Bone Appetit! The Skinny on Bone Ingestion in Dogs

BONE APPETIT! - Written by STEPHANIE WOLSTENHOLME, VMD

Pets presenting for bone ingestion is a common complaint in the ERs of Philadelphia, likely due to the numerous partially consumed chicken bones that litter the streets of the city. Moving towards the Thanksgiving holiday we also commonly see an increase in these cases. Owners frequently bring their dogs in to be assessed in a panic and would like the bones removed - but should emesis be induced? What are the risks with bone ingestion?

Bone ingestion typically occurs due to dietary indiscretion or intentionally in those feeding a raw diet. It can also occur due to ingestion of bone meal fertilizer - as an organic, slow-release fertilizer. It is made from ground animal bones and slaughter-house waste products and is high in calcium, nitrogen and phosphorus. In a case series of 255 cases reported to the Veterinary Poisons Information Service in the UK, 47.1% of dogs did not have signs but 52.9% did. These signs were generally mild GI signs (vomiting and diarrhea), lethargy and abdominal pain. GI impaction and/or perforation occurred in 1.2% resulting  in 2 dogs being euthanized and 1 dog dying1.

Induction of emesis in these cases is NOT recommended as there can be more damage caused to the esophagus by attempting to bring a potentially sharp object back up. In cases where there is significant bone ingestion (such as a very large amount or if a small dog ingests an extremely large bone such as a rib bone) endoscopic removal can be attempted to more safely remove them.

Ingestion of raw bones is actually better than ingestion of cooked bones as cooked bones become brittle and are more likely to splinter when chewed. However, risk of infection by pathogenic bacteria still exists with ingestion of raw bones. In general, complications that can occur from ingestion of bones includes vomiting and diarrhea, constipation or tenesmus secondary to discomfort while defecating, esophagitis, esophageal foreign body, esophageal laceration or perforation and rarely GI perforation. In a study evaluating esophageal foreign bodies in general, 44% of those cases were due to bones2. Only 12% of all dogs in the study developed esophageal perforation and the incidence was increased the longer the foreign body was lodged or if they had ingested a fish hook.

For cases of bone ingestion it is recommended to let the stomach acid do its job to dissolve the bones - do NOT give antacids to these cases and have owners bulk up the diet with W/D or bread to coat any sharp points during digestion. Owners are warned of the unlikely risk of GI perforation.

1. 1. https://bvajournals.onlinelibrary.wiley.com/doi/pdf/10.1002/vrc2.468?casa_token=MUr3Wp64B5gAAAAA:iJ_ZLQMRQhVKpuTNQNyObsvE-NMsKba0pkktp9n48Iotq4mxgOW4ZUjmjjDqq3X4714x6R23nnjLzV29
    

2. 2. https://www.researchgate.net/profile/Audrey-Cook-2/publication/328290562_Likelihood_and_outcome_of_esophageal_perforation_secondary_to_esophageal_foreign_body_in_dogs/links/641843e366f8522c38bd5d5b/Likelihood-and-outcome-of-esophageal-perforation-secondary-to-esophageal-foreign-body-in-dogs.pdf