The Diagnosis, Attempted Endoscopic Retrieval, and Surgical Treatment of Multiple Heroin Packages in the Stomach of a Dog: A Case Report.

objectiveTo describe the clinical signs, treatment, and outcome in a dog after ingestion of heroin packets and repeated exposure. CASE SUMMARY: A 3-year-old intact female American Pit Bull Terrier was referred for management of suspected drug intoxication after possible exposures to marijuana, cocaine, oxycodone, and heroin. The dog was initially treated with naloxone (0.02 mg/kg, IM) after presenting to the primary care veterinarian with cyanosis and unresponsiveness. The dog showed improvement, was then transferred to the authors' hospital, and was discharged the next day. Two days after ingestion, the dog returned for potential re-exposure and was again treated with naloxone (0.02 mg/kg, IV), with improvement of signs. Due to financial constraints, the owner elected outpatient care. Later that same day, the owner reported that the dog had become sedate, and, out of concerns for ongoing exposure from the consumed heroin packets, abdominal imaging was performed, which confirmed the presence of foreign material in the dog's stomach. Endoscopic retrieval was attempted but was unsuccessful. Given the concern for packet rupture, the dog underwent surgery, during which eight packets containing a white substance were removed. The dog made a full recovery. NEW INFORMATION PROVIDED: To the authors' knowledge, this is the first report to describe the ingestion of multiple packets of heroin with attempted endoscopic and ultimate surgical retrieval in a dog. In human medicine, the management of ingested narcotic packets is widely reported due to the prevalence of intentional swallowing of bundles of illicit drugs; however, this has not been described in veterinary medicine. The current report suggests that in dogs with known narcotic ingestion, recurrent clinical signs should prompt clinicians to consider repeated exposure from retained drug packets.