own body can potentially wreak. Autoimmune disease (where the body’s immune system attacks itself) is one example. Colic in horses, where intestines slither and twist into unnaturally painful contortions, is another.

I mention colic because today’s disaster case was kind of like the dog’s version of colic. I guess you could also call GDV (AKA, “bloat” where the stomach fills with gas and twists on its own ligamentous axis) colic-like, but it’s not really about the intestines, as in today’s adventure.

Enough lead in. Today’s patient is a four month-old yellow Lab pup. He and his fellow pups had somehow unearthed and devoured a forty-pound bag of their parents’ food. After about a week, they’d all recovered from their obligatory cases of overindulgence-inspired diarrhea –except for this pup. His had just gotten worse. And now he was vomiting, too.

Simple palpation of his abdomen revealed the problem immediately: intussusception.

His parents had never heard the word, but anyone with experience in major intestinal disturbances might. It’s when one part of the intestine “telescopes” on itself. I like to picture it as one bit of bowel devouring the one that came before it. Here’s a pic of its human version:

Once you can see that in your mind’s eye it makes you wonder how it doesn’t happen more often. Seems like a stupid loop of intestine wouldn’t ordinarily know how to keep itself out of that kind of trouble (especially when stressed by something as inadvisable as the consumption of a whole bag of dog food).

Dogs, horses and goats are the only species I know of who can easily kill themselves in a single act of dietary overconsumption. Humans come darn close, but it usually takes some extra work—or some serious stupidity.

Dogs, by their very nature, are prone to gorging. When they do so, their bowels go into overdrive, working hard to move everything along as best they can. Sometimes the bowels get tired and quit. That’s when we see nasty intestinal slow-downs that lead to vomiting and stinky, slurrried stools. Sometimes the bowels just get overactive in spots, sort of like they’re compensating for their lax counterparts. And that’s when it happens.

It happens with viruses (like parvo), bacterial infections (like salmonella), worms, but most commonly with garden-variety dietary indiscretion, as with this pup. Serious diarrhea is how it starts, usually. And serious vomiting is most commonly how it ends.

In this case, the ileum (the last section of small intestine), was swallowed whole by the adjacent large intestine. Unfortunately, it’s the most common spot for such a travesty. Surgery is the only reasonable option for this disease (as in all intussusceptions). Without it, the ingested loop of intestine dies and the whole bunch of tissue encasing it falls apart like a rancid sausage—not something you want inside your pet’s body.

Problem is, surgery usually means cutting out the affected bits—in this case, a crucial bit of small intestine and a significant bit of the large intestine.

If only I could’ve punted this one to a surgeon—this is a nightmare surgery! But somehow, puppy and kitten cases always get fewer funds allocated to their survival. Here’s one example where the human paradigm doesn’t hold true: While old guys get the benefit of all the years of adoration, babies suffer the misfortune of a proportionate lack of history. Few owners are willing to blow their load on the unknown, it would seem.

That may sound coarse. But it’s the truth. Not always, but this case was no exception. “Do it for under a thousand or euthanize him, Doc.”

What heartless person would stop halfway knowing their work was destined to end in euthanasia unless he stopped cutting mid-surgery? So we finished it, three hours later, for $1,000 in three payments. Don’t seem fair for all the work, stress, materials, drugs, days of hospitalization and staff time—but there you have it.

If this post seems half-a$$ed and whiny, it’s only because I’m tired. All because one pup couldn’t keep his head out of an endless bag of chow. Or is it because one owner couldn’t keep his pups out of it? To be fair, it’s more likely on me. If we weren’t willing to do the work, maybe fewer people would undertake to consider a surgical outcome for a truly nasty disease like this. Knowing we can fix it, though, makes all the difference—to us anyway.