Unusual Large Intra-rumen Complex Phytobezoar in a 5 Year Old Tibetan Goat

Large number of species can suffer because of gastro-intestinal foreign bodies (bezoars); the word bezoar is derived from Arabic “badzehr” or the Persian word “padzahr”, meaning an antidote for poisons, and those found in the goat were considered to have healing properties. Depending on the content, there can be phytobezoars, trichobezoars, trichophytobezoars, lactobezoars, lithobezoars or pharmacobezoars. In the last decades, due to urban development and pollution, it became difficult to ignore the adverse effects of nylon debris on the hayfield or pastures. Although small ruminants have a different prehension than bovines, they can introduce indigestible materials like plastic that may represent a core for the future bezoars. In this paper, a 5-year-old, 17 Kg body weight Tibetan doe was referred in January 2017 to the Teaching Veterinary Hospital (OVUD) at the Department of Veterinary Medicine University of Perugia, Italy, with a sudden occurrence of lateral recumbence, anorexia and opisthotonus. On presentation, the goat had poor body condition score, opisthotonus, congested mucous membranes, tachycardia, dyspnea, tympanic and atonic rumen. Body temperature was 34.7 °C and on transabdominal palpation, a large and consistent intra-abdominal mass was appreciated. At the ultrasound scan, the mass was characterized by a hyperechoic and irregular surface, extending from pelvic inlet to the cranial abdomen. A diagnosis of phytobezoar/trichobezoar was advanced. A left paralumbar fossa laparotomy was carried out in order to remove the foreign body; briefly, a local anesthesia was performed with 10 ml of lidocaine chlorhydrate 2% in a reverse L block technique. Upon partial rumen exteriorization and rumenotomy, the phytobezoar (35 X 30 X 25 cm and 2.3 Kg), composed of a compact mixture of ropes, jute packaging, electric wires, and plastic material, was removed; at external examination, it assumed the shape of the rumen. Postoperative therapy included administration of antibiotics and anti-inflammatory drug. An improvement of the clinical signs was observed in the following two days; then, nervous signs worsen and nystagmus appeared inducing us to perform euthanasia with 6 ml of Tanax® intravenously. At necropsy, the rumen contained a green and dense fluid and its mucosa papillae were alternatively thin and short, whereas the abomasum a compact and mixed foreign body. In conclusion, plastic litter and other indigestible materials could be lethal in small ruminants that are grazing in urban context. Late diagnosis and appearance of nervous symptoms did not allow the recovery of the clinical features even if a prompt rumenotomy was performed.