Changes

===Fluid therapy===

===Fluid therapy===

Diagnosis is usually based on the patient's signalment and a history of unproductive vomiting and abdominal distension. Initial emergency treatment should be aimed at managing the dog's hypovolaemic shock. Large bore (16 or 18 gauge) catheters should be placed into the cephalic or jugular veins and a proportion of the shock dose of Compound Sodium Lactate (90ml/kg/h) should be administered intravenously based on the severity of the dog's clinical signs. Hypertonic saline or colloid fluids may be indicated in very large dogs or those who have not responded to a bolus dose of crystalloid fluids.  

Diagnosis is usually based on the patient's signalment and a history of unproductive vomiting and abdominal distension. Initial emergency treatment should be aimed at managing the dog's hypovolaemic shock. It may be beneficial to provide oxygen supplementation whilst the dog is being stabilised.

Large bore (16 or 18 gauge) catheters should be placed into the cephalic or jugular veins and a proportion of the shock dose of Compound Sodium Lactate (90ml/kg/h) should be administered intravenously based on the severity of the dog's clinical signs. Hypertonic saline or colloid fluids may be indicated in very large dogs or those who have not responded to a bolus dose of crystalloid fluids.  

===Gastric decompression===

===Gastric decompression===

Following a period of aggressive fluid therapy, gastric decompression should be performed. A lubricated large-bore stomach tube is premeasured (from nostril to last rib)and marked. A roll of 2'' adhesive tape should be inserted behind the canine teeth and the dog's mouth should be held closed around the banadage. The stomach tube can then be introduced through the bandage into the oesophagus.  and should not be advanced beyond the marked point. 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. This may allow susequent completion of orogastric intubation for further decompression.

Following a period of aggressive fluid therapy, gastric decompression should be performed. A lubricated large-bore stomach tube is premeasured (from nostril to last rib)and marked. A roll of 2'' adhesive tape should be inserted behind the canine teeth and the dog's mouth should be held closed around the banadage. The stomach tube can then be introduced through the bandage into the oesophagus.  and should not be advanced beyond the marked point. 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. This may allow susequent completion of orogastric intubation for further decompression.

===Radiography===

===Radiography===