Gastric Dilatation Volvulus in Dogs
Gastric dilatation volvulus (GDV) is an acute life-threatening disease, which requires rapid medical and surgical treatment including intensive therapy for shock, gastric decompression, repositioning of the stomach as well as a permanent fixation to prevent re-occurrence. A number of techniques including are described, including incisional, belt-loop, circumcostal, ventral incision/incorporating, stapled, tube, and laparoscopic assisted.
Clinical Findings of Gastric Dilatation and Volvulus in Small Animals
Dogs with gastric dilation and volvulus may present with a history of nonproductive retching, hypersalivation, and restlessness. Acute or progressive abdominal distention may be noted, or the affected dog may be found recumbent and depressed with an enlarged abdomen.
Physical examination findings include an enlarged or tympanic abdomen. Abdominal pain and/or splenomegaly may be appreciated on abdominal palpation. Progression from gastric dilation to volvulus predisposes to hypovolemic shock. Signs of shock are common and can include weak peripheral pulses, tachycardia, prolonged capillary refill time, pale mucous membranes, and dyspnoea. An irregular heart rate and pulse deficits indicate the presence of a cardiac arrhythmia. Additionally, the expanding stomach may compress the thoracic cavity and inhibit diaphragmatic movement, leading to respiratory distress.
Ventral Midline Gastropexy
This article presents the results of a study carried out retrospectively on 203 dogs with ventral midline gastropexy. The aim of the study was to evaluate the recurrence of gastric dilatation volvulus and the incidence of complications in subsequent coeliotomies following ventral midline gastropexy. The owners of the dogs involved in the study were invited to complete a questionnaire and to return to the clinic for an ultrasonographic and radiographic follow-up.
203 owners participated in the questionnaire between 2 and 123 months following operation, and 24 attended the follow-up examination. Of the 203 dogs in the study, 13 (6.4%) underwent subsequent ventral midline coeliotomy and none developed ceomplications related to the gastropexy site. In 23 of the 24 re-evaluted dogs, the stomach was closely associated with the abdominal on radiography and/or ultrasound. The recurrence rate for clinical signs of gastric dilataion or gastric dilatation volvulus after ventral midline gastropexy was 6.4%.
The study shows that the recurrence of gastric dilatation volvulus after ventral midline gastropexy is low and adhesion of the stomach to the abdominal wall is persistent in almost all dogs that were re-examined. The gastropexy site did not appear to interfere with subsequent coeliotomy.