Gastric dilatation-volvulus in dogs

Authors: Broome CJ, Walsh VP
Publication: New Zealand Veterinary Journal, Volume 51, Issue 6, pp 275-283, Dec 2003
Publisher: Taylor and Francis

Animal type: Companion animal, Dog
Subject Terms: Abdomen, Acid/base/pH, Alimentary system/gastroenterology, Anaesthesia/analgesia/sedation, Animal remedies/veterinary medicines, Clinical pathology, Diagnostic procedures, Fluid therapy, Fluid, Metabolic disease, Disease/defect, Mortality/morbidity, Surgery, Treatment/therapy
Article class: Review Article

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Abstract: Gastric dilatation-volvulus (GDV) is a disease in which there is gross distension of the stomach with fluid or gas and gastric malpositioning. It causes pathology of multiple organ systems and is rapidly fatal. It is common in large- and giant-breed dogs. The disease appears to have a familial predisposition. Thoracic depth/width ratio also appears to predispose dogs to GDV. Implicated dietary factors include dietary particle size, frequency of feeding, speed of eating, aerophagia and an elevated feed bowl. A fearful temperament and stressful events may also predispose dogs to GDV. Abdominal distension, non-productive retching, restlessness, signs of shock, tachypnoea and dyspnoea are possible clinical signs. Initial treatment includes treatment of shock and gastric decompression. Surgical treatment should be performed promptly. There are no studies comparing the use of different anaesthetic agents in the anaesthetic management of GDV. Pre-medication with an opioid/benzodiazepine combination has been recommended. Induction agents that cause minimal cardiovascular changes such as opioids, neuroactive steroidal agents and etomidate are recommended. Anaesthesia should be maintained with an inhalational agent. Surgical therapy involves decompression, correction of gastric malpositioning, debridement of necrotic tissue, and gastropexy. Options for gastropexy include incisional, tube, circumcostal, belt-loop, incorporating, and laparoscopic gastropexy. Expected mortality with surgical therapy is 15–24%. Prognostic factors include mental status on presentation, presence of gastric necrosis, presence of cardiac arrhythmia and plasma lactate levels. Prophylactic gastropexy should be considered in dogs identified as being at high risk.
KEYWORDS: Gastric, dilatation-volvulus, gastric surgery, gastropexy, dog, companion animal

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