My dog ate a bed sheet, x-rays clear. What should I do next?

I would recommend contacting Midnight's vet about this. Depending on how long ago he ate it it may be recommended to induce vomiting and to try to get him to throw up the sheet. Otherwise closely monitor him for the next few days to weeks for any sign of intestinal blockage; which can include vomiting, straining to defecate, painful in the abdomen, not eating or drinking. I would also recommend monitoring his stools so you'll be aware when it passes. Best of luck and thank you for using Petco Pet Education Center, formerly Petcoach.

If it is still in the stomach an endoscopy procedure would be the treatment of choice, it can be used to remove the cotton bedding without a minimally invading procedure. otherwise an ultrasound should be performed to determine where the cotton bedding is in the gastrointestinal tract, once the location is found a laparotomy surgery can be performed to have it removed.

Especially in the case of objects that are not metal or bone, which show up quite obviously on x-ray, it can be difficult to distinguish foreign objects in the stomach on x-rays, and sometimes when the results of the x-rays are equivocal we have to make the decision to go to surgery to find out for sure whether there is a blockage. Sometimes it is helpful to put a contrast agent into the GI tract, such as barium or even air, as they can aid in making the diagnosis. However, sometimes even board-certified surgeons and board-certified radiologists are not certain whether there is something foreign in the stomach, and even they make mistakes. Or sometimes we will go in to the abdomen, open the stomach, and indeed find something foreign, only to find out that it is something (like paper) that would have likely passed normally. It can be a very tough call and unfortunately sometimes we don't get a definitive answer until we go in and look.

I would continue to watch Midnight. If she ate part of a bedsheet that gets stuck in her small intestine, dogs will often be lethargic, have a decreased appetite, belly pain, or vomiting. Sometimes things like a sheet will move slowly through the intestines, and it could take 3-5 days to come out. If the dog is feeling ill, then often IV fluids and enemas can help it pass a little faster. If the dog is very ill, then surgery would be needed to remove the obstruction.

I see what you’ve circled in you picture but I think it looks more like a fold in the stomach, especially when you look at the other x-ray view. I would trust the radiologist - if Fergie starts to show symptoms of a gastric foreign body then you might want to have an ultrasound performed.

Acute pancreatitis and gastrointestinal inflammation/infections are still possible as well as foreign body ingestion with material not visible on X rays (ultrasound in these cases might be more sensitive). Given the lack of improvement, I would suggest to have her checked again and have a test for pancreatitis (it is a blood test called cPLI) performed. If not eating and probably in a sort of abdominal discomfort, nutritional support and pain relief meds are needed.

Without knowing what tests or examinations your vet performed, it would be hard to tell how they came to that conclusion. Typically, X-rays are taken to help determine where something is stuck, as it will appear more opaque on the X-ray, though not every foreign body will show up well on one. If she hasn't passed the string, or is acting painful in the abdomen, vomiting, etc, it is possible it may be stuck and she should be brought back into the vet for care.