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Article reprinted with the permission of Advanstar . The article was originally printed in VETERINARY MEDICINE October 2012 . VETERINARY MEDICINE is a copyrighted publication of Advanstar . Communications inc . All rights reserved .
Gastric Dilatation-Volvulus : Controlling the crisis
Eric Monnet , DVM , PhD , FAHA , DACVS , DECVS
Although widely recognised , gastric dilatation-volvulus is still not fully understood . This overview provides up-to-date information on the possible causes , risk factors , diagnosis , and treatment of this life-threatening syndrome .
Gastric dilatation-volvulus ( GDV ) is an acute medical and surgical condition caused by several pathophysiologic effects that occur secondary to gastric distention and malpositioning .
Dilatation Or Volvulus — Which Comes First ? Stomach dilatation is caused by air , gas , and fluid accumulation . Air accumulation in the stomach is most likely caused by aerophagia . The fermentation of carbohydrate by bacteria and the production of gas in the acidic environment of the stomach contribute to gas accumulation . Ingesta , gastric secretions , and transudate from venous obstruction contribute to the accumulation of fluids in the stomach .
It is unknown if volvulus of the stomach occurs before dilatation or vice versa . Volvulus could occur first since it has been documented in some patients without gastric dilatation . Hepatogastric ligaments have been found to be significantly longer in dogs with GDV . 1 With the elongation or stretching of the hepatogastric ligaments , the stomach can twist , which shows that volvulus could occur first . Volvulus will result in occlusion of the lower esophageal sphincter and the pylorus . Thus , dilatation will occur because of the fermentation of gastric content .
Gastric dilatation has been diagnosed in dogs without volvulus and in dogs that have had a gastropexy . Aerophagia is then the major cause of dilatation . When intragastric pressure increases , it likely compresses the lower esophageal sphincter against the diaphragm and interferes with its opening . Intragastric bacteria and bacterial fermentation result in further gastric distention . The distended stomach can then rotate since the hepatogastric ligaments are stretched . 2-4
Risk Factors Although acute GDV has been recognised for many years in dogs , its exact cause is still not clearly understood — only risk factors have been identified : vet360
Issue 06 | DECEMBER 2016 | 26