Beemer was presented to the University of Missouri on June 22nd, 2016 for vomitingand lethargy throughout the day. He was suspected to have ingested a foreign body, and radiographs were taken to confirm this diagnosis. The following day Beemer was transferred to our hospital where Dr. Forbes performed an exploratory surgery, extracting two knee-high pantyhose tied together from his stomach and small intestine, which bound up so much so it looked like a scrunchie! Beemer recovered from the surgery well, and was discharged the following day.
By mid-July, however, Beemer began regurgitating his meals encased in a mucosal sack. Beemer would regurgitate his dry food two or three times per feeding before he was finally able to keep it down. He was brought back in to our hospital for examination, and was suspected to have esophagitis (inflammation of the esophagus). We prescribed a mucosal protectant and an antacid, though he continued to regurgitate his food in sacks.
Radiographs were taken by our hospital to look for an esophageal stricture (narrowing of the esophagus). Nothing remarkable was noted, and so it was recommended to do a swallow study at the University of Missouri with a fluoroscopy to determine the problem. The fluoroscopic swallowing exam uses a noninvasive form of animated radiography to see how patients swallow in hopes to determine problems with efficiency or safety. Possible suspects were: a stricture, decreased mobility of the esophagus due to possible damage from ingesting pantyhose, or severe esophagitis. The results from the fluoroscopy were normal, however. An esophagoscopy was then also performed by interesting a flexible endoscope into the mouth, utilizing a small camera at the end to visualize the esophageal mucosa. The endoscopy exam revealed that Beemer had severe esophagitis and ulceration and edema (swelling) of the esophagus. It also showed edema in his small intestine, and plastic is his stomach (which we later found out that Beemer had ingested something else he should not have the same day he was sent home!).
Beemer was kept on the mucosal protectant and antacid, as well as pain medications, an anti-nausea drug, and a medication to help increase his gastrointestinal mobility. He was also put on a strict diet of low fat canned food to be handfed in meatballs three times a day over a period of 15-20 minutes. Over the next month Dr. Forbes worked alongside veterinarians at the University of Missouri to tweak Beemer’s medications in order to get his vomiting under control. He was additionally put on an antibiotic when he developed diarrhea. By September Beemer was able to stop the pain medications and one of his antacids and started slowly transitioning his meals from three times per day to twice a day. We were also able to start mixing in 6-7 pieces of dry kibble per meatball, which was an exciting step forward. Slowly, we were able to increase the amount of dry food per meal and decrease the amount of wet food. However, Beemer started regurgitating his food once more when too much dry food was added.
Another esophagoscopy was performed, confirming that Beemer still had moderate esophagitis and esophageal ulcers, as well as a small stricture in his distal esophagus. The procedure also showed scar tissue along the esophagus, which left Beemer at an increased risk for more or worsening strictures. The pain medication, antacid, and strict canned-only low fat diet were all added back into Beemer’s rigorous daily medical management for four weeks before a recheck examination to determine his progress.
After this set-back, Beemer was weaned back off the antacid and pain medications, as well as the mucosal protectant and gastrointestinal mobility drug. A small amount of dry kibble was also introduced back into the meatballs, which were still being hand fed over 15-20 minutes. By December Beemer was gradually being fed less canned food and more dry kibble, which was now being softened in water before each feeding. He was also able to eat his food on his own, as long as it was fed at his shoulder height!
It has been a long tumultuous road, but Beemer is now off all of his medications except for one antacid before his breakfast. He is eating all dry food (softened in water, of course) by himself twice a day raised to his shoulder height. Since Beemer is now able to keep his food down, he has gained 13 pounds since after his exploratory surgery, and is now at a healthy weight. We hope to feed plain, dry kibble with no antacid in the near future, but for now Beemer has made tremendous progress, and we are all so proud of him! We are so glad Beemer has such a wonderfully dedicated mom, as she has put in a lot of time and effort to ensure that Beemer receives the best care!
Written by Maggie