Greenies
This is an important message from a Vet student at a large University. Her name has been removed at her request.
I would like to share something with everyone - it doesn't require any response, as I know the Greenies thing is an old issue. I am probably breaking some client/patient/doctor confidentiality, but I will play ignorance and hope someone learns from it.
I was one of those people that believed as long as you are responsible with giving the right size and paying attention to the dog eating it, Greenies really aren't that bad. Well, I hope everyone who still insists on feeding Greenies reads this story. I know that I WILL NEVER FEED ANOTHER ONE TO MY DOGS AGAIN!
I just got home from school and it is now 12:20am. We admitted a 9 year old Lhasa today that was fed a Greenie yesterday. The owner saw the dog choke on it so took the rest away. This morning he went to his regular vet who took x-rays and sent him to the vet school for treatment.
The dog was put under anesthesia at 2pm today. First we tried endoscopy - we put a scope down the esophagus since we could tell the foreign body (FB=the Greenie) was lodged there by the x-rays. We spent 11/2 hours trying to push it into the stomach, break it into pieces or seeing if we could pull it out. We were only able to budge the FB maybe 1/2 inch and the esophagus looked horrible - very inflamed and ulcerated. They were not able to move it much and were afraid of perforating the esophagus, so they sent it to surgery. We began cutting at about 4pm.
I was the student that scrubbed in on the surgery and I am absolutely horrified at what I saw. First we went into the abdomen and cut into the stomach and removed chunks of greenie - they turn orange in the stomach b/c of the acid. We had to use suction with a fine tip and hemostats (flat not sharp scissors) to get large pieces out of the stomach. We could feel the piece that was lodged in the cardiac sphincter (that is the part of the stomach where the esophagus meets it and it is narrowest here) but we were not able to budge it at all. The whole time we were trying to move it we worried about rupturing the esophagus. When we realized that we couldn't get to it from the stomach, we knew we had to get it from the other end. This meant we had to cut into the chest.
We performed a caudal medial sternotomy - we cut from the bottom of the rib cage up. Then we had to move lungs to the sides and the heart forward to see the esophagus. The greenie was lodged in a sideways position - about 2 inches wide and about 2-3 inches long - in the esophagus under the heart. I HELD A HEART IN MY HAND TO REMOVE A CHUNK OF GREENIE FROM A DOG'S ESOPHAGUS! We still had to chip away at it - it breaks into thousands of mushy pieces when it gets soggy. We tried to keep it as sterile as possible - and the University has all kinds of fun tools - but there was bits of greenie all over that dog!
If that isn't convincing enough, I would like to share what a thorocotomy and laparotomy like this involves. The esophagus has a nerve that runs alongside it called the vagus nerve. There is something called vagal tone that helps control blood pressure. Everytime we put pressure on the esophagus to try and reach the FB, the blood pressure would drop down to 20 (normal is more than 90). The vena cava runs alongside the esophagus and everytime we put pressure on the esophagus, the vena cava would get pushed on. The FB also occluded thoracic lymph flow and cause lymph backup in the intestines. We had to put in a chest tube to close the thorax, and a stomach tube to feed the dog through because nothing can pass the esophagus while it heals. We had to pass a urinary catheter so he can urinate. And all this only matters if he doesn't get septic and die from a bacterial infection.
Surgery finished at 9:20pm, and I just left the ICU after getting the dog settled in an oxygen cage for the night. I hope I have a patient in the morning. The resident and clinician that did the surgery said that they see lodged Greenies all the time. The internist that did the endoscopy said greenies will keep us in business if people continue to insist on feeding them.
I know this was long, but I sure hope it convinced all the Greenie-faithful. I know the dogs love them - mine do too. I just gave them their last greenies yesterday. I can promise you that those were their last.
