UC Davis Veterinary Radiologists Help Save Dog with Foxtail Near Aorta
April 4, 2016
Diagnostic imaging saved Joey by discovering a foxtail dangerously close to his aorta.
"Case of the Month" - April 2016
Joey, a 4-year-old male German shepherd mix, loves to play frisbee. While playing nine months ago, he ran into a tree stump. Initially, he appeared to be alright following the event, however, swelling developed over his left hip the next day. Joey’s veterinarian aspirated the wound and drained fluid from it that was consistent with a hematoma.
About a month later, the swelling returned as an abscess. Cultures of the wound revealed a bacterial infection. It was drained again, and Joey was placed on antibiotics which resolved the swelling. A few days following completion of the medications, though, the swelling returned.
After months of unsuccessful treatment, Joey was brought to the UC Davis veterinary hospital, where specialists discussed potential causes of non-healing wounds, including self trauma, infection, or a foreign body in the area.
Dr. Anthony DeRouen—a fourth-year resident with the Diagnostic Imaging Service—and faculty member Dr. Allison Zwingenberger, reviewed imaging options with the Soft Tissue Surgery Service to identify the best way to investigate the cause of the wound. The hospital’s imaging team has more board-certified radiologists than any veterinary hospital in California. Their facilities and expertise include radiographs (x-rays), ultrasound, CT, MRI, and nuclear medicine. Each of these different imaging tests can provide different and useful information about the source of infection. In Joey’s case, their expertise proved invaluable in saving his life.
They recommended starting with an ultrasound examination with an option to do a CT scan if more information was needed. Dr. DeRouen performed an ultrasound scan on Joey that revealed a tract that could be traced from the initial wound area on his hip toward his abdomen. Near the end of that tract was a large foreign body. The tract indicated that the foreign body had burrowed its way into the muscles near the spine, and was likely a foxtail. The ultrasound also located the foreign body to be beside the lumbar vertebrae and about an eighth of an inch from the aorta. The foreign body was clearly visible with ultrasound, and the CT scan was not needed for more information before surgery. X-rays of his back were performed to ensure the infection had not affected his spine.
Based on these findings, the radiologists recommended that surgical removal of the suspected foxtail was the best course of action. Not only was it important to remove it to eliminate the source of infection of Joey’s hip wound, but to prevent the foxtail from migrating toward the aorta, which if penetrated, could result in life-threatening internal bleeding.
The Anesthesia/Critical Patient Care Service placed Joey under general anesthesia, and he was taken to surgery. Surgeons were assisted by Dr. DeRouen, who used ultrasound during the surgery to guide them to the foxtail, and more importantly, avoid the aorta. Following extraction of the foxtail, as much of the infected tissue as could safely be removed was debrided.
Joey remained stable under anesthesia throughout his surgical procedure and recovered well. He was hospitalized after surgery, where he received supportive care from the hospital’s technical staff as they kept him comfortable and monitored him closely for any signs of post-operative or post-anesthetic complications. After two days, Joey was discharged and made a full recovery at home.
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For ultrasound images of Joey's case, please see our Facebook page.
About the Veterinary Medical Teaching Hospital
The William R. Pritchard Veterinary Medical Teaching Hospital at the University of California, Davis—a unit of the #1 world ranked School of Veterinary Medicine—provides state-of-the-art clinical care while serving as the primary clinical teaching experience for DVM students and post graduate veterinarian residents. The VMTH treats more than 51,000 animals a year, ranging from cats and dogs to horses, cows and exotic species. To learn more about the VMTH, please go to www.vetmed.ucdavis.edu/vmth. Timely news updates can be received on its Facebook (www.facebook.com/ucdavisvetmed) and Twitter (www.twitter.com/ucdavisvetmed) pages.
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