Gastric dilation and vovulus

Question 1

Describe how the stomach normally moves during GDV

Answer 1

Pylorus moves ventrally and to the left
Fundus moves to the right

Question 2

GDV Clinical signs

Answer 2

Retching
Unproductive vomiting
Cranial abdominal distension
Circulatory collapse (weak pulses and tachycardic)
Hypersalivation
Dyspnoea

Question 3

Stabilsation of GDV

Answer 3

Fluid therapy
Restore circulatory volume

Gastric decompression
More important than derotation in preventing gastric necrosis
Rapidly improves cardiac output and relieves dyspnoeia

Question 4

Outline how to give fluid therapy to dog with GDV

Answer 4

Place 2 cephalic catheters (as large bore as possible)
Shock fluid bolus
90ml/kg/hr over 15mins then reassess
Repeat up to 4 times

Question 5

Outline 2 waysto give Gastric decompression to dog with GDV

Answer 5

Orogastric intubation (stomach tubing)
- Wide bore stomach tube is measured from nose to 11th rib
- Place 7.5cm coflex bandage roll in mouth (hollow centre) and tape mouth closed in improvised gag
- Pass stomach tube down the core of the roll
- Once passed decompress then gastric lavage

Percutaneous decompression
- Clipped prepped area of tympanic right flank
- 14, 16 or 18g over the needle catheter

Question 6

Stablisation of GDV

Answer 6

Intravenous antibiosis
Oxygen therapy
Anti arrythmics
Lidocaine
Analgesia
Opioid full mu agonist

Question 7

Is surgery compulosory for GDV

Answer 7

Yes All patients will require surgery
The patient MUST be stabilised first

Question 8

Surgery goals for GDV

Answer 8

Reposition stomach
Assess stomach for necrosis
Perform gastropexy

Question 9

Gastropexy

Answer 9

Should be performed in all cases
The purpose of the gastropexy is to form a permanent adhesion between the stomach and the right body wall to prevent the stomach from becoming malpositioned.