Meet Dug Stark: Dug is a 48kg male neutered Bernese Mountain Dog who came to our hospital in a critical state, presenting with lethargy, vomiting green bile, and a distended abdomen. His owners were deeply concerned after noticing his bloated belly and increased discomfort. Time was of the essence, as Dug was showing signs of a life-threatening condition: Gastric Dilatation and Volvulus (GDV).
What is GDV? Gastric Dilatation and Volvulus, or GDV, is a serious and often fatal condition where a dog’s stomach becomes distended with gas and twists on itself. The twist blocks blood flow to vital organs, causing rapid deterioration. Without immediate surgical intervention, the condition can lead to death.
Dug’s Initial Exam: Upon arrival, Dug was hypersalivating, dehydrated (~7%), and had tacky mucus membranes. His vital signs were alarming: a body temperature of 103.4°F, heart rate of 144 bpm, and noticeable discomfort upon abdominal palpation. A “ping” sound in his abdomen indicated trapped gas – a hallmark of GDV.
Diagnostics and Diagnosis: X-rays confirmed the worst: Dug’s stomach had rotated 180 degrees, cutting off blood supply to portions of his stomach. His bloodwork showed elevated glucose, lipase, and amylase levels, with a high lactate of 9.4, indicating significant metabolic stress. Based on these findings, we diagnosed Dug with GDV, and immediate surgery was necessary to save his life.
The Surgery: Dug’s surgery, performed on August 14, 2024, by Dr. Eric Wilson and second-year surgical resident Dr. Connor Pyne, involved de-rotating and decompressing his stomach, followed by a gastropexy—a procedure to attach the stomach to the body wall to prevent future twisting. The surgery revealed moderate bruising of the stomach and irritation to the pancreas, but luckily, his spleen remained viable despite the torn short gastric arteries.
During the surgery, we carefully emptied Dug’s stomach and secured it using a 4cm incisional gastropexy, ensuring the stomach would not twist again. There were no intraoperative complications, and Dug’s recovery began as soon as the surgery was complete.
Postoperative Care and Recovery: Dug was monitored closely post-surgery, receiving medications like Fentanyl for pain management, along with antibiotics and gabapentin. He recovered well, showing interest in food and responding positively to postoperative care. His vitals remained stable, and no complications arose.
Prognosis and Long-Term Care: Dug was discharged in a bright, alert state with a great prognosis. His owners were advised to follow up in two weeks to check his surgical incision and were instructed to limit his activity and feed smaller, more frequent meals to reduce the risk of bloating.
GDV Prevention and Owner Education: One of the most important lessons Dug’s case teaches is that early recognition and treatment offer the best chance of survival for dogs with GDV. Although the gastropexy prevents another life-threatening stomach rotation, it does not eliminate the risk of bloating. We recommend feeding smaller meals to reduce stomach expansion and discussing Dug’s gastropexy in any future surgeries to ensure proper care.
Key Takeaways for Future Cases: GDV is a surgical emergency that requires rapid intervention. For veterinary technicians, it’s important to remember that front limb catheters are vital due to blood pooling in the back half of the body. Abdominal radiographs may also cause significant discomfort, and technicians must be mindful of patient pain during positioning. For veterinary surgeons, it’s essential to discuss the financial and medical risks with owners, as GDV surgery can be expensive, and there are no guarantees for a positive outcome.
Conclusion: Dug’s story is a reminder of how crucial early intervention is in cases of GDV. His owners acted quickly, which allowed our team to save his life through prompt diagnosis and surgery. We’re thrilled to see Dug on the road to recovery, and his case serves as an important reminder for pet owners to stay vigilant and for veterinary professionals to prioritize immediate care in GDV cases.
