Gastric dilatation-volvulus in dogs: A review of the literature from 2000-2020

Authors: Pike A, Smalle TM
Publication: Australian Veterinary Practitioner, Volume 52, Issue 3, pp 132-145, Sep 2022
Publisher: Australian Veterinary Association

Animal type: Dog
Article class: Review Article

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Abstract:

Gastric dilatation-volvulus (GDV) is characterised by distention of the stomach with gas and/or fluid, secondary to gastric malposition. This leads to an increased intragastric pressure, cardiorespiratory dysfunction and shock. GDV is considered an acute life-threatening condition with a high mortality rate. Although reported in nearly all breeds of dog; large and giant deep-chested dogs are overrepresented. Predisposing factors include breed, thoracic conformation, familial history, frequency of feeding, size of food particles, speed of eating, postprandial activity, a fearful/nervous temperament, stressful events, a history of splenectomy and presence of a gastric foreign body.

Clinical signs include abdominal distension, non-productive retching, restlessness, tachypnoea, respiratory distress and signs of shock. Initial diagnostic procedures may involve abdominal radiographs, blood tests and an electrocardiogram. Initial treatment includes aggressive fluid therapy, analgesia and gastric decompression. Plasma lactate, serum pepsinogen-A and canine pancreatic lipase concentrations have been explored as negative preoperative prognostic indicators. Plasma lactate is most widely used with good evidence while the others have limited literature and clinical use.

Prompt surgical intervention is recommended to minimise organ damage secondary to ischaemia and to improve prognosis. The goal of surgical therapy is to reposition the stomach, remove necrotic tissue and perform a gastropexy. A gastropexy involves creating a permanent adhesion between the stomach wall and the body wall to prevent gastric rotation. Incisional and belt-loop gastropexy are most commonly performed. Other techniques include circumcostal gastropexy, gastrocolopexy and laparoscopic gastropexy. Prophylactic gastropexy is recommended in high-risk animals.

KEYWORDS canine, dog, gastric dilatation-volvulus, GDV, gastropexy, prognostic indicators, risk factors

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