Many dogs have a brush with bowel obstructions, which sometimes lead to perforated bowel and peritonitis, which is when the contents of the intestine leak into the abdomen due to the perforation. This is often caused by trying to eat something inedible, like a toy, a collar, or string. For us, this just happened because of a fragment of a raw bone – something not nearly as common, given that raw bones are digestible and dogs (including ours) eat them all the time without issue. Well, until now. This is the story of Mort’s perforated bowel, peritonitis, and intestinal resection as the result of eating a tiny bone fragment off of a large raw femur. I thought I would share our journey in case it helps others notice warning signs, make decisions about what their dogs eat (our minds have obviously been changed), and these posts generally serve as a reminder to me down the road too.
Note: I am not a veterinarian, and blogs from any source are never an alternative to in-person evaluation and care of a professional. Please let this serve as information to be aware of prior to an emergency, but never as an alternative to contacting your vet in the event of one. If you are dealing with a suspected obstruction or perforated bowel, take your dog to a veterinarian immediately.
Please also note: I am not against a raw diet, and will continue to feed raw grind to our dogs (just not bones). We understand that this problem we encountered is rare when feeding raw bones. We are sharing it so you can be aware of this potential problem, and the early symptoms our dog experienced so you can catch it early. There are many benefits to feeding raw bones.
One last warning – there are some photos of a stitched up belly below. If you are sensitive to this, please be aware it is near the end of the post.
Early symptoms of the bowel obstruction
Before we had an x-ray taken, we did not know what the cause of Mort’s upset was. Mort seemed to have a bit of an achy belly, which he usually tells us by stretching his legs or doing a “downward dog” or “playbow” position. This has happened before when he got a bit too much sand off the beach from a tossed ball, but felt fine not too long afterwards.
This time he puked a bit of bark from our evening walk along with a lot of water. Mort loves to carry sticks, and he sometimes breaks them in half and tears them apart. He doesn’t eat them, but I thought he may have ingested some bits of crumbly bark from being on his tongue that had upset his tummy. Apart from that, I didn’t see him get into anything unusual so I thought that must be it.
Mort is an extremely active dog, and gets into things all the time. He’s been known to try chewing inappropriate things, and then he tries to eat them if he gets bored. We’re always watching him, crating him when we’re not home, and everything he might want to chew is put away unless he’s supervised, and actively playing with the object. So mishaps are known to happen, and he’s been through several “close evaluations” on the possible road to the vet. His stomach ache and nausea meant we were now in another such close evaluation, and my gut told me to watch him very closely this time.
We took him for a walk to evaluate him a bit further (he vomited one more time prior to the walk). He was at the end of the leash, acting pretty much “normal”, and apart from a couple leg stretches and a heightened interest in eating grass, not terribly unusual. We thought he may have puked up what was upsetting his tummy, but I still wasn’t calmed. I didn’t really like what I saw – there wasn’t “enough” in his puke to indicate it was stomach contents like it had been before and I was worried about an obstruction from perhaps a larger piece of bark he may have swallowed. Because it was midnight and approaching bedtime, we set the alarm for every two hours to check on him. Just before the first alarm at 2am, Mort puked again and seemed to be in some element of pain now. He was acting a bit more unusual. And that’s when we headed to the vets.
X-rays at the vet revealed raw bone fragments
The vet we go to for emergencies is Adobe Animal Hospital in Los Altos. It’s an open veterinary clinic, which is the best concept ever. Essentially, I get to go wherever Mort does and apart from surgery can watch everything that happens. The ICU has visiting hours between 9am and 10pm. In my opinion, every veterinary clinic should have or at least work towards a policy like this. My anxiety is reduced as a result, and I truly believe the pets anxiety is reduced as well. This emergency vet is about 20 minutes away, and we were on their doorstep at a little after 2am. After a checkover, Mort was in for x-rays, and in his painful state luckily didn’t put up too much of a fight this time. The x-rays revealed two small fragments of raw bone, and gas bubbles.
This result was not necessarily unusual, nor was it particularly unexpected. Mort has eaten a prey model raw diet for about two years (raw grind with bones), until a couple months ago when I switched him to a grind and large “non-consumable” raw bones to clean his teeth. Mort ate his raw bones too quickly at times, and we were having issues with him swallowing them correctly (one episode landing him at that same vets – he managed to puke it up before surgery was needed). So we switched him to huge femurs and knuckle bones – things he couldn’t eat, but would still clean his teeth. So the fragments weren’t much of a surprise, as the large bones had meat, ligaments, and small bits attached that could be consumed. The fragments in the x-ray were simply pieces of these, and they should normally be digestible. They are in most dogs, have been in our dogs for years.
Our hope is that the offending fragment would pass through and digest, as they normally do. We were praying for poop.
Mort got fluids, pain medication, and antacid while at the vets, and we were sent back home with instructions to try feeding him at 10am. If he wasn’t eating and acting normal by then, to return.
The next morning – the symptoms were worse
Mort was checked on at 3am (sleeping) and we got up at 7am. Mort didn’t really want to get out of bed, but was awake. And staring at us, and definitely not his self. Complicating an assessment of the situation were the pain meds he was given only 4 hours before – I didn’t know what was a result of being doped up, or what may have been pain, obstruction or heaven forbid a perforation.
It was time to do a quick evaluation in the form of a potty walk, but I knew this would be followed by heading to the vets. Mort did not want to get off of the bed, so he was helped down. He walked to the stairs himself, but sat down at the top of them. When my husband lifted him up to carry him down the stairs, Mort snapped at his face. Goes without saying this was a massive warning sign something was terribly wrong.
We took him outside to potty, and it was pretty obvious he wasn’t well. His rear legs were a bit shaky, and it’s hard to explain, but he was walking very lightly on them. Sort of like his rear half was being favored. He kept going to the grass like he wanted to poop, but couldn’t. Then he would sort of stand there, and half close his eyes. Oddly though, he actually wanted to go on the regular walk, and I had to force him to turn around and head back home so we could take him to the vets. Despite seeming pretty well out of it and in a lot of pain, he wanted to power through our regular walk.
When we got home and dashed around to collect our wallets to go into the vets, Mort didn’t even leave the front door. He usually dashes around the house at top speed. Our little dude was really quite unwell.
Back to the vets for an ultrasound
We returned to Adobe Animal Hospital, where Mort was checked over and whisked back for immediate treatment. His temperature was normal, but respiration wasn’t. The doctor decided to give him an ultrasound, and got to see the entire analysis. Little dude lay there the whole time, completely stationary and just staring at me. It was pretty clear the bone was jutting up through his intestine, there was some free fluid around the area, and that this little guy was in a pretty bad predicament. It was announced he was a surgical case, we signed the papers, and he was set to go into surgery that same morning. The doctor explained that there were three main possibilities:
- The object could be massaged through the intestine into the colon, where it could then be left to pass. This was the least invasive, but it was pretty unlikely in his case because the bone fragment was sharp and this could cause damage.
- An incision could be made in the bowel, and the object pulled through and removed and then closed up. This weakens the bowel, but it’s less risky overall. The doctor was hoping this would be the case for Mort.
- If the bowel was damaged, a piece would need to be removed and then the two ends joined back together again (resectioning). This is the most risky and dangerous, hopefully this wouldn’t be necessary.
We stayed with him until he was on a drip with more pain meds, and about 10 minutes from being taken to surgery. He seemed a lot more comfortable as soon as he was given the medication, and was getting pretty drowsy. I told him to be a strong little man, and we left him in the care of surgery.
The time between initial symptoms (that were subtle) to surgery was about 12 hours.
Peritonitis: It was worse than we thought, but he was lucky
When we heard from the doctor, Mort was in a much worse predicament than we previously thought. He not only had an obstruction, but the bone had in fact perforated his bowel and started leaking harmful bacteria into his abdomen. This is called peritonitis. From Vetlearn.com:
Septic peritonitis is an inflammatory condition of the peritoneum originating from a combination of bacterial and chemical contaminants within the abdomen. It is the most common form of peritonitis in dogs. Septic peritonitis can have a wide variety of clinical courses and outcomes depending on the signalment of the patient, the source and degree of contamination, and the body’s response to the contamination. This clinically important condition is associated with high morbidity, and mortality ranges from 20% to 68%.
The doctor had to remove about 6 inches of his small intestine, and sew the two ends up. They tested the resection (by filling it with water, essentially), and the test was successful. Hopefully his bowels will work. Here is his surgical scar – this was major surgery indeed.
We learnt that the intestine where the perforation occurred had not deteriorated. We also learnt that it had not leaked all that much, and because of this we seemed to have caught it very early. This could very well have saved Mort’s life. We were told that had he come in, say, 12 hours later “we would be having a very different conversation”.
A blood test revealed that his numbers were normal, which indicated that the peritonitis was probably caught early enough not to do damage to his overall system. So while Mort ended up having the worst predicament, we caught it early enough that he has a good prognosis.
When we visited Mort that night, he seemed a lot better than he had been in the morning. He had gone on a walk, peed with a lifted leg, and even stood up and paws at the door when we arrived. He was very dopey, but seemed much better off overall.
The bone that caused this
We were given the bone that caused all of this in a small ziploc baggie. Well, I was asked “do you want to keep this?” and I replied “Well… I’m a dog blogger, so yes.” Here it is, with a coin to help with scale.
To put this in perspective, dogs eat bones with ease that are much larger than this. Our other dog takes down chicken necks nearly whole, and will crunch a chicken leg once and swallow. Typically the bones are broken down and digested. We had an unlucky break with this one, which ended up being quite sharp despite being fed raw (which do not splinter). For our takeaways about this, continue reading.
Where do we go from here? What have I learnt?
Mort, at this time, is still in the ICU. He got through surgery with flying colors – luckily he is a young, active dog in very good physical condition. Obviously we learned a lot from this.
- First off, we had very bad luck. Raw bones are edible and digestible and most dogs do just fine and thrive on them, as they have been for thousands of years. Choking is a more recognized hazard, and still not terribly common. That said, this has scared me off of raw bones completely. Our dogs will no longer be getting bones of any kind, but will continue to get raw grind.
- Listen to your gut when trying to determine “is something wrong?”. Look in your dogs eyes – what do you think you should do? Listen to your answer. And always defer to going to the vet if you are ever unsure.
- This is the fifth time I have had to use an emergency vet in about 4 years, 3 of them have been with Mort, 2 of which have involved surgery and another was a surgical close call. Living close to an emergency vet or having one to call in an emergency is important. Having insurance is important, particularly with an active dog.
- Active dogs get into things. But it’s not necessarily those things that cause the most trouble! It can be unexpected things like relatively safe bones that send them into surgery.
- You can try your best, think you’re doing the right thing, but still run into unforeseen issues.
- Having an “open vet office” is very important to me, greatly reducing the anxiety I feel while being at the vet and not having to wait behind closed doors wondering what is going on. And greatly benefiting the animal by having a known entity in the room. Mort often would stare at one of us, probably for reassurance while in pain and being scared with what is being done to him. I will seek and always choose an open vet office over a closed one if I can.
For more information on bowel obstructions, perforated bowel, and peritonitis in dogs
WebMD: Intestinal Obstruction and Gastrointestinal Foreign Bodies in Dogs
Peritonitis: Septic Peritonitis: Etiology, Pathophysiology, and Diagnosis
UPDATE: For an account of another dog who experienced a perforated bowel from a raw bone (in this case, chicken), please read this description and question posted on DOGthusiast.
And as mentioned at the beginning: I am not a veterinarian, and blogs from any source are never an alternative to in-person evaluation and care of a professional. Please let this serve as information to be aware of prior to an emergency, but never as an alternative to contacting your vet in the event of one. If you are dealing with a suspected obstruction or perforated bowel, take your dog to a veterinarian immediately.