GDV

Question 1

GDV

Answer 1

Blood flow alterations.
Increased intra-abdominal pressure->difficult inspiration and decrease 02 delivery.
Caudal vena cava compressed -> cardiogenic shock
Portal vein compression-> portal hypertension and bacterial translocation throughout GI.
Portal hypertension-> decreased hepatic reticuloendothelial system-> impaired clearance of bacteria

Question 2

GDV results in

Answer 2

Leads to:
Cardiac dysfunction (myocardial ischemia- impaired systemic perfusion).
Gastric wall necrosis (increased intragastric pressure- ischemia and necrosis)
Reperfusion injury (ROS and toxins released after correction)

Question 3

Emergency management

Answer 3

Surgical emergency, but must try to stabilize.

IV fluids in front legs. Pain medications. Point of care blood work and typical monitor. Gastric decompression

Question 4

GDV anatomy

Answer 4

Esophagus is on the left and pylorus on the right. Pylorus shifts left and ventral. Stomach attachments are dorsal.
Cardia is twisted and the pylorus compressed. Gas is trapped.
Derotate by grasping the pylorus and pulling ventral and right. Push fundus dorsally and the same time.

Question 5

GDV surgery

Answer 5

Make sure to pass oronasogastric tube to help decompress stomach/ regurge/
Most patients regurge after flipping the stomach
Black ,grey, green, no peristalsis, thin is no good
Dorsal fundus and cardia most affected.
Have to make a rent to see dorsal stomach to see if it’s okay. You don’t need to close it.

Question 6

Gastropexy- Right sided incisional

Answer 6

Right sided incisional gastropexy is recommended. Simple to perform, strong, safe.
Incision in the pyloric portion of the stomach. Incision through muscularis. Incision just behind the last rib.
Choose place in pyloric antrum. Two knots between. Not longitudinal in this instance. Make the incision through the seriomuscualris and into the body wall. Cranial stomach and suture simple cutaneous and tie to the tail of the knot. And then back again.

Question 7

Belt loop gastropexy

Answer 7

Layer of seromuscularis through a loop of muscle

Question 8

Circumcostal gastropexy

Answer 8

One-hinged seromusclar flap or two hinged. Attach to abdomen wall

Question 9

Incorporating gastropexy

Answer 9

Suture it to the body wall incision- fastest way

Can cut straight into the stomach when opening the body

Question 10

Post op

Answer 10

Maintain adequate hydration, correct electrolytes, treat cardiac arrythmias, feeding 12-24 hours later
73-90% survival
Good indications for survival:
Lactate <6
Absolute improvement of lactate <4
Final lactate <6.4