This is the urgent one
If there is one guide on this site to act on immediately, it is this one. String, thread, ribbon, tinsel, dental floss, and the fibers from shredded rope toys behave completely differently from anything else a dog swallows, and they are far more dangerous.
Call straight away, even if your dog seems perfectly well. Our foreign body removal surgery team treats linear cases as the highest priority there is.
If you can see string at your dog’s mouth or anus, do not pull it.
The other end may be anchored deep in the intestine. Pulling can tear the bowel wall from the inside. Leave it exactly where it is and call.
What makes a linear foreign body different
A solid object lodges in one spot and stops. A linear foreign body does something much worse.
One end catches, typically wrapped around the base of the tongue or snagged at the pylorus, where the stomach empties. The rest travels onward, and the intestine does what intestines do: it contracts in waves, trying to move the string along.
Because one end cannot move, the bowel gathers itself up along the string instead, like fabric bunched on a drawstring. This is called plication, and it has a distinctive look on imaging.
Meanwhile the string is pulled tight around the inside curves of the bunched intestine. Every contraction saws it a little deeper into the bowel wall. Given time, it cuts all the way through in several places at once, leaking gut contents into the abdomen and causing peritonitis.
Here is a realistic example. Two days after a holiday dinner, a young terrier in a Talleyville home is quieter than usual and vomits twice. Nobody connects it to the butcher’s twine that was tied around the roast, which went into the kitchen trash. On the third morning her owner notices she is drinking but refusing food, and lifts her lip to find a thin loop of string around the base of her tongue. They call immediately, without pulling it. X-rays show bunched bowel loops with small trapped gas bubbles. The surgeon frees the anchor under the tongue first, then retrieves the twine through three short enterotomies. Because she was seen before any perforation, no bowel needs to be removed.
The signs
- Repeated or persistent vomiting
- Refusing food
- Lethargy that gets worse rather than better
- A painful belly
- Visible string at the mouth or anus, which is an emergency regardless of anything else
- Fever, which suggests a perforation has already happened
Some dogs with a linear foreign body look surprisingly stable for the first day. That is not reassurance. It is the window in which the damage is being done quietly.
What we look for on imaging
String itself does not show on radiographs, so the diagnosis relies on the pattern. Plicated, bunched loops of bowel have a characteristic appearance, often with small comma-shaped or teardrop-shaped gas bubbles trapped between the folds. Abdominal ultrasound shows the plication clearly and can sometimes pick out the string itself as a bright line running through it.
The surgery
Linear foreign body surgery is more involved than removing a single lodged object. The anchor point must be found and released first, then the string retrieved, often through several enterotomy incisions along the gut, because it cannot simply be pulled through from one end.
Any section of bowel that has been cut through or has lost its blood supply is removed and the healthy ends joined. If a perforation has occurred, the abdomen is thoroughly flushed and broad-spectrum antibiotics are given.
The cost starts at around $1,200 and rises with the extent of the damage. Every price includes pre-op radiographs, pre-anesthetic bloodwork, IV fluids, anesthesia with continuous monitoring, and post-operative medications.
Common sources worth securing
Sewing thread and spools, dental floss, ribbon and gift wrap, tinsel and holiday decorations, shredded rope toys, kitchen twine from a roast (which has the added appeal of tasting like meat), and elastic hair ties.
What to do right now
If your dog is collapsing, has a rigid, painful belly, a fever, or cannot keep water down, go to the nearest emergency hospital immediately.
Otherwise, contact us immediately or call Talleyville Dog Surgery on (302) 599-0299. Tell us what kind of string, roughly how long, when it was swallowed, and whether any is visible. With linear foreign bodies, the time between swallowing and surgery is the biggest single factor in the outcome.