Purpose of the Procedure:
Enterotomy is a surgical procedure that involves opening the intestines to remove blockages and foreign bodies.
Obstructions can be caused by various substances such as rope, small marbles, bottle caps, toy pieces, small cloth fragments, or socks. Typically, these blockages occur in the small intestines.
While this condition can affect cats and dogs of all breeds, it is more prevalent in Siamese cats.
Patients afflicted with this condition may exhibit symptoms including vomiting, loss of appetite, diarrhea or constipation, and a noticeable decline in their overall health. In cases of complete and sudden bowel obstruction, patients may experience vomiting and be unable to pass stools. The patient may become unusually quiet, and signs of pain may become evident within the first 24-48 hours. Without a timely diagnosis, the patient’s condition may deteriorate, potentially leading to fatal consequences within a few days.
The disease can be accurately diagnosed through the use of X-rays, with or without the administration of contrast agents
Preoperative Considerations:
Before the operation, it is crucial to assess the patient’s overall health in consultation with the physician. This ensures that the patient is in good condition and not at risk during anesthesia administration. Depending on the veterinarian’s discretion, X-ray, ultrasound, or blood test results should be reviewed.
If the patient’s general health is satisfactory, they should be closely monitored before the operation, and antibiotics should be administered along with fluid treatments. However, this process should not be prolonged to avoid the potential for necrosis, septicemia, and adhesion.
In cases of complete intestinal obstruction, emergency surgery should be promptly performed. If the patient has any medication allergies, it is imperative to inform the physician. The patient should abstain from food and drink for 12-24 hours prior to the operation to ensure a smoother administration of anesthesia. In instances where there is no complete blockage in the intestines, it is advisable to monitor the patient’s nutrition and provide liquid foods until a diagnosis is made.
Operation Technique:
Sterilization procedures take place in the patient’s preparation room, where sedatives are administered for the operation. Initially, the fur in the operation area is shaved, and the spot is then disinfected using an antiseptic solution. Following these steps, the physician determines the level of anesthesia, and the area is covered with a sterile drape, preparing the patient for surgical intervention.
The most suitable area for the operation is the middle abdominal line, known as the linea alba. In this area, there are few veins, minimizing the risk of bleeding. Accessing the intestines from this area is straightforward. The area is opened in the abdominal cavity where the intestinal obstruction is located, and the obstruction is removed. In certain cases, the impact of the obstruction may lead to the rotation of the intestines or stomach. The intestines and stomach are assessed in case of complications. If a complication arises, it is addressed, and an incision is made slightly further from the area where the foreign body is located (undamaged solid tissues), allowing the object to be removed. After the foreign body is extracted, the bowel is closed using sutures.
During the operation, it is crucial to prevent the flow of intestinal contents into the abdominal cavity. Therefore, intestinal clamps should be applied on either side of the blocked section.
Exposed intestines can dry out quickly. To prevent this, the intestines are regularly moistened with serum during the operation and are not allowed to dry.
Following the suturing of the intestines, the abdominal cavity is also sutured and closed.
Postoperative Considerations:
Antibiotics should be administered to the patient after the operation. The dosage and timing of antibiotics should be determined according to the physician’s recommendation. After the operation, the WinPet MedVest should be used to prevent the patient from causing damage to the operation area by licking or scratching. Vigorous movements, such as jumping, that could jeopardize the patient’s healing process should be avoided. The WinPet MedVest acts like a snug corset and helps prevent undesirable outcomes.
After the operation, the patient should fast for 48-72 hours, and their general health condition should be regulated through fluid therapy. Only watery foods should be provided to the patient for the next few days.
Full recovery typically occurs within about 10-12 days, at which point the stitches can be removed.
During this period, if the patient experiences bloating, redness, inflammation, or any other concerning symptoms, they should be promptly examined by a veterinarian.
A few days after the operation, it is advisable to conduct an X-ray with contrast material to assess the functionality of the bowel.
Possible Postoperative Complications:
When proper sterilization, appropriate material usage, and regular antibiotic administration and serum treatment are managed effectively during the operation, the risk of complications is very low.
However, the patient should refrain from excessive and inappropriate exercise. Stitches should be safeguarded after the operation. The WinPet MedVest should not be removed from the patient during the healing process, as doing so may lead to evisceration (sutures opening and internal organs protruding).
The primary rule of the operation is to prevent the contents of the bowel from entering the abdominal cavity. Otherwise, the patient may develop peritonitis, which is a critical complication. Symptoms may include deterioration of health, weakness, loss of appetite, high fever, and septicemia.
