What is gastric dilation volvulus?
If you have
seen the heart wrenching movie “Marley and Me”, you may be more familiar with
the disease than you think. In the story, Marley was diagnosed with a condition
referred to in the movie as a “stomach twist” which is medically known as
gastric dilation volvulus. The movie gave us the notion that it is a very
serious disease, but doesn’t really give us much beyond that. Today, we will
dive into what happens behind the scenes in the case of GDV.
What is GDV?
Gastric dilation volvulus (GDV) is a
life-threatening condition in which the stomach twists on itself and causes
distension of the stomach. The stomach can twist anywhere between 90° and 360°.
The torsion causes the outflow tract of the stomach (pylorus) and the esophagus
(if the twist is greater than 180°) to close, kind of like twisting two ends of
a Tootsie Roll. This means gas, solids, and liquids cannot enter or leave the
stomach. This causes the stomach to bloat. The gas distended stomach occludes the
blood vessels that lead to the heart which prevents proper blood flow and
causes the pet to go into shock. If left untreated, GDV can lead to organ
failure from lack of oxygen rich blood, heart arrhythmias, stomach rupture,
sepsis, and death. Because there are blood vessels that connect the spleen to
the stomach, the spleen is sometimes involved in the torsion.
What Causes GDVs
GDV most commonly occurs in large breed, deep
chested dogs, such as the Great Dane and the Doberman. It tends to occur when
dogs consume large amounts of food or water followed by exercise.
Signs to Watch For
It is assumed a dog experiencing GDV will look
bloated. Though many dogs will be visibly bloated, some dogs’ stomachs are
tucked up within the rib cage which would hide the bloat. Therefore, it is
important to consider GDV if your pet fits the following characteristics and is
showing the following signs.
●
Distended abdomen
●
Retching without vomiting
●
Pain
●
Restlessness
●
Recently consumed a lot of food or
water followed by exercise
●
Large breed and deep chested
dog
Diagnosis and Treatment
A confirmatory diagnosis is based on a right
lateral (right side of patient on table) abdominal radiograph (x-ray). The
radiographs will show a gas distended stomach that takes the shape of a smurf
hat or Popeye’s arm.
Treatment
Decompressing the stomach and IV fluid therapy
are the most important steps in treating GDV. Passing a stomach tube may be
attempted, but if the esophagus is twisted, then passing a tube will not work.
In those cases, puncturing the stomach with a needle (trocarization) can
relieve the pressure until the surgery can be performed. Once the patient is
stabilized, the dog is put under anesthesia for surgery. The stomach is first
untwisted so that a stomach tube may be passed to clear the contents of the
stomach. Then a procedure, called gastropexy, is performed in which the stomach
is tacked to the left side of the body wall to decrease the risk of torsion in
the future.
Prevention
The gastropexy procedure mentioned above can
also be performed prophylactically to decrease the risk of stomach torsion in
large breed, deep chested dogs. It is actually a common procedure performed in
military and police dogs. A gastropexy can be requested to be done at anytime
if your pet is an at risk breed. It is often a procedure performed in
conjunction with a spay or neuter.
Sometimes, It’s Not GDV
It is possible for dogs to experience bloat
without torsion of the stomach in a condition called gastric dilation or simple
bloat. This usually occurs in gluttonous dogs who have the tendency to eat too
much, too fast. This condition, unlike GDV, is usually not life threatening.
However, the pet should be immediately evaluated by a veterinarian because the
symptoms are indistinguishable from GDV. As stated previously, radiographs of
the abdomen can be taken for a confirmatory diagnosis.
Dr. Jalika Joyner
No comments:
Post a Comment