Meet Ludo, a gorgeous 1-year-old Whippet. Ludo presented to our internal medicine team with an acute onset cough and increased breathing effort, which occurred directly following a walk in a grass field.
Prior to him being referred to Lumbry Park Veterinary Specialists, Ludo’s referring veterinary practice assessed him and performed chest radiographs (x-rays). These radiographs (Image 1) documented a suspected foreign body in the lower trachea (windpipe), extending into the right main bronchus.
Image 1. A chest x-ray (right lateral) taken which demonstrates the clearest image of the suspected tracheobronchial foreign body (highlighted by the blue arrows). This was taken by the referring veterinary surgery, prior to referral, and assessed by our diagnostic imaging team.
We discussed emergency intervention with Ludo’s owner, a veterinary nurse herself, and recommended bronchoscopy-guided retrieval as a minimally invasive approach to remove the foreign body. This is where a camera is inserted into the airways to identify where the foreign body is and to guide a retrieval forceps to its’ precise location.
Endoscopic assessment confirmed our suspicion that the foreign body was in fact a large grass awn (Images 2, 3 and 4). Non-invasive retrieval proved extremely difficult as the barbed ends of the awn had lodged the grass awn very firmly into place in the right main stem bronchus.
From L to R: Image 2. The grass awn (green material) can be seen here, wedged within the bronchus prior to removal, Image 3. This picture is a more detailed close up of the grass awn within the bronchus (airway) and Image 4. The metal foreign body retrieval forceps can be seen in this image (silver object to the right of the image) grasping the grass awn.
Using different techniques and approaches, endoscopic removal of the grass awn, and multiple other small grass seeds, was eventually successful after several hours of hard and delicate work (see Image 5).
Image 5. The grass awn post-removal, next to a 2.5ml syringe for perspective and the retrieval forceps.
While several clinicians from the internal medicine team focussed on the endoscopic retrieval, our anaesthesia team managed to keep Ludo very stable and comfortable throughout the prolonged general anaesthesia.
Ludo recovered from his procedure with a cough, but otherwise resumed eating well. He was discharged 24 hours later (Image 6). We are very pleased to report that three weeks later little Ludo has returned to full health (Image 7), and we hope he will think again before inhaling any foreign bodies!
From L to R: Image 6: Ludo at time of discharge with the grass awn and Image 7: Ludo recovering at home.
The internal medicine team are happy to discuss or accept referral any of your challenging medicine cases. Please do get in touch.
