Porcupine Quill Migration in the Thoracic Cavity of a German Shorthaired Pointer

Abstract

A 7 yr old German shorthaired pointer presented with progressive respiratory distress and lethargy. Two weeks prior to presentation, the dog had porcupine quills removed from the left forepaw, muzzle, and sternal area. At the time of presentation, the dog had bounding pulses and friction rubs in the right dorsal lung field. Harsh lung sounds and decreased lung sounds were ausculted in multiple lung fields. Radiographs revealed a pneumothorax and rounding of the cardiac silhouette suggestive of pericardial effusion. Computed tomographic imaging was performed and revealed multiple porcupine quills in the thoracic cavity. Surgery was performed and quills were found in multiple lung lobes and the heart. Following surgery the dog remained hypotensive. A post-operative echocardiogram revealed multiple curvilinear soft-tissue opacities in the heart. Given the grave prognosis the dog was subsequently euthanized and a postmortem examination was performed. A single porcupine quill was discovered in the left atrium above the mitral valve annulus. The quill extended across the aortic root, impinging on the coronary artery below the level of the aortic valve. To the authors' knowledge, this is the first known report of porcupine quill migration through the heart.

Cervical porcupine quill foreign body involving the spinal cord of a dog: A description of various imaging modality findings

“…The authors believe these radial keratin structures are what could be seen as multiple hyperechoic lines within the quill. Echocardiography appears to be a good modality for detecting intra-cardiac migratory quills, but few cases have been described (Costa et al 2014 ; Guevara et al 2015 ; Nucci & Liptak 2016 ). Ultrasound imaging is obviously limited by bone or air interfaces (Mattoon & Nyland 2015 ), with further visualisation of the cranial quill in our case not being possible, despite being suggestive of vertebral canal location.…”

“…A case of an intra-cranial porcupine quill described the HU as ranging from 52 to 68 (Sauvé et al 2012 ), which is markedly lower than 115–160 as found in our study. Another report on thoracic, including intra-cardiac, migration of quills, reported that they exhibited a soft tissue attenuation (HU not given) that made detection difficult, and thus a quill within a cardiac chamber was missed (Guevara et al 2015 ). A third report (Costa et al 2014 ) also could not detect an intra-cardiac quill.…”

“…An increased time between quill injury and presentation to the veterinarian is associated with an increased risk of complications; dogs that were presented for quill injuries more than 24 h after injury were 5.2 times more likely to experience complications, compared to dogs presented within less than 12 h (Johnson et al 2006 ). Quills frequently break off, thus hampering their identification at the time of patient presentation for veterinary care (Guevara et al 2015 ). Therefore, early diagnosis and subsequent complete removal improve the patient’s prognosis (Johnson et al 2006 ).…”

Pyothorax induced by an intrathoracic foreign body in a miniature dachshund: Migration of a popsicle stick from the stomach

“…The presence of intrathoracic foreign bodies, resulting from a penetrating thoracic injury [ 5 , 8 , 11 , 15 , 19 , 20 ], migration of an implant such as a Kirschner wire [ 6 , 10 ], or migration of a foreign body from the respiratory [ 2 ] or gastrointestinal tract [ 4 , 12 , 13 , 23 , 26 ], is not often reported in small animals. Wooden foreign bodies such as kebab or popsicle sticks are often ingested by dogs because of their palatability, and given their length and sharply pointed ends, can easily migrate from the gastrointestinal tract.…”

Two Cases of Injuries with Porcupine Quill

“…JL Guevara et al (7) reported that porcupine spike had migrated to the heart after penetrating the thorax.…”