GDV

INTRODUCTION
Gastric dilatation (bloat) is most often seen in large breed dogs but can also be seen in smaller patients. In this disease process, gas and fluid accumulates in the stomach causing distention. In some instances, the stomach can twist on itself. This is called volvulus (occasionally referred to as "torsion"). If a volvulus occurs, the esophagus and intestines are "twisted" closed, resulting in an obstruction to normal gastric (stomach) emptying. This condition is called GASTRIC DILITATION-VOLVULUS or GDV.

The source of gas accumulation in the stomach is most likely due to aerophagia; air swallowed during eating or drinking or during excitement. A very small amount of air may be due to fermentation of food. In patients with distention, the normal ability to eructate or burp may be hindered.

Fluid accumulation is due to gastric juices, ingested water and fluid entering the stomach from the circulation secondary to an obstruction.

Gastric dilatation can cause discomfort and a bloated appearance. In most instances, the dilatation can be relieved by passing a stomach tube. If a volvulus has occurred, this often causes a life-threatening condition. The blood supply to the stomach, pancreas, spleen and other abdominal organs is decreased and areas of the stomach can die or rupture. In addition, toxins build up that have serious effects on the heart. Heart irregularities (cardiac arrhythmias) or cardiac arrest may occur.

Gastric dilatation-volvulus occurs most often following an unusually large meal or water consumption and excitement or activity. GDV is an emergency situation! Shock and cardiac arrest can occur as the air is being removed from the bloated stomach (decompression). Decompression restores the blood supply and can result in a rush of these toxins back to the heart.

TREATMENT
Surgery is performed as soon as the patient can be stabilized. In most instances, the stomach is sutured to the body wall after it is placed into normal position. This surgery, called gastropexy, significantly decreases the chance of a volvulus in the future.

Once a patient has had gastric dilatation (just an episode of bloat), he or she may have more episodes. Because of the chance that a volvulus could occur during a subsequent episode, a prophylactic (preventative) gastropexy is recommended for these patients. Prophylactic gastropexy may be performed laparoscopically without the need for open abdominal surgery.

After-Care After surgery, daily feeding habits need to be changed for life. Small amounts of food and water are given multiple times (3-4) throughout the day. Also, your pet should not exercise for approximately 1 hour before or after eating. Sometimes after surgery, a patient will also need medication to help the stomach empty. If your pet experienced heart arrhythmias, he or she may also be on medication for this at home.

Prophylactic (preventative) gastropexy can be performed on patients that are at high risk before GDV occurs. High-risk patients generally include dogs that have a family history of GDV. Again, prophylactic gastropexy may be performed laparoscopically without the need for open abdominal surgery.

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