Milo Swallows A Penny

Milo is a one-year old male cat who is full of curiosity and has a taste for metal. He was brought to Berkshire Veterinary Hospital on Sunday April 19th, 1998 with an unusual history. His young owner had been counting her savings when Milo happened to stumble upon the cache. Before she knew it he had picked up a penny and swallowed it. At first the owners were not sure he had ingested the penny but after seeing him pick up a second penny it became clear he had a liking for them. When they called Berkshire Veterinary hospital we advised that he be seen right away and we would radiograph him to determine if indeed he had swallowed the Penny. Milo’s physical exam was normal but his abdominal radiograph clearly demonstrated a round metal object in Milo’s stomach

Ingestion of coins, and in particular pennies, can result in serious medical problems. The first common problem encountered is intestinal obstruction as the body attempts to pass the coin through the intestinal tract. It is possible for many coins to pass through the intestinal tract of larger animals but in a cat it is almost certain a penny will become lodged once it leaves the stomach and starts down the narrow small intestines. The second problem is less obvious but potentially more serious. It is zinc toxicity. Pennies minted after 1982 contain significant amounts of zinc, which can be very toxic to animals. Zinc can also be found in other objects animals may swallow, such as zinc-coated nuts and bolts, some medicinal ointments, and even metal game pieces from board games.

Abdominal radiograph with
an end-on view of the penny
Abdominal radiograph with
a circular view of the penny

Once in the stomach zinc containing pennies may cause significant local irritation to the gastrointestinal tract. Vomiting, and loss of appetite are probably the most common clinical signs. Gastric ulcers can easily develop. If enough zinc is absorbed into the circulation, potentially fatal anemia and organ failure can result.

With radiographic proof that Milo had ingested the penny, Dr. Makuc and his owners discussed the best way to manage his case. Without question it was in Milo’s best interest to remove the penny and to do so before it passed from the stomach into the small intestine. Surgery would be one way to remove the foreign material, but with the help of a fiber-optic endoscope and a specially designed coin retriever, the more invasive surgical procedure might not be necessary. The decision was made to retrieve the coin endoscopically.

Milo was anesthetized with an inhalation anesthetic. He was placed on a circulating warm water blanket to maintain his body temperature during the procedure. His heart rate and blood oxygen saturation were monitored with a pulse oximeter. The endoscope was passed down his esophagus and into his stomach. Once the penny was located the coin retrieval instrument was passed down the instrument channel of the scope to grasp the coin and pull the penny out the way it went in. Although the penny had only been in his stomach for a little over four hours, Milo was already developing a gastric ulcer.

The additional advantage of the endoscope is that it also allows us to clearly visualize the lining of the organ being examined. In this case, Dr, Makuc was surprised to see that an ulcer was forming so soon after the ingestion of the coin. Fortunately, by removing the penny, and with proper medication, he would be able to prevent Milo’s ulcer from developing into a more serious problem.

Milo had a smooth recovery from the inhalation anesthesia and was ready to be discharged from the hospital the following day. He was pleased to be spared the additional risk and longer recovery period associated with a surgical procedure.

Dr. Makuc as he retrieves the penny
from Milo’s stomach