Ask a Vet 24/7: Swallowed Object & Broken Toe

Have you ever gotten home after a vet visit and realized you forget to ask them something important about the discharge instructions or home care? Of course, this scenario typically happens after the vet hospital is closed and lines of communication are severed.

Embrace is proud to partner with VetLIVE.com to offer policy holders access to a team of licensed and accredited vets - at their fingertips! Whether your need to double-check with a veterinarian on a medication, have a question about a potential toxicity, or you have more detailed pet health concerns, VetLIVE’s veterinarians are available to provide guidance when you need it most.

Below are real questions asked of VetLIVE veterinarians! Hopefully, the answers could help you in an emergency.

Swallowed Object

Question: “Tank, a 6 m/o Golden Retriever, swallowed a chunk of a rawhide chew. It was a flat, thin piece. He is trying to cough it up at sporadic times. He is happy, licking, fine, and it is not a consistent cough. Should I leave him alone or force him to throw up with something? Thanks. ”

Answer:

Hi there. Poor Tank! I would not advise you to induce vomiting because he could damage his esophagus or it could actually lodge in his esophagus if he vomits it up in the wrong direction (sideways).

I would recommend you monitor him regularly throughout the night, as we can't be certain the rawhide isn't already caught somewhere. You can offer him some peanut butter to help coat the rawhide if it isn't stuck. The peanut butter won't cause harm (provided he is not allergic) and will help coat his intestines for a brief period. If he continues coughing or it worsens, I would take him to the ER vet with the concern being a blockage/ choking.

Let me know if you have any questions and good luck tonight!

Broken Toe

Question: "Sophia has a broken Distal Phalange. Not sure when or how it happened, but believe it was about 3 weeks ago. It is on her right rear foot, on the outermost toe.

Symptoms:

  • Overall she acts fine. She is eating well, walking fine, running fine, playing with other dogs, etc.
  • Only time she shows pain is if she snags the toe on something. Then she will yelp and hold that foot up for a few seconds.
  • There was a small amount of crusted blood around the base of the nail at first.
  • She occasionally licks it.

Treatment to date:

  • 2 weeks ago vet put her on antibiotics and Rimadyl as she was not sure if there was a fracture or just an infection at the root of the claw.
  • After 2 weeks (yesterday) she got X-rays that showed she had a break on the Distal Phalange at the Ungual Crest.
  • Still on antibiotics and pain med while we decide what to do.

Treatment Options Presented:

  • Option 1 - Cut off claw at base, place toe/paw in a splint and let it heal. Continue with same meds.
  • Option 2 - Amputate entire distal toe.

These options range from $500 for Option 1 to $900+ for Option 2. So I am I looking to confirm if these are in fact the best options, and also if just splinting her toe myself, wrapping it good, and continuing with the meds is a viable option. I only consider this because it is essentially the same as their Option 1, and she is showing so little pain or issues with it.

Are there other options I should consider?

Answer:

This is a common injury in dogs, and most often the pet parents are unaware of how it happened. I have successfully treated the vast majority of these patients with option #1: brief anesthesia to cut off the nail at the base, frequent bandage changes (especially to monitor the healing), antibiotics and pain meds. Also, an e-collar will likely be needed or most/all dogs will rip the bandage right off.

While this may not seem painful to her, based upon the x-ray results, this is indeed painful. Many large breed dogs are very stoic. I can tell from the picture the toe is swollen and inflamed. She has increased blood flow to this toe, so I think it is a safe assumption that the toe is painful despite how she is acting. Many large dogs (small dogs can be a different story) don't show pain until they are severely injured or near death.

I have not had an injury heal on it's own if the fracture goes back to the ungual crest. There is little risk to try and wait to see if it will heal on its own, other than the whole healing process being delayed. An additional part of the risk is that the nail will continue to get snagged on things and have pressure pull it, even when it is bandaged. This will hurt the healing process and be painful. Option #1 addresses the problem and the healing can begin immediately. This is not an accurate analogy, but when you have a nail that is injured or bent back, getting it clipped off to begin healing feels better than continuing to have that nail pressed in the wrong direction. This is a very minor example of what is happening, but of course Sophia bears weight on her nails and uses them to balance, dig, etc. That is the closest example I can think of to illustrate how removing the problem and letting a healthy nail come in is the quickest and least painful option.

If you are in the USA there are generic medications that can be scripted out to help keep the cost of her drugs down, if you vet isn't already doing this. Your vet would simply write a script to a human pharmacy that participates in something called a $4 program where many antibiotics and non-steroidal anti-inflammatory drugs are available for $4. This is a great way to save some money while still providing pets with the treatment they need. While Rimadyl isn’t on there, there are generic versions of similar drugs, such as meloxicam. Of course she does have to be the appropriate weight but given that she is a Boxer, there is a good chance she is, at least with the antibiotics, if not both. In addition, you may have to cut the pills in half, but this isn't a great challenge.

It is great she is on antibiotics as these injuries can get infected quickly when not treated. Cutting the nail back, though it will bleed profusely while she has this done, will help her feel better much more quickly in my experience. I don't see a need to amputate the entire distal toe if there were no complications found, such as an infection moving up the bone of the toe, which would show up on the x-rays.

These heal wonderfully in my experience with a treatment similar to the first option. There will be some bandage changes and rechecks, but this is just to watch closely to ensure proper healing.

Sophia is lucky to have you on her team researching her options so thoroughly!

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