Gastric Dilation Volvulus (GDV)
What is a Gastric Dilation Volvulus (GDV):
The GDV is a life threatening condition that occurs in, usually, in older, larger breed dogs. The condition is commonly referred to as ‘bloat’ because the stomach becomes distended with gas. Dogs with GDV will typically present retching, depressed, have a distended appearing abdomen and may or may not be in cardiovascular shock. The condition tends to progress rapidly and if left untreated, will result in the patient’s death. A ‘bloat’ is always an emergency.
Situational Awareness
Although these cases are more commonly handled by emergency hospitals; they have been reported to account for approximately 3 to 6 out of each 1000 hospital admissions (JAVMA 1994).
It is understandable that a small animal general practitioner may experience anxiety when faced with treating a patient with this rapidly progressive, life-threatening condition as they may not see more than 1 case per year, maybe less.
Time is of the essence in treating GDV. The condition requires swift intervention; the veterinarian must act quickly to assess the severity of the situation, stabilize the dog’s condition, and perform surgery; but most importantly, take the time to properly educate the pet owner and guide them with the decision making (surgery in general practice, referral, euthanasia).
$250
Get ready to Perform a Gastric Dilation Volvulus
All the information you need.
Fully narrated surgical videos.
In depth guide and more.
Pre-Surgical Considerations
Pre-operative diagnostics:
- Right lateral abdominal radiograph confirming the GDV.
Cardiovascular stabilization:
- I.V. fluids shock rate.
- Decompress the stomach.
Prepare for surgery:
- Have orogastric tube, pump and 2 buckets.
- Large abdominal shave.
- Prep the patient in lateral recumbency if possible.
- Ideally have the surgeon scrubbed and ready in the OR.
What the client needs to know:
- Death is certain without intervention.
- The twist will not “undo” itself.
- Time is of the essence.
- The gastropexy can prevent the twist from occurring but the pet may still bloat.
- Consider potential risk factors for bloat (diet, stress, genetics).
Step by Step GDV surgery:
- Figure 1
Be ready! Have the surgery and anesthesia “teams” aware, prepared and ready.
- Figure 2
Incise from xiphoid to mid way between umbilicus and pubis. Be prepared to lengthen incision if necessary.
- Figure 3
Confirm the twist and direction of rotation and derotate the stomach.
- Figure 4
Lavage the stomach via orogastric intubation and explore the abdomen.
- Figure 5
Perform an incisional gastropexy by making a 4-5 cm incision in the antrum, sparing the mucosa; and one behind the last rib through the transverse abdominal muscle.
- Figure 6
Suture the stomach incision to the body wall incision.
Get ready to perform a GDV surgery
Preferred instrumentation for surgery:
• Laparotomy sponges
• Balfours (large)
• Extra hemostats (in case of splenectomy or gastric resection)
• Suction for abdominal lavage
• 2-0 PDSTM
for the gastropexy
Post-operative Considerations:
• Will very likely require overnight monitoring.
• Manage the pain.
• IV fluids (rate according to patient’s cardiovascular stability).
• Consider monitoring for arrhythmias.
• Consider GI motility modifying drugs.
• Consider esophageal and gastric protectants.
What you get when you register:
The most difficult part about these cases is feeling confident that you are managing them properly.
This workshop offers a narrated video filled with the important information for stabilizing, sedating, anesthetizing and monitoring
these patients by Dr Nancy Brock.
Dr Sylvestre delivers information on how to prepare for surgery, how to decompress the stomach giving you tips and tricks
for making it work; and of course there are videos filled with detailed information on what to expect at surgery; what to do and what to look for, how to perform an incisional gastropexy and of course, how to stay out of trouble.
Q & A
Can a GDV stomach untwist itself?
• No, a stomach that has twisted will stay twisted. There is always mention of that being a possibility on the internet and the odd textbook but that is an extremely rare; ‘one of’ occasion. If your dog has GDV get help NOW. This is an emergency!
Can my dog’s stomach twist again after the GDV surgery?:
• When a dog undergoes surgery for a GDV; the surgeon will derotate the stomach, assess the abdominal organs and then do a “gastropexy”. This is a procedure that attaches the stomach to the body preventing it from rotating again. A dog that has had a gastropexy can still bloat however (the stomach fills with gas); but will not twist. The bloat is readily managed with the passing of a stomach tube (no surgery required). Often careful dietary management can help with the bloating issue.
Workshop Content
Infofónal Session: Anesthesia of the GDV Patient
You don't currently have access to this content
Informational Session: Decompressing the GDV Patient and Surgery Prep
You don't currently have access to this content
Informational Session: The GDV Surgery
You don't currently have access to this content
Surgical Procedure: Gastropexy, using a blade
You don't currently have access to this content
Surgical Procedure: Gastropexy, using Metzenbaums
You don't currently have access to this content
Managing the Patient with Gastric Dilation Volvulus – Quiz.
You don't currently have access to this content