Gastric Dilitation & Volvulus (GDV)

What is a GDV or gastric dilitation & Volvulus?

This emergency illness tends to occur in large breed dogs. When it occurs it can be associated with a mortality rate as high as 45%. This event is caused by enlargement of the stomach with rotation of the stomach causing an obstruction. When the stomach becomes twisted it prevents fluid or gas from leaving the esophagus or entering the small intestines. This causes the stomach to continue to get bigger. The combination of the twisting and filling with fluid and gas damages the blood supply to the stomach.
Why does it happen? 

The cause of GDV is unknown. It does however seem that exercise after ingestion of a meal or water can contribute to the occurrence of a GDV.
What can be done to prevent GDV?

The best way to prevent a GDV is to have a procedure called a prophylactic gastropexy. This can be done when your female dog is spayed. It does require a slightly longer abdominal incision but this is the ideal time. If you have a large breed male dog a gastropexy can be done when he is neutered.

How do you know if your dog has a GDV or bloated?


Common Clinical Signs of Bloat or GDV:
  • unproductive retching
  • does your dog seem like they are vomiting but only bringing up saliva
  • are they collapsed, pale and weak
  • does their abdomen seem very bloated or distended
What's the next step?

Gastric diliation and volvulus is a surgical emergency. You must see your veterinarian immediately. If this occurs after hours you cannot wait go to the nearest emergency clinic. I am available in Milford at Veterinary Care Specialists upon request.


Treatment:

Stabilization is very important. This requires an iv catheter, iv fluids, pain medications, physical examination
Bloodwork is very important. If you can obtain a lactate this can be a good measure of perfusion and give you a clue to the how severely your patient is affected by shock.

Once stabilized a right lateral radiograph should be obtained to confirm the diagnosis. 

If the patient is greater than 7 or 8 years of age I would also recommend getting chest radiographs to rule out any other disease process. GDVs can occur secondary to other disease processes on occasion. 
Once the patient is stabilized the stomach should be decompressed via trocarization or stomach tube. Ideally this should be done prior to transfer or surgery. 

Surgery is a necessity. This problem will not resolve. The longer it goes without definitive treatment the more severely the dog is affected by shock, gastric necrosis is possible, and splenic damage. 

A gastropexy needs to be performed in the stable patient. It is possible that if gastric necrosis has occurred that a portion of the stomach may require removal. The spleen must be evaluated to determine if it is viable. If thrombosis has occurred it must be removed. 
How can I help?

If I am available I can perform the surgery in your office if you feel you can manage aftercare within your facility. I am also always available at Veterinary Care Specialists in Milford. I am available after hours if the owner wants to have a board certified surgeon perform the surgery. The on call doctor will call me in to take care of your clients.
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