A Retrospective Study of Factors Influencing Survival Following Surgery for Gastric Dilatation-Volvulus Syndrome in 306 Dogs

Abstract

Gastric dilatation-volvulus (GDV) is a life-threatening condition in dogs that has been associated with high mortality rates in previous studies. Factors were evaluated in this study for their influence on overall and postoperative mortality in 306 confirmed cases of GDV between 2000 and 2004. The overall mortality rate was 10%, and the postoperative mortality rate was 6.1%. The factor that was associated with a significant increase in overall mortality was the presence of preoperative cardiac arrhythmias. Factors that were associated with a significant increase in postoperative mortality were postoperative cardiac arrhythmias, splenectomy, or splenectomy with partial gastric resection. The factor that was associated with a significant decrease in the overall mortality rate was time from presentation to surgery. This study documents that certain factors continue to affect the overall and postoperative mortality rates associated with GDV, but these mortality rates have decreased compared to previously reported rates.

Cardiovascular and Systemic Effects of Gastric Dilatation and Volvulus in Dogs

“…5,16,17,19,22,23 Direct compression of the portal vein and decreased cardiac output also compromise intestinal blood flow in dogs with GDV, resulting in villous injury and compromise of the mucosal barrier. Subsequent translocation of bacterial PAMPS such as lipopolysaccharide from gram-negative bacteria contributes to the systemic inflammatory response seen in dogs with GDV.…”

Chronic gastric instability and presumed incomplete volvulus in dogs

“…The condition is characterised as sudden onset of gastric dilation and rotation about its long axis. Prompt medical and surgical treatment is essential to prevent development of gastric and splenic ischaemia, necrosis and irreversible shock (Glickman and others 1994, Beck and others 2006, Buber and others 2007, Mackenzie and others 2010). In spite of immediate intensive treatment, mortality rates in acute GDV range from 10 to 67% accounting for 2·5% of all reported canine deaths (Mathiesen 1983, Evans and Adams 2010, Mackenzie and others 2010).…”

Specialized Gastrointestinal Techniques

“…6,7 However, most dysrhythmias in A combination of opioids and benzodiazepines, such as diazepam or midazolam, usually suffices.…”

“…[7][8][9][10][11] One study used trocarization alone for presurgical decompression, without orogastric intubation, and reported a low overall mortality rate of 10%. Gastric trocarization often decreases the time to gastric decompression and therefore may decrease the risk of gastric necrosis.…”