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Flashcards in The GDV dog Deck (24):
1

Define GDV

Gross gaseous distension of the stomach with rotation
of the stomach around the long axis of the
oesophagus

2

Pathogenesis

Failure of eructation --> dilatation
Delayed/impaired gastric emptying --> dilatation
How dilatation leads to volvulus and vice versa is uncertain

3

End results of GDV - 3

-metabolic derangements
-arrhythmias
-inflammation, endotoxaemia, DIC

4

How does GDV lead to hypovolaemic shock?

Obstruction of CdVC -> decreased venous return to heart, decreased cardiac output --> hypovolaemic shock

5

How does GDV cause gastric wall necrosis?

increased gastric pressure and avulsion of short gastric vessels ->mucosal heamorrhage and ischaemia and gastric wall necrosis

6

Why do you get poor ventilation with GDV?

cranial pressure on diaphragm

7

Why do you get splenic necrosis?

stretching and avulsion of splenic vessels and splenic torsion --> splenic necrosis

8

Outline emergency treatment of hypovolaemia

restoration of intravascular blood volume, place large bore catheters in both cephalic veins, give a shock dose (90ml/kg isotonic fluids).
AIM = to decrease HR and improve pulse quality

9

Which radiographic sign is diagnostic for GDV?

Division of the stomach into two compartments by a soft tissue band. (take a right-lateral radiograph (i.e. right side of dog is on the table)). ). Normally stomach is within costal arch. Distended stomach = caudal to the costal arch.

10

Why shouldn't you put catheters in the saphenous vein in such cases?

because you have a compromised vena cava and the fluids wouldn't reach heart to be pumped round

11

treatment of choice = ?

gastric decompression by orogastric tube

12

What is the second best treatment option if you cannot pass the orogastric tube?

take the dog to surgery, decompress the stomach by passing a catheter (percutaneous gastric decompression). Remember to avoid the spleen!

13

What is the sign of GDV during exploratory laparotomy?

the omentum covers the stomach (see image on right. Normally it doesn't) . Stomach has moved from RHS to LHS

14

What should you check for after repositioning the stomach? What colour will this be?

necrosis of any abdominal organ. very red= bruised. brown/white = necrotic

15

Why doesn't it matter if the short gastric arteries tear during GDV?

blood supply ensures the fundus is still supplied with blood

16

What surgery is essential to prevent recurrence of GDV?

gastropexy

17

What are the different types of gastropexy?

incisional gastropexy or belt loop gastropexy

18

What is the feeding method of choice after gastropexy?

gastrostomy feeding tube (use chinese finger trap suture to hold in place)

19

What are the indications for the different types of gastropexy?

 tube gastrostomy so stomach can be deflated and nutrition can be provided - use in chronic cases
 Incisional gastropexy - easiest and fastest so best for new grad. make sure incision is long enough (at least 3cm). recommended.
 belt-loop gastropexy - lowest rate of GDV recurrence but more fiddly.

20

Suggest some post-op care for after gastropexy - 7

o fluid therapy
o potassium supplementation
o analgesia
o treatment for gastric ulceration - sucralfate
o gastric motility drugs - continuous metaclopramide
o ABs
o nutrition (when eating = on way to recovery)

21

Biggest lung problem associated with GDV =

aspiration pneumonia

22

post-op complication that can affect the heart = ? Prognosis?

idiopathic ventricular tachycardia = increased HR due to premature ventricular complexes. As long as bp and HR are fine, animal will recover from these without treatment normally.

23

GDV prognosis (with and without gastric necrosis)

• quoted survival rates vary between publications
• survival has improved with increased ICU facilities in recent years
• without gastric necrosis, survival rates of up to 98% have been reported
• with gastric necrosis, survival rates of 66% have been reported

24

7 important points to remember for GDV cases:

• if a client reports abdominal distension and non-productive retching, see their dog immediately
• aggressive IV therapy is essential for pre-op stabilisation
• a right lateral radiograph confirms the diagnosis
• do not place excessive force on a stomach tube
• check all abdominal organs for ischaemic necrosis (death due to loss of blood supply)
• gastropexy is essential
• post-op intensive care is as important as surgery