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SA Sx > GDV- Exam 2 > Flashcards

GDV- Exam 2 Flashcards

1
Q

Gastric Dilatation

A

distention of stomach w/ fluid, food or gas

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2
Q

What is the tx route for gastric dilatation?

A

Medical tx

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3
Q

Gastric dilatation volvulus

A

Enlargement of stomach associated w/ rotation on its mesenteric axis

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4
Q

What is the tx route for gastric dilatation volvulus?

A

Sx tx

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5
Q

What are the only two proven predisposing factors in dogs w/ GDV?

A

First degree relative w/ hx of GDV

Increasing age

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6
Q

What are some factors related to diet that are thought to contribute to GDV?

A 
Increased volume of food fed SID
Dry kibble
Fats/oils in first four ingredients
Raised food bowl
Fish/egg DECREASE risk
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7
Q

T/F: Playing/running after eating has been shown to increase chances of GDV?

A

FALSE- recent studies shows that exercise has no play in GDV development

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8
Q

What is the poster child for GDV?

A

Great dane- large, deep chested dogs

40% increased risk in this breed

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9
Q

What abdominal sx can predispose development of GDV?

A

Splenectomy

Connection between stomach & spleen through short gasttric a

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10
Q

What affect does GDV have on the lungs?

A

V-Q mismatch- pressure against diaphragm leads to this

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11
Q

How is the CV system affected in a patient with GDV?

A

Stomach twists on the caudal vena cava leading to poor perfusion and resulting in myocardial damage

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12
Q

What is a major concern for when the GDV is corrected sx?

A

REPERFUSION INJURY

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13
Q

What is the most common direction of GDV?

A

Clockwise rotation

Pylorus moves along ventral abdominal wall to left side

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14
Q

What is the defined rotational angles when differentiating torsion from volvulus?

A

Torsion: < 180 degrees
Volvulus: > 180 degrees

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15
Q

What is a differential when talking about clockwise vs. counterclockwise rotation GDV?

A

Stomach covered by omentum in clockwise rotation

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16
Q

Describe the movement of the stomach in a counterclockwise rotation

A

Pylorus moves dorsally to lie adjacent to esophagus

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17
Q

What is commonly presented in a patient with counterclockwise GDV?

A

Chronic GI signs

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18
Q

What is a CS seen in patients with GDV that the patient does to help relieve gastric pain?

A

Praying posture

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19
Q

What percentage of GDV patients will end up with arrhythmias and what type?

A

> 50% will end up with arrhythmias

VENTRICULAR

20
Q

What is the most important step in treatment of a GDV patient?

A

STABILIZATION

Aggressive fluid therapy in jugular or cephalic veins

21
Q

Why should the hind limbs be avoided when administering fluids to a patient with GDV?

A

decreased blood flow back to the heart due to pressure on caudal vena cava

22
Q

What are the initial fluid therapy choices vs. maintenance fluid therapy choices?

A

Initial: crystalloid or hypertonic saline
Maintenance: crystalloids and colloids (maintain BP)
Continue fluids until GDV resolved

23
Q

Why are lactate levels important to check on a GDV patient?

A

measures perfusion, prognostic indicator for dogs doing well/poorly with GDV

24
Q

What is the goal of tx for GDV patient?

A

Stabilize CV, respiratory and renal systems FIRST

25
Q

What is the rate of fluids initially given to a patient with GDV?

A

90mL/kg

25% initially given and then re-evaluate

26
Q

What is the first choice method used for gastric decompression?

A

Stomach tube decompression (OG tube)

27
Q

If an OG tube cannot be passed initially, what can be done in order to allow the OG tube to be successfully passed?

A

Trocharization and then tube
Done at most tympanic site
Watch for the SPLEEN

28
Q

What is a landmark used when selecting your OG tube size?

A

Xiphoid

29
Q

The following are examples of what:

Acetylcysteine, vitamin C, vitamine E, desferoxamine, and lidocaine

A

Free radical scavengers

30
Q

What is the technique used for gastric repositioning?

A

push down on fundus w/ right hand –> grasp pyloric antrum w/ left hand and rotate stomach counterclockwise

31
Q

How can confirmation of proper reduction be performed?

A

Examine the gastroesophageal junction

32
Q

What is a standard criteria of gastric viability in GDV patients?

A

peristalsis- should immediately resume after correction

33
Q

What is another common indicator of viability in GDV sx correction?

A

Gastric slip

34
Q

What is the most common part of the stomach that has gastric necrosis?

A

Greater curvature near short gastric arteries

35
Q

What are three complications involving the spleen in a GDV patient and which two require splenectomy for tx?

A 
Venous congestion (self-limiting)
Vessel thrombosis (splenectomy)
Splenic torsion (splenectomy)
36
Q

What is the % of recurrence of GDV w/ or w/out pexy?

A

W/ pexy: 4%

W/out pexy: 50%

37
Q

T/F: Gastropexy prevents dilatation from occurring again?

A

FALSE- prevents volvulus from occurring

But if dilatation occurs again- it wouldn’t be considered emergency-just need to relieve pressure

38
Q

Describe an incisional gastropexy

A

Incise seromuscular layer in gastric antrum and R abdominal wall –> suture R abdominal wall to gastric incision w/ simple continuous pattern
Mucosa NOT penetrated
Minimum of 3 cm long incision in transversus abdominus

39
Q

Describe a circumcostal gastropexy

A

Strongest w/ most potential risks

Seromuscular flap around 13 rib

40
Q

What are risks of circumcostal gastropexy?

A

Rib fractures and pneumothorax

41
Q

What are two prophylactic gastropexy procedures?

A

Laparoscopic-assisted

Endoscopic assisted

42
Q

T/F: Prophylactic gastropexy prevents dilatation

A

FALSE

43
Q

How long should a GDV sx patient be NPO post-op?

A

12-24 hrs.

44
Q

How long should you monitor a patient for arising arrhythmias post-op GDV sx

A

24 hrs

45
Q

When would you expect a post-op GDV death?

A

in the first 4 days

46
Q

What are electrolyte disturbances seen with GDV patients?

A

Hypokalemia

Hypochloremia

47
Q

What are the expected arrhythmias for GDV patients?

A

Ventricular arrhythmias caused by myocardial ischemia

SA Sx (22 decks)

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