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==Description==

==Description==

   

   

Gastric Dilatation and Volvulus (GDV) is an acute, life-threatening emergency condition affecting large and giant breed dogs. Commonly affected breeds include German Shepherds, Great Danes, Irish Wolfhounds, St Bernards and Doberman Pinschers. GDV has also been reported to occur in cats, primates and rarely small breed dogs such as Dachshunds and Miniature Poodles.

Gastric Dilatation and Volvulus (GDV) is an acute, life-threatening emergency affecting large and giant breed dogs. Commonly affected breeds include German Shepherds, Great Danes, Irish Wolfhounds, St Bernards and Doberman Pinschers. GDV has also been reported to occur in cats, primates and rarely small breed dogs such as Dachshunds and Miniature Poodles.

==Risk factors==

==Risk factors==

Studies have shown that dogs with a reduced thoracic width to depth ratio are at a in increased risk of developing GDV. Other risk factors include obesity, stress, exercise following feeding and feeding of a dry food diet. Female dogs are also more likely to develop GDV than males.  

Studies have shown that dogs with a reduced thoracic width to depth ratio are at an in increased risk of developing GDV. Other risk factors include obesity, stress, exercise following feeding and feeding of a dry food diet. Female dogs are also more likely to develop GDV than males.  

==Pathogenesis==

==Pathogenesis==

==Treatment==

==Treatment==

The most important first line treatments are fluid therapy and gastric decompression. Large bore (16 or 18 gauge) catheters should be placed into the cephalic or jugular veins (ideally two into both cephalic veins). Shock doses of Compound Sodium Lactate (Lactated Ringer's Solution) (60-90ml/kg/h) should be administered. Monitoring of the animal's cardiovascular status  should be done by regular blood pressure measurements, heart rates, PCV and total solids and urine output.

Treatment begins with rapid fluid therapy and gastric decompression followed by surgical assessment, repositioning of the stomach and gastropexy. Large bore (16 or 18 gauge) catheters should be placed into the cephalic or jugular veins. Shock doses of Compound Sodium Lactate (Lactated Ringer's Solution) (60-90ml/kg/h) should be administered. Monitoring of the animal's cardiovascular status  should be done by regular blood pressure measurements, heart rates, PCV and total solids and urine output.

Gastric decompression is performed by introduction of a lubricated premeasured (from nostril to last rib) stomach tube or by trocharizing the most tympanic area caudal to the ribs with a 14 to 16 gauge catheter. Sedation may be required to allow the passage of the stomach tube. Suitable drugs for this include Butorphanol, Fentanyl or diazepam.

Gastric decompression is performed by introduction of a lubricated premeasured (from nostril to last rib) stomach tube or by It is important to mimimise stress when this procedure is carried out. Sedation is not usually required but suitable drugs for this include Butorphanol, Fentanyl or Diazepam. It the animal is resistant to orogastric intubation or becomes stressed, trocharizing the most tympanic area caudal to the ribs with a 14 to 16 gauge catheter.

Other treatment may include broad spectrum antibiotics e.g. Cephalosporin and a Fluoroquinolone. Thses should also be given at surgical induction through to the postoperative period. For cardiac arrythmias: indicated if weakness, syncope, tachycardia runs with R on T complexes, ventricular tachycardia at rates >150bpm. Treated by correcting [[Essential Ion and Compound Balance and Homeostasis - Anatomy & Physiology#Acid / Base|acid-base]], [[Essential Ion and Compound Balance and Homeostasis - Anatomy & Physiology|electrolyte]] and [[Haemostasis - Pathology|haemostatic]] disturbances. The treatment is [[Local Anaesthetics#Lidocaine|lidocaine]] by bolus or continuous rate infusion or procainamide if they persist.

Other treatment may include broad spectrum antibiotics e.g. Cephalosporin and a Fluoroquinolone. Thses should also be given at surgical induction through to the postoperative period. For cardiac arrythmias: indicated if weakness, syncope, tachycardia runs with R on T complexes, ventricular tachycardia at rates >150bpm. Treated by correcting [[Essential Ion and Compound Balance and Homeostasis - Anatomy & Physiology#Acid / Base|acid-base]], [[Essential Ion and Compound Balance and Homeostasis - Anatomy & Physiology|electrolyte]] and [[Haemostasis - Pathology|haemostatic]] disturbances. The treatment is [[Local Anaesthetics#Lidocaine|lidocaine]] by bolus or continuous rate infusion or procainamide if they persist.

==Prognosis==

==Prognosis==

Simple GDV mortality rates are around 15%. Patients suffering from gastric necrosis, gastric resection or splenectomy have a higher mortality rate at over 30%. Gastric necorsis can be predicted by measuring plasma lactate. Values >6mmol/l indicates necrosis (Specificity 88%, Sensitivity 66%)

Simple GDV mortality rates are around 15%. Patients suffering from gastric necrosis, gastric resection or splenectomy have a higher mortality rate at over 30%. Gastric necrosis can be predicted by measuring plasma lactate. Values >6mmol/l indicates necrosis.

==References==

==References==

Tivers, M. and Brockman, D. (2009) '''[[http://inpractice.bvapublications.com/cgi/reprint/31/3/114?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=brockman&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT|Gastric dilation–volvulus syndromein dogs 2. Surgical and postoperative management]]''' 31(3):114 ''In Practice''

Tivers, M. and Brockman, D. (2009) '''[[http://inpractice.bvapublications.com/cgi/reprint/31/3/114?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=brockman&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT|Gastric dilation–volvulus syndromein dogs 2. Surgical and postoperative management]]''' 31(3):114 ''In Practice''

[[Category:Stomach_and_Abomasum_-_Pathology]][[Category:Dog]]

[[Category:Stomach_and_Abomasum_-_Pathology]][[Category:Dog]]

[[Category:To_Do_-_SophieIgnarski]]

[[Category:To_Do_-_SophieIgnarski]]