Changes

==Description==  

==Description==  

Gastric Dilatation and Volvulus (GDV) is an acute, life-threatening emergency affecting large and giant breed dogs. The condition is characterized by accumulation of gas in the stomach, malpositioning of the stomach, increased intragastric pressure and shock. Successful management relies on prompt diagnosis and appropriate emergency treatment as the disease will rapidly progress to death if untreated.

Gastric Dilatation and Volvulus (GDV) is an acute, life-threatening emergency affecting large and giant breed dogs. The condition is characterised by accumulation of gas in the stomach, malpositioning of the stomach, increased intragastric pressure and shock. Successful management relies on prompt diagnosis and appropriate emergency treatment as the disease will rapidly progress to death if untreated.

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.

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==

The exact aetiology of the condition is unknown but a number of risk factors have been identified. Studies have shown that dogs with a reduced thoracic width to depth ratio are at an in increased risk of developing GDV. Female dogs are also more likely to develop GDV than males and stressed, anxious dogs are more likely to develop GDV than calm, placid dogs. Other risk factors include obesity, feeding a dry food diet and exercise after feeding.  

The exact aetiology of the condition is unknown but a number of risk factors have been identified. Studies have shown that dogs with a reduced thoracic width to depth ratio are at an in increased risk of developing GDV. Female dogs are also more likely to develop GDV than males and stressed, anxious dogs are more likely to develop GDV than calm dogs. Other risk factors include obesity, feeding a dry food diet and exercise after feeding.  

==Pathogenesis==   

==Pathogenesis==   

===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 inch 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, trocharization of the most tympanic area caudal to the ribs with a 14 to 16 gauge catheter may be performed. 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 inch 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. 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, trocharization of the most tympanic area caudal to the ribs with a 14 to 16 gauge catheter may be performed. This may allow subsequent completion of orogastric intubation for further decompression.

===Radiography===

===Radiography===

===Other diagnostic tools===

===Other diagnostic tools===

Plasma lactate concentration has been reported to have a strong link with the patient's prognosis due its association with gastric necrosis and systemic hypovolaemia. A plasma lactate greater than 6 mmol/L is associated with a poor prognosis.  

Plasma lactate concentration has been reported to have a strong link with the patient's prognosis due its association with gastric necrosis and systemic hypovolaemia. A plasma lactate greater than 6 mmol/L is associated with a poor prognosis.  

Electrocardiography (ECG) is essential as cardiac arrhythmias may occur in up to 40% of dogs with GDV. Most arrhythmias are ventricular in origin and occur within 36 hours of admission. Ventricular tachycardia is the most common rhythm disturbance seen but many other arrhythmias may occur.

Electrocardiography (ECG) is essential as cardiac arrhythmias may occur in up to 40% of dogs with GDV. Most arrhythmias are ventricular in origin and occur within 36 hours of admission. Ventricular tachycardia is the most common rhythm disturbance displayed but many other arrhythmias may occur.

==Treatment==

==Treatment==