Visiting Vet: Bones are not humerus

Be sure to keep the bones away from your pups this Thanksgiving.

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Three families. Four dogs. A whole lot of short rib bones. The first people were not regular clients, but referred to me as “the vet on call.” I think on a Saturday afternoon. The second folks emailed me one evening. The subject line was something like “Both dogs ate bones, I’m freaking out.” These two households contacted me immediately after they realized the dogs had gotten the bones. At least I think that’s right. Honestly I can’t remember the timeline. The third family . . . hmmm . . . I think they called 24 hours after ingestion. But I might be wrong. Then there was the gentleman whose dog ate 40 pieces of sugar-free xylitol gum. Oh, and another dog who bit an albuterol inhaler. (These last two I sent immediately off-Island as both situations warranted hospitalization and careful monitoring.) But the bones, well, we see a lot of dogs who eat a lot of bones. With Thanksgiving upon us, and what with me being on call (yet again) on Turkey Day, I expect a few more cases soon. 

So let’s talk bones. A number of factors impact how serious the risks are when a Puppy Pilgrim eats bones. What kind of bones?  Cooked or raw? Did Pilgrim chew them or swallow them whole? Poultry bones are generally smaller and softer than beef or pork. Pilgrim is more likely to chew them into smaller pieces, which might pass through the system more readily. On the other hand, they may be more likely to break into dangerously sharper fragments. Cooked bones of any kind are more likely to splinter than raw bones, posing greater risk of perforating the gastrointestinal tract. And if Pilgrim swallows a  big chunk of knuckle bone whole, that’s at greater risk of lodging in the intestines, causing an obstruction.

When Pilgrim eats bones, the first decision needed is whether to induce emesis. In other words, do we make Pilgrim vomit in hopes the bones will come back up the way they went down?  Advice on this may vary vet to vet. Here are factors to consider: Are the bones likely to be able to move through the intestines and come out the other end without getting stuck or causing serious damage? A large dog who ate a small bone will likely be able to pass it, especially if he chewed it well. A small dog with a large bone? More of a problem. 

Why not  make every dog vomit? Because that can sometimes do more harm than good. Throwing up is a spasmodic action, with forceful contractions that push ingesta out of the stomach and back up the esophagus. If the bones in question are sharp, they might perforate or even tear the esophagus as the muscles contract vigorously. A torn esophagus is bad news. Another rare but potential risk is that a large bone may only get halfway up, then lodge  in the esophagus, unable to move either up or down. This may leave Pilgrim in worse distress than before and likely require urgent transport off-Island to an emergency facility with a fiberoptic endoscope. Other factors to consider include age, breed, and health of the dog. For example, small pug-faced dogs can have more trouble vomiting and higher risk of complications like aspiration pneumonia. Finally, inducing vomiting is only useful if the bones are still in the stomach. For the folks who contacted me 24 hours after the ingestion, that would be unlikely. It is often advisable to get  X-rays before doing anything, so we can be sure how many bones Pilgrim ate, how big and sharp the fragments are, and exactly where in the gut they are located.

I like to discuss risk factors with the owners. Then, if together we decide the benefits  of inducing vomiting outweigh the risks, I have them feed Pilgrim several slices of nice squishy bread. The idea is to wrap those bones in a soft, smooth breadball cushion before making him throw up. Vomiting can be induced at home with oral hydrogen peroxide. Mixed in a little milk, most dogs will lap it right up. (Consult your veterinarian first for the proper dose. Too much peroxide can cause severe gastritis, and even stomach perforation.) Vomiting can also be induced at your veterinarian’s office with medications such as apomorphine or the recently approved product called Clevor. If we do not induce vomiting, I still tell folks to feed that soft bread, followed by a lubricant gel like Laxatone (a hairball treatment for cats) and to repeat this for a few days..

We did not induce vomiting in any of the four dogs. Everyone had radiographs taken. The smallest dog got X-rayed twice over two days because his first film showed several concerning large fragments, but all four dogs ultimately passed all the bones uneventfully. Not every case ends so simply. Like the time two 4-month-old golden retriever puppies each ate a rib bone. Not short ribs. These were loooong ribs. I haven’t a clue what the owner was thinking when he handed a bone to each puppy but within seconds each swallowed their bone whole. We’re talking 3 to 4-inch-long ribs, clearly too large to have any hope of passing naturally. We went immediately to surgery, one pup after the other, to remove the bones from their stomachs. 

So now we’ve spent Thanksgiving talking about vomiting, pooping, and surgery, do everyone a favor. Get rid of those turkey and ham bones. Close trash cans securely. Don’t underestimate the ability of a determined dog to get into the garbage. Don’t put bones in your compost. One of my short rib dog’s owners told me they now do not put any bones in the trash. They collect them in a bag safely stowed in the freezer until dump day. Good thinking! While you are at it, put away the sugar-free gum, raisins, grapes, chocolate, inhalers, all medications including vitamins, and your stash of edibles so we can all have restful, emergency-free time with family and friends.

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