Lecture 1: Gastric Dilation & Volulus 1 (Exam 1) Flashcards
(32 cards)
Define a Gastric Dilatation-Volvulus (GDV)
Enlargement of the stomach associated w/ rotation on its mesenteric axis (AKA bloat or gastric torsion)
Define simple dilatation
Stomach is engorged w/ air or froth but not malpositioned (no rotation)
Describe GDV syndrome
- Acute condition
- Mortality rate in treated animals = 20% to 45%
What is the cause of GDV Syndrome
Dilatation thought to be from functional or mechanical gastric outflow obstruction which prevents norm emptying (like eructation, vomiting, or pyloric emptying)
What is essential for a px to survive GDV Syndrome
Early recognition & intervention
What is the cause of a gastric outflow obstruction
Unknown but there are many potential predisposing factors
What are the predisposing factors for GDV syndrome
- Male gender
- Increasing age
- Being underweight
- Large volume feeding
- Eating once a day
- Eating rapidly
- Aerophagia
- Raised feeding bowl?
- Fearful temperament
- Anatomic predisposition (breed & conformation)
- Stress
- Ileus
- Trauma
- Vomiting
- First degree relative w/ GDV ( parent or sibiling)
- Feeding a dry dog food in which one of the first four ingredients is an oil or a fat
- Primary gastric motility disorders
- Atmospheric influence in military working dogs
What are some contributing caused (that have unsupported by data) for GDV syndrome
- Exercise before/after large meals or water
- Soy based or cereal based dry dog food
- Gastric Instability following splenectomy
What are some recommendations to tell clients
- Feed several meals ea day ( at least 2)
- Avoid stress during feeding
- Restrict exercise before & after meals ( more than or equal to an hour)
- Do not use elevated feeding bowls
- Do not breed dogs w/ a 1st degree relative w/ a H/O GDV
- Consider a prophylactic gastropexy in high-risk dogs (esp w/ like a great dane)
- Seek vet car @ 1st sign of GDV
- Slow feeder?
How does the stomach rotate in a GDV
In a clockwise direction when viewed from the surgeon’s perspective (duodenum & pylorus moves ventrally left of midline & Spleen is usually displace to the right ventral abdomen)
What happens to the caudal vena cava & portal vein in a GDV
compression reduces venous return & cardiac output, causing myocardial ischemia
What is there a reduction of when GDV is present
- Central venous pressure
- Stroke vol
- Mean arterial pressure
- Cardiac output
What organs can be affected by obstructive show & inadequate tissue perfusion
- Kidneys
- Heart
- Pancreas
- Stomach
- Small intestine
What can occur if obstructive shock & inadequate tissue perfusion cause (especially if gastric necrosis)
Cardiac arrhythmias
What type of injury has been implicated as causing much of the tissue damage that ultimately results in death after a correction of GDV
Reperfusion injury
What is an ischemia reperfusion injury
- Paradoxical exacerbation of cellular dysfunction & death following restoration blood flow to prev ischemic tissues
- May also induce systemic damage to distant organs & potentially leads to multi-system organ failure
What is the typical signalment of a dog w/ GDV
- Large deep chested breeds
- Middle age to older dogs (can be at any age)
- High correlation of the thoracic depth to width & GDV (lateral compression)
What is the typical history of a px w/ GDV
- Progressively distending & tympanic abdomen (Sounds like a basketball when pinged)
- Painful (arched back, restless, grunting, & panting”
- “Dog sitting”
- Hypersalivation
- Nonproductive (or min productive) retching
- Dyspnea
- Restlessness
What can be found in a PE w/ a dog w/ GDV
- Abdominal palpation reveals distention & tympany
- Splenomegaly
- Clinical signs of shock
What are the clinical signs of shock
- Weak peripheral pulse
- Tachycardia
- Prolonged CRT
- Pale mm
- Dyspnea
What radiographs will you take w/ a possible GDV
- Right lateral
- Dorsoventral
What can be seen on a radiograph w/ a dog in GDV
- Right lateral view - pylorus lies cranial to the body of the stomach & is separated from the rest of the stomach by soft tissue creating a “reverse C sign” or “Double bubble”
- DV view - pylorus appears as gas-filled structure to the left of midline
What does free abdominal air suggest
Gastric rupture
What does air within the wall of the stomach indicates
Necrosis
