CT case report links grass awn migration to carotid injury in dog: full analysis

A newly published case report in Veterinary Radiology & Ultrasound details an unusually severe consequence of grass awn migration in a dog: esophageal perforation and common carotid artery erosion with pseudoaneurysm formation. The patient, a 4-year-old Kerry Blue Terrier, presented with a cervical mass, and contrast-enhanced CT helped clinicians identify the migrating plant foreign body and the extent of the associated damage before surgery. (pmc.ncbi.nlm.nih.gov)

Grass awns are a familiar seasonal problem in small animal practice, but their migration patterns can be difficult to predict. Veterinary literature has previously described awns reaching the thorax, genitourinary tract, prostate, and other deep tissues, sometimes with serious complications. What makes this report stand out is the combination of esophageal perforation and carotid artery injury in the neck, a particularly high-risk location because of the potential for catastrophic hemorrhage. (pmc.ncbi.nlm.nih.gov)

According to the report, CT findings were critical in mapping the lesion complex. The imaging showed the consequences of the awn’s migration, including cervical soft-tissue involvement, esophageal perforation, and a carotid pseudoaneurysm. Histopathology later confirmed the grass awn as the cause. The paper was published online in April 2026 and appears in the May 2026 issue of the journal. The authors state that, based on their literature review, this is the first report describing CT findings of migrating plant material leading to esophageal perforation, common carotid artery erosion, and pseudoaneurysm in a dog. (pmc.ncbi.nlm.nih.gov)

Broader literature supports the authors’ emphasis on imaging. Other reports have shown that CT can be useful not only for directly identifying migrating grass awns in some cases, but also for revealing the secondary tissue reactions and complications they create, which may be the more actionable finding for surgeons and internists. A recent 2026 case report in BMC Veterinary Research, for example, described another vascular pseudoaneurysm linked to a migrating grass awn, this time involving the pulmonary artery, highlighting how these foreign bodies can create dangerous vascular sequelae in different anatomic sites. (link.springer.com)

Expert commentary specific to this paper was limited in public sources, but the clinical message is consistent with the wider imaging literature: when a dog presents with a cervical mass, draining tract, fever, pain, dysphagia, or recurrent swelling and there is any suspicion of migrating plant material, advanced imaging may be warranted sooner rather than later. In this case, the value of contrast-enhanced CT was not just diagnostic, but strategic, because it helped characterize the relationship between the lesion and major cervical structures. That’s especially important when surgery could involve the esophagus, large vessels, or both. (pmc.ncbi.nlm.nih.gov)

Why it matters: For veterinarians, this report sharpens the differential diagnosis for cervical masses and abscess-like lesions in dogs, particularly in regions and seasons where grass awns are common. It also reinforces a practical point: if clinical findings seem disproportionate to a presumed superficial infection, or if there are signs of dysphagia, hemorrhage risk, or deep neck involvement, contrast-enhanced CT can change management by exposing occult perforation or vascular injury. That has implications for referral timing, surgical planning, anesthetic risk assessment, and client communication with pet parents about urgency and prognosis. (pmc.ncbi.nlm.nih.gov)

What to watch: The next question is whether this case influences how quickly clinicians escalate to advanced imaging in suspected grass awn migration cases of the head and neck, and whether additional reports clarify how often vascular injury is being missed until late in the course. (pmc.ncbi.nlm.nih.gov)