Intussussception

Maddie_before_2 Maddie sort of "fell through the cracks".  That’s just a figure of speech, though here she looks thin enough to fall through a crack.  The "crack" she fell through was the one that formed when the marriage split.   She’s really Mom’s dog, but she liked to go down to the farm shop and hang out around Dad, who was pretty busy on the farm.  So Mom didn’t get to see her just every day.  A couple of weeks earlier she noticed that Maddie didn’t look just right, but she looked a lot better than this.  We’re talking about a beautiful Golden Retriever who’s only about a year old, and she looks like she’s dying of some terrible disease.

Maddie’s attitude was surprisingly good when you consider her emaciated condition.  Her bloodwork was pretty normal, except for the abnormalities you’d expect in a starving dog (anemic, low albumin, etc.).  Of course, she had plenty of food available, so why would she be starving?  Her abdominal X-ray did appear really abnormal, so it looked like an exploratory surgery was in order (after 24 hours on I.V. fluids, that is; she was pretty dehydrated).

Intuss_2 This is what we found inside.  And what might this be, you ask?  Uh, the title of the post is "Intussussception", so that would be a pretty good guess.  Right… so what is an intussussception? I mean, besides a really long word that’s hard to say?

Intuss_diagram_2 Here is a diagrammatic representation of what you see in the photograph, minus the blood and stuff.  For unknown reasons, a section of intestine folds inside of another section of intestine, the way the old pirate’s telescope collapses as the sections slip inside one another.   This produces a nearly complete blockage.  Liquids can pass through, but solids can’t make it.  A slow starvation like this is one presentation, but some individuals get very ill, very suddenly.  Sometimes it happens when a dog has a whipworm infestation.  Sometimes it happens after a bad intestinal infection with lots of cramping (I’ve seen it as a complication in puppies with parvovirus — a fatal complication in those cases).  Lots of times we just don’t have any idea why it happened.

Intuss_diagram_xsection Here’s a cross-sectional view.  Doesn’t it look like a telescope?  I mean a floppy, pink, gooey telescope that’s full of crap instead of stars?  Sure, it does.  What may not be obvious to you is that the part that’s inside has its blood supply pulled around a 180 degree corner.  That pretty much crimps it shut, meaning no blood supply for the "inside part", meaning it dies. SO, even though it looks like we could just pull on the ends and open up the telescope, that doesn’t work.  You have to cut out the whole mess and join the rest of the intestine back together again (what we surgeons refer to as "intestinal  resection and anastomosis" — this post is just full of big words, isn’t it?).

Maddie_10_days Here’s Maddie just 10 days later when we took out her stitches.  She’s gained 8 pounds, up to 52.  Not back to her fighting weight, but on the right track.  The surgery must have gone okay.

Maddie_march_08_2 And here she is at a contented 73 pounds, which is about right (maybe even a little chubby).  I love a happy ending (especially when you’ve taken 18 inches out of the middle).

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