CPD ACCREDITED ARTICLE
Article sponsored by Petcam®
tric wall with Metzenbaum scissors to the level of healthy
gastric tissue. A two-layer closure with a continuous
inverting suture pattern using 3-0 absorbable monofilament suture is necessary to close the stomach. This
technique has been associated with a 60% mortality.22
If autostapling equipment is available, a gastrointestinal
Postoperative Complications
After surgery, monitor the dog for arrhythmias, DIC, hypotension, and peritonitis. All these complications result
from the pathophysiology of GDV.
Shock after surgery is usually caused by inappropriate
treatment before surgery, blood loss during surgery, anesthesia effects, or fluid sequestration due to ileus. Septic shock can result from toxins and bacterial absorption
from gastric mucosa necrosis and peritonitis.
Negative prognostic indicators are gastrectomy with
splenectomy, hypotension, DIC, arrhythmias, and peritonitis.9,15,20 Gastrectomy alone is not a prognostic indicator
for survival, but it increases the risk of complications (peritonitis, arrhythmias, hypotension).15
4A. Gastric necrosis occurs along the greater curvature of the stomach in the body and the fundus. Automatic stapling equipment assists in removing the necrotic section.
anastomosis device (GIA 50—Covidien) or a thoracoabdominal device (TA 90—Covidien) can be used to perform the gastrectomy (Figures 4A & 4B). Advantages of
this technique include decreased risk of abdominal contamination from gastric spillage and decreased surgical
time. Mortality rate with the autostapling equipment is
close to 10%.23 Stomach rupture is associated with severe
peritonitis that would require appropriate treatment.
Gastropexy
After gastrectomy, a gastropexy is required to stabilise
the pyloric antrum on the right side of the abdominal
cavity. Gastropexy substantially decreases the chance of
recurrence—after a gastropexy, dogs can still dilate their
stomachs but not rotate them.
A belt-loop gastropexy and an incisional gastropexy are
the two techniques most commonly performed. The
modified incisional gastropexy with incorporation of the
body of the stomach in the midline closure is not appropriate since it does not stabilise the pyloric antrum in the
right side of the abdomen.
If needed, a splenectomy is performed in a routine fashion. The abdominal cavity is then flushed with warm sterile saline solution and closed in a routine fashion.
vet360
Issue 06 | DECEMBER 2016 | 30
Ventricular arrhythmias are common in patients with
GDV, especially within 36 hours after surgery. They result
from poo