Diagnosis of chronic gastric instability using computed tomography in a Great Dane that progressed to gastric dilatation and volvulus: A literature review and case report

Abstract

Chronic gastric instability (CGI) is part of the gastric dilatation and volvulus (GDV) complex and contributes to the pathophysiologic mechanism of volvulus. Clinical signs can be attributed to a flaccid and mobile stomach. This manuscript reviews the literature regarding CGI and presents a case where computerized tomography is utilized in combination with abdominal radiography to diagnose CGI in an 8 year old spayed female Great Dane. The patient presented for nonspecific clinical signs including hypersalivation, anorexia, and regurgitation, and was euthanized after failing medical management and developing acute abdominal pain. Necropsy revealed a distended stomach with 180o rotation along its long axis. This case demonstrates that CGI and GDV share a continuum, and cases of CGI may progress to GDV without prophylactic surgical intervention.

CT findings in dogs with gastric malposition: 6 cases (2016‐2019)

“…The authors have noted gastric malposition in CT studies of several patients presenting for reasons not suggestive of acute gastric dilatation and volvulus. Following a search of the databases, Pubmed and Science Direct, for the keywords CT, gastric instability and gastric malposition on the 20/08/2020 only one case report was found that described the CT findings of chronic gastric instability in a Great Dane (Czajkowski & Hallman 2018). The purpose of this paper was to describe the CT findings in six dogs diagnosed with suspected chronic gastric instability and to identify consistent imaging features between these patients.…”

“…Chronic gastric instability is defined as a flaccidity of the stomach with resulting intermittent gastric malposition (Czajkowski & Hallman 2018). Dogs with chronic gastric instability can present with a protracted history of non-specific clinical signs including vomiting, lethargy, abdominal discomfort and weight loss (Funkquist & Garmer 1967, Paris et al 2011.…”

Identification of Genetic Susceptibility Factors Associated with Canine Gastric Dilatation-Volvulus

“…Increased body weight is associated with increased risk [1] as well as lean body condition [14] and increased thoracic-depth-to-width ratio [1,15,16]. Other risk factors in dogs include primary ligament laxity [17], dysregulation of gastric motility (abnormal gastric motility patterns, delayed gastric emptying, and, sporadic acute gastric dilation) [2], and chronic gastric instability (CGI) which often precedes GDV episodes [18,19]. Various dietary factors are also associated with GDV risk such as smaller food size particles in Great Danes [20], dry foods containing an oil or fat among the first 4 ingredients [21], feeding a single food type, and a large volume of food at a time [14].…”