Gastric Dilatation-Volvulus

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Gastric Dilatation-Volvulus
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What is it?

• GDV is when the dogs stomach bloats and twists.
• This is a life threatening disorder.
• Fatality rate ranges from 10 - 60

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• The bloating could come from
• Accumulation of
• Air
• Gas
• Food
• Liquid
• Any combination of these

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• When the stomach accumulates too much of one of
  these, it can start to distend.
• If severe enough, the stomach will flip over on
  itself.
• This is called torsion

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• Bloat usually leads to torsion, although torsion
  can happen without a bloat.

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• Since the stomach is securely fixed only at one
  spot near the top, when the stomach is dilated,
  it can rotate on that one fixed axis.

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• The stomach generally rotates in a clockwise
  direction and can rotate up to a maximum of 360
  degrees.
• A less common rotation is counter-clockwise
  direction and can rotate up to 90 degrees.

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• If the rotation is severe enough, it could mean
  the displacement of both the stomach and the
  spleen.
• In other words, they will switch places.

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• After the stomach has twisted, it will cut off
  both the stomach contents and the blood supply.
• Blood vessels that feed the stomach are kinked
  and stretched as the stomach twists.

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• Where the stomach has twisted, toxins start to
  build up in the dying stomach lining.
• The liver, pancreas, and upper small intestines
  may be damaged also.

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• Shock can occur from the low blood pressure and
  endotoxins rapidly develop.
• Endotoxins- potentially toxic, natural compounds
  found inside pathogens such as bacteria.

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• Sometimes the stomach will rupture, leading to
  peritonitis.
• Peritonitis- an inflammation of the membrane that
  lines the wall of the abdomen and covers the
  abdominal organs.

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Causes of GDV

• The exact cause is unknown however there are
  many theories.
• Gulping food down
• When the dog eats too fast and swallows a lot of
  air at the same time.

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• Eating large meals in one sitting
• Drinking large amounts of water immediately after
  eating
• Vigorous exercise/work after a full meal.
• Due to the extra stomach contents and the belly
  swinging while full.

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• Eating food that swells excessively when soaked
  in water.
• Certain food types such as
• Peas
• Onions
• Beans
• Beet pulp

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• There are also some medical problems such as
• Gastric fermentation (digestive disorder)
• The speed in which the stomach empties itself.
• The pace of the stomachs digestive contractions.

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What are the symptoms?

• Abdominal distention
• Abdominal pain
• Restlessness
• Depression

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• Anxiousness
• Respiratory dysfunction
• Hypersalivation
• Belching

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• Retching
• Frequent attempts to vomit
• Vomit foamy mucous
• Mucousy foam around lips

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• Pale mucous membranes
• Lethargy
• Weakness
• Whining for no apparent reason

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• Thumping sound on abdomen
• Cant get comfortable
• Excessive panting

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• Prolonged capillary refill time
• gt2 seconds
• Rapid heart rate
• Greater than 120 bpm
• Rush dog to the vet, this is an EMERGENCY!!

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What we do for it

• Decompress by placing a large bore needle or
  trocar catheter through the skin and muscle
  directly into the stomach.
• Attempt to pass a stomach tube.

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• Place one or two large catheters and pump them
  with fluids and steroids for shock.
• X-rays, ECG, and blood tests.
• Treatment will probably start before all test
  results are in.

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Ways to prevent it

• Feed multiple, small meals throughout the day.
• Add liquid to food before feeding.
• Restrict exercise an hour before and two hours
  after eating.

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• Consider a bloat kit.
• Contains the essentials needed to deal with a
  bloat. Usually includes a rubber hose for each
  dog, tools needed for an emergency, and even a
  large bore needle to puncture your dogs stomach,
  should help not be available in time.

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• Use lubrication on the tube, if none available
  use water.
• Pass the tube down slowly and gently.
• Push it down an inch or so at a time, only after
  the dog has swallowed, without gagging, the
  section you have already pushed in.

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• NEVER FORCE TUBE DOWN!!
• You can do severe damage to the internal organs.

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• If the tube passage is unsuccessful due to
  internal obstruction, then it means that the
  stomach has probably twisted

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• Improperly used may harm your dog even more.
• DONT TAKE THIS LIGHTLY!!

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• Gastropexy
• This is a surgical procedure, but should be done
  anytime a dog bloats or even preventively for
  breeds that are predisposed
• The stomach is attached to the body wall to
  prevent twisting, or future episodes of volvulus.
• Recurrent volvulus can be pretty effectively
  managed with a gastropexy, but dilatation can
  still occur.

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Just to know

• All the female working dogs leaving Lackland Air
  Force Base have had a gastropexy done. They do
  this during the spay surgery.

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• People used to say that elevating the food bowl
  would help prevent GDV. Raising the bowl may
  actually increase the chance.

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Case Study

• Dec 2006 Joop B021
• Returned from deployment to Iraq one month
  earlier (survived numerous IEDs)
• Presented on emergency late at night with severe
  bloat/GDV
• Last check on dog was 4 hours prior to
  presentation, MWD was fine at that time
• CAN HAPPEN QUICKLY!!!!

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Any Questions?