Gastrointestinal foreign bodies occur when animals (or people, for that matter) consume items that are not edible. Dogs are especially notorious for consuming foreign objects. I’ve seen dogs who have swallowed rocks, sticks, toy squeakers, socks, underwear, and tampons.
Cats are much less silly than dogs when it comes to swallowing strange things, but there are two particular gastrointestinal foreign bodies that seem to be especially common in feline companions: ear plugs and sewing needles.
Cats evidently are drawn to ear plugs because of the unique smell of ear wax. Ear plugs, unfortunately, are just the right size and shape to lodge in cats’ intestines.
How about sewing needles? Believe it or not, many cats are drawn to them. They appear to enjoy chewing on thin metallic objects. But although cats sometimes swallow needles on their own, more often needles are consumed as a consequence of playing with sewing thread.
The notion of a kitten playing with a ball of yarn is burned into the American consciousness in a Norman Rockwellesque fashion. It is unfortunate that kitschy painters have not shown an interest in depicting the gory surgeries that often are necessary after kittens or cats consume thread or yarn. If they had, perhaps more people would realize just how dangerous such items are for our feline friends.
Here is a scenario: A distressed client rushes her cat to the vet. The cat was playing with sewing thread, and began to consume it. The woman realized with horror that a needle was attached to the end. In the scenario, which has played out dozens of times in my career, the owner watched in horror and unsuccessfully attempted to intervene as the cat slurped up and then swallowed the needle.
Your cat has just swallowed a sewing needle. What could possibly go wrong? Sadly, plenty.
The annals of history no doubt contain many examples of cats who have swallowed sewing needles and then, over the course of a day or two, passed them through their intestines and defecated them into the litter box without incident. Such cats have dodged metaphorical bullets.
Many other cats have come to great harm from sewing needles. The harm can occur in a number of manners.
Sewing needles are sharp, and they can lodge in the mouth or the pharynx (the back of the throat). They can lodge in the esophagus; this has significant potential to cause harm because the esophagus does not heal well when injured. They can perforate the esophagus, stomach, or intestines.
Gastrointestinal juices, which are rich with bacteria, may leak into the abdomen when needles perforate the stomach or intestines and cause a life-threatening condition called septic peritonitis.
And then there is the matter of the thread. If the needle lodges in the system, the thread can cause the intestines to bunch up as they try, unsuccessfully, to move the thread. This so-called linear foreign body can cause severe intestinal lacerations and multifocal intestinal necrosis (a condition that is even more scary, and much more deadly, than it sounds).
Many things can go horribly awry when cats swallow sewing needles. Therefore, when I am presented with a case of needle ingestion I recommend X-rays to identify the needle’s location. And, in almost every instance, I recommend endoscopy to remove the needle before it causes trouble.
Endoscopy involves the use of a special device that allows a camera to be inserted into the gastrointestinal tract. Endoscopes are equipped with tools that can be used to remove needles and other foreign objects. Endoscopy carries a much lower morbidity rate than surgery, and cats generally are home and acting like nothing happened the day after.
Although the recommendation to proceed immediately with endoscopy for needle swallowers is common sense, it turns out that that for most of my career it was not evidence-based. In other words, nobody had done a study to prove that it was better than alternatives such as surgery or watching and waiting.
I am happy to report that as of August 1, 2014, I can recommend endoscopy not only from personal experience, but also based upon true evidence.
On the date above the Journal of the American Veterinary Medical Association (JAVMA) published a paper titled, “Sewing needle foreign body ingestion in dogs and cats: 65 cases (2000-2012).” Here are the authors’ conclusions.
Conclusions and Clinical RelevanceÔÇöEndoscopic removal of ingested sewing needles was highly successful and should be recommended to prevent gastrointestinal tract perforation and associated morbidity. Prognosis for dogs and cats receiving definitive treatment for sewing needle foreign body ingestion was excellent.
Science has supported what common sense already suggested. If your cat swallows a sewing needle, don’t wait for problems to develop. Go straight to the vet for endoscopy.
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