Stomach

Question 1

How do we avoid trauma during stomach procedures?

Answer 1

Appropriate instruments, stay sutures and atraumatic needles. Want to preserve blood supply and ensure good haemostasis.

Question 2

A dog has just undergone surgery and is in recovery. How long should we wait until drinking and feeding resumes?

Answer 2

12 hours water & glucose.
Highly palatable low residue high digestible food every 4 hours.
Resume normal diet gradually.

Question 3

When does normal strength return to stomach during healing?

Answer 3

14 days

Question 4

Describe chronic gastric outflow obstruction.

Answer 4

Cause- pyloric hypertrophy or tumours
Causes chronic vomition.
Y-U pyloroplasty, excise to restore lumen diameter.

Question 5

When would you do gastrotomy?

Answer 5

FB removal, biopsy, mucousa inspection

Question 6

How do you determine wall viability?

Answer 6

Serosa colour
Gastric wall perfusion
Vessel
Palpation

Question 7

Describe gastric dilatation volvulus where it’s common & clinical signs.

Answer 7

Twisting of stomach.
Usually large breeds.
Salivation, restless, abdominal distension, retching

Question 8

Why does dilatation occur after volvolus?

Answer 8

First stomach twists then fluid & gas accumulates.

Question 9

How does GDV cause peritonitis?

Answer 9

Ulcerations from gastric acid can perforate & cause peritonitis

Question 10

Why do you get endotoxaemia from GDV patient?

Answer 10

Decreased hepatic circulation so endotoxins/bacteria in GIT cannot be removed

Question 11

What is the most common rotation of GDV?

Answer 11

220-270 degrees clockwise

Pylorus & duodenum go ventral & left

Question 12

Describe pre-operative, operative & post operative treatment of GDV.

Answer 12

Preop- stabilise, gastric decompression.
Op- Derotate stomach & spleen, gastric wall viability, splenectomy, haemostasis, gastropexy, Y-U pyloroplasty, abdominal lavage. ALWAYS do exploratory celiotomy.
Postop - Amoxicillin & metronidazole prevent sepsis & peritonitis. Nil per os 3days.

Question 13

What’s the best gastropexy techniques?

Answer 13

Incisional
Smeak costal
Circumcostal

Question 14

Which condition causes vomiting of undigested food 6-8 hrs after eating usually projectile vomiting?

Answer 14

Gastric stasis - motility inhibition

Question 15

How do we treat gastric stasis?

Answer 15

Diet
Metoclopramide
Cisapride

Question 16

What causes gastric stasis?

Answer 16

Primary gastric disease
Hypokalaemia
Chronic dilatation
Chronic pyloric obstruction 
Decreased gastric emptying