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Background
Bones and raw food (BARF) diets are increasing in popularity amongst dog owners despite the majority of the veterinary profession still having considerable reservations with their use.
This case describes a dog which was diagnosed with segmental volvulus at exploratory coeliotomy and effective management with enterectomy. The atypical clinical presentation and the clinical findings at coeliotomy suggested that the BARF diet may have contributed to the volvulus occurrence.
This case will contribute to increasing veterinarians' awareness of segmental volvulus, its clinical presentation and effective management.
Case presentation
A four-year-old 32 kg neutered female golden retriever dog presented with a two-day history of intermittent vomiting, inappetence and lethargy. It was fed an exclusively BARF diet twice a day. The owner described this as consisting of uncooked chicken legs and breast, but no chicken thighs. Boiled pasta and potatoes were fed most days while variable quantities of carrots and broccoli were fed inconsistently. There was no history of foreign body ingestion.
On clinical examination the patient was alert and ambulatory. There was an area of localised intestinal thickening and dilation as well as mild mid-abdominal discomfort. No foreign body was palpated. Mucous membranes were pink in colour and not tacky to touch whilst the heart rate and respiratory rate were elevated. Pulse quality was good. Temperature was normal, but haematochezia was noted.
Investigations
Full biochemistry, haematology and electrolyte blood sampling were performed; the results were unremarkable.
Sedation with 20 [micro]g/kg burprenorphine (Vetergesic; Alstoe UK) and 20 [micro]g/kg acepromazine (ACP; Novartis) administered intramuscularly allowed abdominal radiography to be performed. This showed prominent loops of dilated small intestine, foreign body material within the small intestine and generalised loss of abdominal contrast. Gas dilatation of the stomach was also evident ( Fig 1 a, b).
Differential diagnosis
The differential diagnoses considered were: Intestinal obstruction Foreign body ingestion
Intussusception
Intestinal volvulus
Intestinal neoplasia
Functional obstruction Intestinal ileus
Gastroenteritis Infectious (bacterial/viral)
Dietary indiscretion.
Treatment
It was decided to immediately progress to exploratory coeliotomy. Intravenous fluids were administered 10 ml/kg/hour of 0.9 per cent saline (Vetivex 1 (9 mg/ml) solution for infusion for cattle, horses, dogs and cats; Dechra Veterinary Products) while ranitidine (Zantac; GlaxoSmithKline) was administered at 2 mg/kg intramuscularly. Cefuroxime (Zinacef; GlaxoSmithKline) was administered intravenously at 20 mg/kg preoperatively and...