Gastric dilatation volvulus: a treatment guide

Gastric dilatation volvulus (GDV) is a relatively common emergency presentation in small animal veterinary practice. Typically, deep-chested large and giant breed dogs are affected. The exact cause of the condition is unknown (Monnet, 2003), however many risk factors have been identified. Risk factors include (Glickman et al, 1994; Glickman et al, 2000; Beck et al, 2006; Pipan, 2012):

The reported mortality rate for dogs with GDV ranges from 3.2–33.3% (Glickman et al, 1998; Belch et al, 2017), with more recent reports demonstrating improved survival rates.

Dogs presenting with GDV will typically exhibit signs of restlessness, retching and unproductive vomiting, distension of the cranial abdomen, ptyalism and respiratory compromise. Some dogs present collapsed. Clinical examination findings are consistent with hypovolaemic shock, including pale mucous membranes with prolonged capillary refill time, tachycardia and weak peripheral pulses (Williams, 2015). Cranial abdominal distention with or without tympany may not always be easily detected, particularly in very deep chested dogs where the stomach may be within the costal arch. Prompt recognition, stabilisation and surgical correction of the GDV are required for successful treatment. This article discusses the approach to investigation, stabilisation, surgical correction and postoperative management of GDV.