GDV

Question 1

What is GDV

Answer 1

Gastric dilitation/ volvulus

Question 2

What is dilitation

Answer 2

Gas/fluid filled beyond normal - but no malpositioning

Question 3

What is dilatation/volvulus

Answer 3

Gas/fluid filled and rotated on mesenteric axis

Question 4

T/F the etiology of GDV is unknown

Answer 4

TRUE - theories include retrograde transit, delayed emptying, emptying dis function

Question 5

Risk factors for GDV (8)

Answer 5

Large/giant breed dogs
Increased thorax depth
Older dogs
Rapid eating/exercise after eating
Nasal parasites
Raised food bowl
Large meals
Stress situations

Question 6

How does the stomach typically rotate

Answer 6

90 degrees clockwise
Sometimes 360

Question 7

What gets compressed during a GDV

Answer 7

Caudal vena cava
Portal vein
Splenic veins

Question 8

What type of shock does GDV cause & what does it do to vitals

Answer 8

1) Obstructive
Reduced cardiac output - decreased MAP, decreased CVP, ischemia
2) hypovolemic
Increased portal pressure - interstitial edema
3) septic shock
Bacterial translocation

Question 9

What happens after decreased visceral effusion starts

Answer 9

Gastric necrosis, splenic necrosis, renal failure, metabolic acidosis
Respiratory compromise - diaphragm pressure decreases tidal volume and pet increases resp rate and effort
Compensation failure - increased CO2 leads to respiratory acidosis

Question 11

What species can get GDV

Answer 11

Canine
Guinea pigs

Question 12

What clinical signs come with GDV (5)

Answer 12

Anxious
Praying posture due to painful stomach
Vomit/retching with nothing coming out
Weak/reluctant to move
Respiratory distress with rapid/shallow breathing

Question 13

Clinical appearance of GDV

Answer 13

Abdominal distension - very tight abdomen
Unproductive retching
+/- hypersalivation
Shock signs

Question 14

What can affect the severity of a GDV

Answer 14

Degree of rotation
Vascular compromise
Degree of distention
Duration

Question 15

Labs needed for GDV

Answer 15

Complete blood count
Coagulation profile

Question 16

What shock signs will you see with gdv

Answer 16

Pale MM with increased CRT
tachycardic
Weak pulse

Question 17

What lab results would you see in GDV

Answer 17

Renal insufficiency
Decreased potassium
Decreased TP and albumin
Lactate - if high signals tissue death

Question 18

Is diagnostic imaging necessary for GDV, how do you position the pet for radiographs

Answer 18

not always - only if owner would not want surgery and wants to confirm
Right lateral and look for popeyes arm/double bubble

Question 19

Immediate goals in medical therapy for GDV

Answer 19

Vascular access
Decompression of gas
Fluid therapy with balanced crystalloids with colloids

Question 20

Fluid rate for GDV

Answer 20

90 ml/kg/hr and evaluate after 15 minute with crystalloid

Question 21

What size catheter should you use for GDV and where do you place it

Answer 21

Large as possible to decrease resistance to flow and wherever you can get it

Question 22

What is gastric decompression

Answer 22

Getting gas out of the stomach via orogastric intubation or precutaneous catheter

Question 24

How do you know you’re in the esophagus when placing an orogastric tube

Answer 24

Patient will swallow then you can advance to your premarked position while twisting in a counter clockwise position

Question 25

What is your next step if an orogastric tube wont pass during a GDV

Answer 25

Precutaneous decompression using an over the needle 14g catheter Take needle out and let air escape through catheter

Question 26

How do you know where the stomach is when placing a precutaneous catheter

Answer 26

Ping the stomach If hollow sound not the stomach

Question 27

What supplementation does a GDV dog need

Answer 27

Oxygenation Electrolyte support (potassium and magnesium) Fluids to fix acid-base imbalance (LRS or normosol)

Question 28

What do you monitor for with a GDV dog

Answer 28

Fluid response (CRT, MM, blood pressure) ECG for arrythmias continuously for 12-24 hours after surgery