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

Recurrent opioid toxicity signs should prompt imaging to identify retained drug packets.

This case report describes a 3-year-old female American Pit Bull Terrier presenting with clinical signs consistent with opioid toxicity after suspected ingestion of multiple drugs including heroin. The dog initially presented with cyanosis and unresponsiveness, responding to naloxone administration (0.02 mg/kg IM). After initial improvement and discharge, the dog returned two days later with recurrent sedation and clinical deterioration. Abdominal imaging confirmed the presence of foreign material in the stomach. Endoscopic retrieval was attempted but unsuccessful due to packet configuration. Surgical intervention was pursued due to concerns regarding packet rupture and continued drug exposure. Eight packets containing white substance were successfully removed via gastrotomy. The dog recovered completely. This represents the first veterinary report of multiple heroin packet ingestion with attempted endoscopic and surgical retrieval, though such cases are well-documented in human emergency medicine. The case highlights the importance of recognizing recurrent clinical signs in patients with known narcotic exposure as potential indicators of retained drug packets and ongoing toxin exposure.

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