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BVetMed3 Alimentary > GDV > Flashcards

GDV Flashcards

1
Q

What does GDV stand for?

A

Gastric Dilation-Volvulus

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2
Q

What changes occur to the stomach in a dog with GDV?

A

Gross gaseous distension
Rotation of the stomach around the long axis of the oesophagus

(Pelorus moves from the RHS along the ventral body wall to the left)

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3
Q

What can lead to gastric dilation?

A

Failure of eructation

Delayed/impaired gastric emptying

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4
Q

What are the four key immediate effects of GDV?

A

Obstruction of the caudal vena cava

Increased gastric pressure and avulsion of the short gastric vessels

Stretching and avulsion of splenic vessels and splenic torsion

Cranial pressure on the diaphragm

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5
Q

How can obstruction of the caudal vena cava affect the patient?

A

Decreased venous return to the heart

Decreased cardiac output

Hypovolaemic shock

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6
Q

What happens as a result of increased gastric pressure and avulsion of the short gastric vessels?

A

Mucosal haemorrhage and ischaemia

Gastric wall necrosis

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7
Q

What happens as a result of stretching and avulsion of the splenic vessels and splenic torsion?

A

Splenic necrosis

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8
Q

What happens as a result of increased cranial pressure on the diaphragm?

A

Poor ventilation

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9
Q

What are the downstream results of GDV which may present as clinical signs?

A

Metabolic derangements

Arrhythmia should

Inflammation, endotoxaemia, disseminated intravascular coagulation (DIC)

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10
Q

What are some key parts of the history which may indicate GDV?

A

Large breed

Exercise

Dog is deteriorating, progressive weakness

Evidence of potential respiratory collapse (e.g. respiratory collapse)

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11
Q

What is the normal resps for a large breed?

A

90-100

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12
Q

A dog presents with suspected GDV. What interventions do you perform.

A

Place IV catheter and give fluids

Take a radiograph of the abdomen

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13
Q

How would you administer fluids to this patient? Why?

A

Place large bore catheters in BOTH cephalic veins

If you put fluid in saphenous, it will get obstructed at the level of the caudal vena cava.

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14
Q

What radiographic signs are characteristic of GDV?

A

Division of the stomach into two compartments by a soft tissue band.
- Pylorus forms top small section.

This can help differentiate between GDV and GD.

(Stomach stretching beyond the costal arch indicates dilation)

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15
Q

How would you perform gastric decompression?

A

Orogastric tube

Measure from nose to costal arch then mark with tape

Give a small amount of sedation and use a roll of tape to stop dog chewing

Pass tube through mouth into stomach

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16
Q

If you are unable to pass a stomach tube in to the stomach on the first attempt, what should you do?

Why?

A

Decompress the stomach by passing a catheter through the skin and into the stomach

(Percutaneous gastric decompression)

Buys you time

17
Q

What are the aims of surgical treatment of GDV?

A
  1. Derotation of the stomach
  2. Removal of necrotic tissue
  3. Gastropexy
18
Q

How could you tell whether the stomach has twisted clockwise or anticlockwise?

A

If you can see OMENTUM over the top of the stomach, the stomach has twisted CLOCKWISE

19
Q

What should you do once you have returned the stomach to its normal position?

A

Empty the stomach with a tube into a bucket on the floor.

Flush through with warm water

20
Q

Which part of the stomach commonly dies in GDV cases?

Why?

A

Fundus

Rupture of short gastric vessels PLUS pressure necrosis of mucosa

21
Q

When is there poor prognosis for patients with gastric necrosis?

A

When necrosis reaches the oesophageal junction

22
Q

Why is gastropexy important?

A

To prevent GDV recurrence

23
Q

How should a gastropexy be performed?

A

Incisional gastropexy

Suture pylorus to right body wall
Place sutures closest to the thorax first and then move caudally.

24
Q

When might you perform a tube gastropexy ?

A

Some dogs will be more likely to bloat after surgery

25
Q

What post-operative care is required for patients who have undergone GDV corrective surgery?

A 
Fluid therapy
Potassium supplementation 
Analgesia 
Treatment for gastric ulceration 
Gastric motility drugs 
Antibiotics (to prevent endotoxaemia)
Nutrition
26
Q

What disease of the lungs is often present in dogs with GDV?

A

Aspiration pneumonia

27
Q

What post-op complication can affect the heart?

What treatment is required?

A

Idioventricular rhythm

As long as BP is maintained, you don’t need to treat

28
Q

What factors affect the prognosis of GDV patients post treatment?

A

Very good if no necrosis present

Survival rates around 70% with gastric necrosis

29
Q

What client report is indicative of GDV?

A

abdominal distension with non-productive retching

30
Q

How should a patient be stabilised before surgery?

A

Aggressive IV fluid therapy

31
Q

What diagnostic imaging should be used to confirm GDV?

A

Right Lateral Radiograph

BVetMed3 Alimentary (16 decks)

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