Prophylactic Gastropexy - VCA Specialty Animal Hospitals

FIRST RIGHT FOLD-OUT “WIDOW” PANEL
BACK COVER
FRONT COVER
<<VCAHOSP>>
<<VCAStreet>>
<<VCACity>>, <<VCAST>> <<00000-0000>>
<<000-000-0000>>
<<www.hospurl.com>>
What To Expect After Surgery
Most dogs go home within 24 hours
of surgery. Rarely does a dog with a
prior history of bloating develop GDV
following gastropexy. Some gastropexied
dogs are so prone to bloating that they
may still develop distention of the stomach
requiring medical care, but an effective
gastropexy prevents volvulus and the
need for emergency surgery. Some
veterinarians may recommend an
ultrasound examination 6 to 12 months
after surgery in order to confirm that
a gastropexy is present.
Prophylactic
Gastropexy:
VCA Specialty Animal Hospitals work
closely with local veterinarians to provide
comprehensive, specialty level veterinary
care to pets. Our board certified specialists
are up to date on the very latest developments
in their field. They have access to the most
sophisticated diagnostic and treatment tools
and techniques, including ultrasonography,
endoscopy, chemotherapy, radiation therapy,
and advanced surgical procedures.
Todd Tams, DVM, DACVIM
(Internal Medicine)
Vice President and
Chief Medical Officer
VCA Animal Hospitals
<<SKU #>> (<<MM/YY>>)
What Owners Need To Know
What Is A Gastropexy?
A gastropexy secures the antrum (bottom
of the stomach) to the right abdominal wall.
This adhesion prevents the deadly twisting
of the stomach during bloat (referred to
as gastric dilatation-volvulus or GDV).
Rather than wait for a life-threatening
bloat, owners of large-breed dogs should
ask their veterinarian if their pet would
benefit from a preventive gastropexy.
Emergency Bloat Presentation
Bloating dogs quickly exhibit signs of GDV,
usually soon after eating, and often subsequent
to drinking water, exercising, or becoming
excited. Early signs may include nonproductive retching, increased salivation,
rapid breathing, and general discomfort. The
abdomen progressively distends, frequently
with tympany (gas distention of the stomach).
Although depressed, many dogs will continue
to stand and pace around slowly. As they
progress to shock, however, they become
depressed and lie down. Death from
toxic shock often occurs rapidly.
immediately by a veterinarian. Veterinary examination of the abdomen
usually finds distention with gas. Radiographs are used to determine the
source of distention and whether the distention also includes twisting
(vovulus) of the stomach. Intensive and expensive diagnostics and
treatment must be initiated rapidly.
Prognosis For Bloated Dogs
Clinical studies have found that approximately 15 percent of dogs do
not survive even after appropriate treatment for gastric dilatation-volvulus.
This mortality rate increases to 26 percent when the total includes dogs
that presented “dead on arrival” at the emergency room or whose owners
elected euthanasia. Many factors affect a dog’s survival, but the most
critical is whether the dog has gastric distention or distention plus
volvulus. Mortality occurs in only one percent of dogs with distended
stomachs; but mortality increases when the stomach has both distention
and volvulus, even when appropriately treated, and approaches 100 percent
when GDV is left untreated.
Although no data suggests that certain breeds are more likely to die
when bloated, an abundance of data has identified dogs more likely
to bloat. Great Danes lead the list with a lifetime risk for bloat as high
as 25 percent. Other highly susceptible breeds include Irish Wolfhound,
Newfoundland, Saint Bernard, Akita, Bloodhound, Collie, Irish Setter,
Rottweiler, Standard Poodle, Greater Swiss Mountain and Bernese
Mountain dogs, and other large breeds with a deep chest-to-width ratio.
In addition to the breeds known to be at greater risk, GDV can occur in
small-breed dogs and in cats as well. Having a parent or sibling that has
All acutely bloating dogs are considered
bloated more than doubles the lifetime risk over the breed average. In fact,
emergencies and must be examined
we recommend that dogs with a first-degree relative that has had GDV
not be used for breeding and a prophylactic
gastropexy is recommended for these pets.
Military and police working German
Shepherds and Malanois are particularly
bloat susceptible. When not treated with a
gastropexy, over 80 percent of the dogs that
have previously bloated and been managed
medically die of GDV within one year. Other
factors increasing the risk for bloat include
increasing age, aggressive temperament, being
fed one large meal per day, eating aggressively,
increasing breed size, decreased food particle
size, lean body condition, and being a purebreed dog. Owners unable to monitor their
dog for a few hours after feeding should
Bloat (GDV) combines stomach distention (Gastric Dilatation) followed by rotation (Volvulus).
consider a gastropexy.
A
A
Once volvulus develops, blood flow is altered and shock develops, which can produce death.
Abdominal radiograph of a
normal dog.
Radiograph demonstrating gas
distention of the stomach, which
appears to have undergone volvulus
(rotation) during bloat.
When Is A Gastropexy Performed?
When dogs develop bloat, many are operated on to correct the
stomach position and perform a gastropexy to keep the stomach
properly positioned. In contrast to emergency surgery, preventive
gastropexies can be performed when bloat-susceptible dogs are healthy.
Gastropexies: Which Dogs? When? How?
All large-breed dogs should be considered as candidates for a
preventive gastropexy, especially if they are undergoing other
abdominal surgery. Other abdominal surgeries include spays,
cryptorchid castrations, and foreign body removals. Even middleaged dogs are candidates, as increasing age increases the risk for
bloat. Ask your veterinarian if your dog should have a gastropexy.
In addition to discussing a preventive gastropexy to avoid volvulus
when bloat develops, you should discuss medical management
procedures that may reduce the likelihood of bloat.
Common gastropexy techniques are circumcostal, belt-loop, and
incisional when performed during a traditional abdominal surgery.
Another option is a laparoscopic-assisted incisional gastropexy, which
can be performed through small holes. All produce a strong gastropexy
and have proven effective in preventing volvulus when the stomach
dilates. Gastropexies can be performed by veterinarians experienced in
surgery. Laparoscopic gastropexies can be performed by veterinarians
and surgeons trained in laparoscopy.