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GI/Nutritional Disorders > GDV > Flashcards

GDV Flashcards

1
Q

Which breeds are predisposed to GDV?

A

Large, deep-chested breeds

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2
Q

Which breed is the poster child for GDV?

A

Great dane

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3
Q

What is the approximate mortality rate for GDV?

A

15-30%

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4
Q

What are common clinical signs of GDV?

A

Non-productive retching/vomiting, abd distension, hypersalivation

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5
Q

What is the pathophysiology of GDV?

A

Counter-clockwise rotation of the stomach (view from Cr to Ca in dorsal recumbency)

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6
Q

How does volvulus of the stomach cause cardiovascular problems?

A

Venous compression, congestion, and local blood perfusion compromise to the stomach (necrosis)

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7
Q

Which vessels can be torn d/t a gastric volvulus?

A

Short gastric vessels

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8
Q

What do the short gastric vessels connect?

A

Connect stomach and spleen

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9
Q

What type of shock does GDV cause?

A

Obstructive or hypovolemic

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10
Q

What radiographs are diagnostic for GDV?

A

R lateral

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11
Q

What sign do we see on R lateral radiographs that is definitive of GDV?

A

“Double bubble”

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12
Q

What is the likelihood that a Great Dane will develop GDV in its lifetime?

A

37%

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13
Q

What other factors of a dog’s lifestyle predispose them to GDV?

A

Anxiety, very fast eaters

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14
Q

What arrhythmia is most likely assoc. w/GDV?

A

VPCs

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15
Q

When are arrhythmias assoc. w/GDV most likely to occur?

A

Especially after surgery

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16
Q

What will a GDV blood gas analysis show?

A

Metabolic acidosis

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17
Q

How do you stabilize a GDV patient?

A

2 large bore cephalic catheters + shock dose crystalloid fluids, decompress stomach

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18
Q

Why should you try to avoid putting catheters in the saphenous veins of a GDV?

A

Caudal venous return is poor

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19
Q

What is the shock dose of crystalloid fluids in a dog?

A

80-90mL/kg

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20
Q

What are pros of using an orogastric tube to decompress the stomach?

A

More effective emptying

21
Q

What are cons of using an orogastric tube to decompress the stomach?

A

Requires heavy sedation, tube might not pass, possible esophageal trauma/rupture

22
Q

What are pros of trocarization to decompress the stomach?

A

More rapid intervention, does not require sedation

23
Q

What are cons of trocarization to decompress the stomach?

A

Limited decompression, risk of lacerating gastric wall, puncturing spleen

24
Q

What lactate levels might predict gastric necrosis?

A

Greater than 6mmol/L

25
Q

What lactate levels are generally associated with a good prognosis?

A

Less than 6mmol/L

26
Q

What is the goal of GDV surgery?

A

Fully decompress and reposition the stomach

27
Q

When you enter the abdomen of a GDV, what will you see?

A

Omentum drape covering the stomach

28
Q

How can you prevent a GDV from occuring/reoccurring?

A

Gastropexy

29
Q

Which gastropexy technique poses a risk for future abdominal surgery on the dog and why?

A

Incorporating - tacks stomach to ventral body wall, so if another ex lap is performed, risk of accidentally cutting into stomach when opening the abdomen

30
Q

What are negative prognostic indicators for GDV?

A

Lactate >6mmol/L, need for gastric resection/splenectomy, long onset of signs to presentation, recumbency at presentation

31
Q

If gastropexy is performed, what is the rate of GDV recurrence?

A

4%

32
Q

If gastropexy is NOT performed, what is the rate of GDV recurrence?

A

50%

33
Q

How can you prevent GDV?

A

Prophylactic gastropexy in predisposed breeds during other routine procedure

34
Q

Which gastropexy technique is considered “best”?

A

Incisional b/c suture to abd wall and easy

35
Q

Why do you want a R lateral radiograph to dx GDV?

A

Gas will fill left displaced pylorus

36
Q

How do you reposition the stomach when correcting a GDV?

A

Push down on fundus, grab pyloric antrum and rotate stomach counterclockwise

37
Q

How might the esophagus appear on radiographs of a GDV?

A

Dilated from aerophagia

38
Q

Which pain control drugs should you use for GDV?

A

Opioids for minimal CV effects

39
Q

What drug can scavenge reactive oxygen species to help prevent reperfusion injury?

A

Lidocaine

40
Q

How soon after repositioning the stomach will peristalsis begin again?

A

Almost immediately if tissue still healthy

41
Q

Where is gastric necrosis most likely to occur?

A

Greater curvature near short gastric arteries

42
Q

If the spleen is also twisted, how do you treat it?

A

DO NOT UNTWIST, splenectomy

43
Q

Does a gastropexy prevent dilation?

A

No

44
Q

Which gastropexy technique is considered the “strongest”?

A

Circumcostal

45
Q

What type of gastropexy technique is reserved mostly for prophylactic treatment?

A

Laparoscopic-assisted

46
Q

Death following GDV usually occur within how much time post-op?

A

Usually within 4 days

47
Q

What are the main causes of death following GDV surgery?

A

Shock, gastric necrosis –> peritonitis, cardiac arrhythmias

48
Q

When is it necessary to treat post-op VPCs?

A

HR >180bpm, multifocal VPCs

49
Q

How do you treat a VPC?

A

Lidocaine

GI/Nutritional Disorders (29 decks)

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