Abstract Case Report
On 19 January 2002, animal husbandry staff was notified by a zoo patron that a sweater containing stuffed toys had fallen into the Komodo monitor exhibit. The 14-year-old, 60-kg, male Komodo monitor (Varanus komodoensis) had been observed to ingest one of the toys. As the monitor exhibited normal behavior, it was thought the toy was small enough to pass through the gastrointestinal tract without medical intervention.
Veterinary staff was notified of the incident the following morning. The animal’s behavior continued to be normal as was its defecation pattern and fecal quality. This animal’s gastrointestinal transit time was previously determined as roughly 24 hours for small meals. Diagnostic procedures were not performed since behavior was normal and less than 24 hours had passed since ingestion. However, it was given 300 g of ground horsemeat (Toronto Zoo Feline Diet, Milliken Meat Products Ltd., Toronto, ON, Canada) mixed with 120 ml of mineral oil and 30 ml of barium sulfate suspension (Opti-Be, MMI Inc., Southfield, MI, USA) to aid foreign object passage and assist with radiographic interpretation if the toy did not pass.
The following morning, feces containing rat fur and quail feathers were found in the holding area. These food items had been fed immediately prior to the toy ingestion. As the monitor continued to act normally, no diagnostic procedures were performed at this time. Although it was clinically normal and was passing feces containing barium, the lizard was scheduled for radiographs the next day.
The monitor was coaxed into the transport crate with 150 g of ground horsemeat mixed with 60 ml of mineral oil and 15 ml of barium. Radiographs were taken without removing the animal from the crate. Lateral radiographs could not be obtained, and positioning was difficult for dorsoventral views. However, a poorly defined area of barium (22×9 cm) along the midline ended caudally about 30 cm cranial to the cloaca. The animal was given 400 g of ground horsemeat and 360 ml of mineral oil once returned to its holding area.
The day following the procedure, the lizard was acting normally and passed a small amount of feces. It was not fed this day. However, the next day, the zoologist reported the animal somewhat lethargic. No feces had been voided overnight. The animal was again crated. This time, radiographs revealed the faint outline of the foreign body in the mid-abdomen of the lizard. There was also an accumulation of barium more aboral in the intestinal tract. Venipuncture of the caudal vein was performed to collect blood for a CBC and serum chemistries. A normal CBC was present while the chemistry panel revealed mild elevations of alanine aminotransferase, 39 IU/L (ISIS normal range 21±17); phosphorus, 7.7 mg/dl (ISIS normal range 5.6±1.6); and amylase, 1642 U/L (ISIS normal range 712±691). An abbreviated barium series was performed using 200 g of ground horsemeat and 30 ml of barium. The radiographs delineated the foreign body as a filling defect extending from the gastric body to the pylorus.
The following day, anesthesia was induced in the monitor using intravenous propofol (PropoFlo, Abbott Laboratories, North Chicago, IL, USA; 3.5 mg/kg to effect over 12 minutes). It was intubated and maintained initially on sevoflurane (SevoFlo, Abbott Laboratories) then isoflurane (IsoFlo, Abbott Laboratories). Endoscopy revealed the stuffed toy wedged firmly in the pyloric region of the stomach. A 3-nail grasping forceps (Endoscopy Support Services, Inc., Brewster, NY, USA) was broken attempting to pull the toy loose. A retrieval snare (Endoscopy Support Services, Inc.) was then attached to the toy, but it could not be freed with a substantial amount of traction. A 4-inch diameter PVC pipe was utilized as an oral speculum. The author (Rasmussen) was able to reach the toy and manually extract it. The endoscope was reintroduced, and examination of the stomach revealed mild inflammation of the pylorus. The animal recovered uneventfully from anesthesia and has had no complications from the experience.