Lately at the emergency clinic we’ve been having a run of linear foreign bodies.
What, you ask, is a linear foreign body? To understand linear foreign bodies, one must first understand the concept of foreign bodies. A foreign body is something other than food that is consumed, in this case, by a cat. Foreign bodies can run the gamut. Small, flexible, non-toxic foreign bodies (such as very small pieces of plastic bag) may (may is the key word) be harmless. Such foreign bodies may (may) pass through the intestines and into the litter box without causing any harm. Other types of foreign bodies, such as rubber bands and hair bands, sometimes pass without incident, but are more likely to lodge in the intestines. Others, such as ear plugs (it is surmised that cats consume ear plugs because they smell like ear wax), frequently lodge in the intestines.
Over the years I have seen some crazy things pass through cats’ intestines without incident. I also have seen small items that should have passed get stuck; this happens most often when such items bind to each other to form a wad (a so-called bezoar).
When a foreign body lodges in the intestines, trouble follows. The foreign body blocks the way for food as it moves through the intestines. Food and intestinal juices back up in the area that leads to the foreign body. As pressure builds, vomiting often occurs. A cat with a foreign body often will lose its appetite. Diarrhea may occur due to stress on the intestinal tract from the foreign body. Dehydration is common. The cat may become lethargic. He may suffer from abdominal pain.
And that’s just the start. A foreign body may lead to pressure on the wall of the intestine in the area in which it is lodged. That pressure compromises blood flow to the area. The affected area of intestine may then die — the term for this phenomenon is intestinal necrosis. Dead intestines are prone to leaking, and bacteria from inside the intestinal tract may leak into the abdomen. This may result in an overwhelming infection called septic peritonitis. Death often follows.
If you think regular foreign bodies are scary, I’ve got bad news. Linear foreign bodies are even worse.
Linear foreign bodies are long and thin — in other words, they are linear. Common examples include thread, yarn, string, dental floss, and fishing line. And ribbon. Such as the ribbon that is used when wrapping Christmas presents.
Christmas, unsurprisingly, is the peak of the season for feline linear foreign bodies. Unfortunately, cats are drawn to linear items. Anyone who has ever owned cats knows they like to play with string. In the lead up to Christmas, lots of ribbon may be lying around the house. Cats also have been known to attack ribbon on packages underneath the tree. And Christmas morning may present a bonanza of loose ribbons on the family room floor after the orgy of gift unwrapping has concluded.
What happens when a cat consumes a piece of ribbon? The ribbon may pass through the cat’s intestines without harm, only to be found later in the litter box or hanging partway out of the cat’s anus. (Note — never pull on a ribbon hanging from a cat’s but. Cut it instead, and call the vet for advice.)
Or the ribbon may get hung up somewhere along its way. If it somehow gets anchored anywhere in the system, utter disaster may strike.
The intestines move food through the intestines using something called peristalsis. Muscles in the guts contract and relax in waves, gripping food and pushing it from front to back. If a linear foreign body such as a ribbon becomes anchored somewhere in the intestines, peristalsis has a different effect. The intestines grip the ribbon and attempt to move it. But the ribbon is lodged and cannot move. So instead the actions of the muscles move the intestines. The intestines bunch together as more and more segments “climb” the foreign body.
The bunched up intestines become blocked, and all of the symptoms of a foreign body obstruction occur. Intestinal necrosis occurs with linear foreign bodies as well — but in a more dangerous way. With standard foreign bodies intestinal necrosis usually focal. If caught in time, the devitalized portion of intestine can be removed. With linear foreign bodies, intestinal necrosis may occur in multiple small areas of the intestines. Sometimes there is too much damage for removal to be feasible.
Worse still, some ribbons have sharp edges. These edges may saw through the walls of the intestines as the guts climb up the ribbon. Severe septic peritonitis can result.
The bad news is that, clearly, linear foreign bodies are super dangerous. Fortunately there also is some good news: if they’re removed before they become anchored, no harm is likely.
There are two relatively straightforward ways to eliminate a recently swallowed ribbon from a cat’s stomach. The first is to make the cat vomit. Unfortunately, although cats are well know for vomiting when nobody wants them to, it is difficult to make them vomit when we actually want them to. Although you may find recipes involving salt or hydrogen peroxide on the Internet, be aware that those recipes are extremely dangerous, they may cause severe harm, and they should not be used. I do not recommend attempting to induce vomiting at home.
Instead, if a cat swallows a ribbon I recommend a trip to the vet. Vets have access to a medication, called xylazine, that causes cats to vomit about half of the time. It’s what I generally use when I’m confronted with such a situation. If the cat vomits, he will be cured once he no longer is sedate (xylazine also is a sedative).
If the cat does not vomit, the owner has two choices: Wait it out and hope for the best (which may end in catastrophe, or in a major surgery), or move on to endoscopy. I always recommend endoscopy. An experienced endoscopist usually can retrieve ribbons without too much difficulty. The cat usually comes out of the experience none the worse, although the owner’s bank account suffers a bit of a hardship.
Of course, the best option by far is to avoid exposure in the first place. Knowledge is power. Know that the ribbons on Christmas presents are dangerous to cats, and keep your cat safe this season.
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