Small Animal Emergency and Critical Care Medicine Q&A 09

This question was provided by Manson Publishing as part of the OVAL Project. See more Small Animal Emergency and Critical Care Medicine Q&A.

Your triage nurse alerts you that a three-year-old, male Coonhound (40 kg) with a few hours’ history of non-productive retching and pacing has entered the hospital. Primary survey reveals poor perfusion, rapid and irregular heart rate, and a tympanic, distended cranial abdomen. A lateral radiograph reveals gastric dilatation and volvulus.

Question	Answer		Article
What are the pros and cons of the following surgical procedures for preventing gastric volvulus from recurring: circumcostal gastropexy; antral incisional gastropexy; tube gastropexy; midline abdominal closure gastropexy?	Circumcostal gastropexy. Pros: most reliable adhesions obtained. Cons: time-consuming preparation; potential for rib fractures; potential for entering pleural space and causing pneumothorax. Antral incisional gastropexy. Pros: rapid technique with less technical difficulty. Cons: none. Tube gastropexy. Pros: ability for postoperative decompression and feeding control. Cons: requires time for fistula formation before tube can be removed; requires exposure of the gastric lumen. Midline abdominal closure gastropexy. Pros: rapid technique. Cons: makes a reapproach to the cranial abdomen very difficult.		[[|Link to Article]]
What vessels are most commonly torn during a gastric dilatation/volvulus episode, and where are these located?	Short gastric arteries and left epiploic artery along the greater curvature of the fundus.		[[|Link to Article]]
What surgical findings would indicate that a splenectomy is required?	Dark/black areas suggesting an infarction/ischemia; lack of palpable pulses in the splenic hilus suggesting arterial thrombosis; disseminated masses that may be neoplastic; bleeding mass; uncontrollable hemorrhage of the spleen.		[[|Link to Article]]