GDV

Question 1

What are the clinical signs of GDV?

Answer 1

Agitation, restlessness, lethargy Progressive abdominal distention Unproductive vomiting/retching Collapse Signs of hypovolaemic shock Abdominal distension and tympany

Question 2

Which breeds are over represented?

Answer 2

Great danes GSDs Irish setters Standard poodles

Question 3

What are the extrinsic risk factors for the development of GDV?

Answer 3

Feeding a small number of large meals Speed eating n.b. it is thought to arise as a result of aerophagia

Question 4

What is the key reason why GDV will develop?

Answer 4

Failure to eructate/lack of pyloric outflow (delayed gastric emptying)

Question 5

What are the main effects of GDV?

Answer 5

• Local:
  
  • gastric pressure and small vessel avulsion (also thrombi formation) -> necrosis -
  • pressure and avulsion of splenic vessels (also thrombi formation) -> necrosis -
  • pressure on diaphragm -> poor ventilation
• Systemic:
  
  • Pressure on caudal vena cava & hepatic portal vein -> hypovolaemia
  • Ischaemic reperfusion injury (IRI)
  • Gastric perforation
  • Severe SIRS & DIC

Question 6

What should be done straight away when a dog presents with GDV?

Answer 6

Treat the shock:

• Fluid therapy
• PCV, TS, electrolytes and venous blood gas

n.b. may need to give blood products or colloids if indicated by the PCV

Question 7

When should analgesia be given to a GDV patient and when?

Answer 7

Straigh away - a pure opiod, this will also provide some sedation for later procedures

Question 8

Other than fluid therapy and analgesia, what else can be done on presentation of GDV?

Answer 8

ECG if available

Question 9

What are the steps that should be carried out after things have been done to stabilise the patient?

Answer 9

• Gastric decompression
  
  • Oro-gastric tube
  • Percutaneous gastrocentecis
• Can do radiography, although not essential
  *

Question 10

What should be remembered when aneasthatising a dog with circulatory compromise?

Answer 10

A reduced amount of induction agent is needed.

Question 11

Are antibiotics indicated for GDV patients?

Answer 11

Yes they are perioperatively. Post-operatively they may be given if there is contamination at the time of surgery.

Question 12

What are the aims of surgery on a GDV patient?

Answer 12

1. Decompression and derotation of the stomach.
2. Removal of necrotic tissue
3. Gastropexy

Question 13

What does a stomach covered in omentum indicate in an ex lap?

Answer 13

This indicates that the stomach has rotated.

Question 14

What region of the stomach, if necrosed, would indicate euthanasia?

Answer 14

The cardia to pyloric region, if there is no chance of the dog having a functional stomach then euthanasia is indicated

Question 15

What might form the post operative care for a GDV patient?

Answer 15

• Fluids
• Potassium supplementation
• Analgesia
• Treatment for gastric ulceration
• Gastric motility drugs
• Antibiotics
• Nutrition