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Case of the Month July 2005 Foxtails
"Barney" is a 9-month-old male Labrador Retriever. His owners have had Barney since he was 6-months-old and he has been in good overall health. Barney lives on a few acres in Fallbrook and has free run of the property. The lush spring grass has started to dry out and there are an abundance of foxtails on the property according to Barney's mom. HISTORY: Barney presented with a 4-day history of progressive difficulty breathing. At first, the owner noticed that he seemed to be snoring more than he used to, but now Barney is having obvious inspiratory stridor and cannot exercise without becoming distressed. PHYSICAL EXAMINATION: Barney is subdued and his temperature is 103.9. He is mildly dehydrated and his respiration is obviously labored. He is swallowing more than normal and seems to have difficulty doing so. Palpation of his neck in the region of his larynx reveals a large firm swelling between his larynx and his cervical vertebra. Chest auscultation and abdominal palpation reveal no abnormalities. Barney has bilateral Osteochondrosis in his hocks and is scheduled to have surgery in 2 weeks at the Veterinary Surgical Specialists. PROBLEM LIST:
A complete blood panel and UA were performed. Radiographs of Barney's neck and chest were obtained. RESULTS: Barney had an elevated white blood cell count (WBC) of 38,400. The rest of his blood work and his urinalysis were normal. Radiographs of his neck revealed a large soft tissue density in the dorsal cervical area that was displacing his trachea downward and impinging on his pharyngeal region. With the owner's permission we imaged the cervical swelling with ultrasound and guided a 22g 1 ½" needle into the area to aspirate a sample. A purulent material was obtained and submitted for cytology and bacterial culture and sensitivity. TREATMENT PLAN: Barney was sent home overnight on antibiotics and scheduled for surgical drainage of the abscess in 2 days at which time our cytology report was back confirm our diagnosis of a retropharyngeal abscess. Upon re- admission, Barney was given pain medication and an IV catheter was placed. He was given a general anesthetic and following routine surgical prepping, an approach was made to the area of the abscess from the right side of his neck just behind the of the jaw. This area is know as Vyborg's Triangle and is the Bermuda Triangle of anatomy. It is bordered by the carotid artery and the jugular vein, both major anatomical features to be avoided all costs! Deep dissection through the muscles of the region finally allowed access to the abscess. The wall of the abscess was penetrated with blunt dissection and a large amount of pus and a single foxtail were removed. The area was flushed with copious amounts of sterile saline solution and a rubber drain was placed in the deep tissues to allow further drainage over the next few days. Barney recovered from surgery uneventfully and was kept on antibiotics for 4 weeks. He has had no further problems. DISCUSSION: Foxtails are a seasonal hazard in southern California and other regions of the U.S. Foxtails can be easily recognized by their wheat-like appearance and barbed sharp points. In late spring and summer when the grasses go brown due to lack of water, these lethal plant pods will attach themselves to whatever is available. The most common presentations for foxtails are either acute onset of sneezing or head shaking due to a foxtail lodged in the nose or ear respectively. In addition, the frequently make their way into eyes or in between toes resulting in a small abscess that the pet will lick at persistently. Left untreated, foxtails can migrate throughout the body and have the potential to cause serious harm or even death. (We have lost two dogs this year to foxtail-induced pleuritis. While this is unusual, it does illustrate the importance of preventing exposure to foxtails and to seeking treatment should you suspect your pet has a foxtail.) To prevent foxtail problems you can do the following:
- The Bay Park Pet Clinic Staff |
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Phone: (619) 276-1616 - 3024 Hancock Street, San Diego CA 92110 |
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