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VET433: Gastroenterology > Canine GDV > Flashcards

Canine GDV Flashcards

1
Q

gastric dilation and volvulus

A

bloat w/ clockwise rotation of the stomach

ALWAYS AN EMERGENCY

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2
Q

gastric dilation

A

bloat without rotation

NOT emergent

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3
Q

intrinsic risk factors for GDV

A
  • deep chested
  • older
  • underweight
  • if first degree relatives are affected
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4
Q

extrinsic risk factors for GDV

A
  • once daily feeding
  • feeding from raised bowl
  • aerophagia
  • stress
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5
Q

signalment for GDV

A

large and giant breeds
wide age range
no sex predilection

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6
Q

clinical signs of GDV

A
  • retching
  • non-productive vomiting
  • hypersalivation
  • restlessness
  • abdominal distention
  • weakness
  • collapse
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7
Q

PE of GDV patients

A
  • distended, tympanic cranial abdomen
  • splenomegaly
  • hypovolemic shock
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8
Q

is hyperlactatemia a sufficient reason to take to surgery

A

NO - helps guide prognosis because lactate > 6 mmol/L is associated with a greater risk of gastric necrosis and complications

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9
Q

diagnosis of GDV

A
  • clinical signs
  • radiographs
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10
Q

radiographs of GDV

A

ALWAYS do right lateral and VD views

gas dilated stomach WITH gastric shelf sign

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11
Q

treatment for GDV

A

surgical emergency
- stabilize patient prior to surgery

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12
Q

steps of GDV surgery

A
  1. gastric decompression
  2. gastric derotation
  3. prophylactic gastropexy
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13
Q

gastric decompression

A

orogastric tube vs trocarization

orogastric tube: placing a tube from the mouth into the stomach to release the gas

trocarization: place catheter into stomach in paracostal space

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14
Q

gastric derotation

A
  1. grab pylorus on patient’s L side and the stomach on the R side
  2. push the stomach down on the R side and pull the pylorus up from the L side
  3. gently untwist the stomach in counterclockwise rotation by pulling pylorus ventrally and to the right
  4. assess for gastric wall viability
  5. resect necrosed gastric wall
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15
Q

parameters for assessing gastric wall viability

A

seromuscular layer MUST be viable - mucosa does not

  • color
  • consistency
  • blood flow
  • motility
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16
Q

prophylactic gastropexy

A

most often an incisional gastropexy

  1. incise partial thickness into the antrum of the stomach
  2. incise into the transverse abdominal muscle BEHIND LAST RIB on the RIGHT SIDE of the body
  3. suture the cranial end of the antrum incision to the cranial end of the abdominal wall incision
  4. suture the caudal end of the antrum incision to the caudal end of the abdominal wall incision
  5. place 2 simple continuous suture lines to close either side of the incision, bringing the abdominal wall and antrum together
17
Q

goal of the incisional gastropexy

A

create a permanent attachment between the antrum and the R side of the body wall

18
Q

how do you know if it is a true GDV when you open the abdomen

A

omentum will be overing the stomach

if no omentum covering – dilation only, no volvulus

19
Q

postoperative management

A
  • fluids
  • analgesia
  • gastric wall protection (PPIs, H2 blockers, sucralfate)
  • antibiotics
  • prokinetics
20
Q

what are common complications of GDV

A
  1. arrhythmias - can give lidocaine for Vtach
  2. aspiration pneumonia
  3. DIC - poor prognosis
21
Q

prognosis of GDV

A

if NO gastric necrosis - excellent, only 2% mortality

if gastric necrosis - 34-46% mortality

overall mortality: 15-30%

22
Q

overall surgical approach to GDV

A
  1. decompression and derotation of stomach
  2. exploratory laparotomy - check for hemoabdomen, spleen, pancreas, gastric outflow
  3. assess gastric wall integrity
  4. incisional gastropexy
  5. +/- biopsies + cultures
  6. closure

VET433: Gastroenterology (16 decks)

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