Gastric dialatation is an acute condition and when associated with volvulus is an acute fatal condition. Gastric dialatation was recorded in two dogs which had abdominal distension, retching, salivation and dullness. Dogs had tachycardia, fever, tachypnoea, congested mucus membranes, cardiac arrhythmia, anemia and leucocytosis. Radiography of the right lateral thorax and abdomen revealed free gas in stomach and the condition was diagnosed as gastric dialatation. Dog was treated with Ceftriaxone, dexamethasone sodium phosphate, Ranitidine along with other managemental practices.
Gastric dialatation (GD) and gastric dialatation and volvulus (GDV) is an acute, often fatal, syndrome of uncertain etiology occurring primarily in large, deep-chested breeds of dogs. Commonly, present condition occurs in dogs which take large amount of food and water very quickly and exercise soon after. The stomach dilates when it fills with food and water and the gas that is produced during exercise. Accumulation of fluids, food and gas cause the stomach to pyloric twist, blocking the pyloric sphincter and gastroesophageal sphincter of the stomach so that food, water, and gas cannot escape. When the stomach is dilated and is maintained in its normal position, the condition is known as gastric dialatation . Dilatation refers to a condition in which an organ or structure is stretched beyond its normal dimensions. The stomach becomes enlarged as gas or fluid or both accumulate in the lumen. The gas probably comes from aerophagia, bacterial fermentation of carbohydrates, diffusion from the blood stream and metabolic reactions may contribute. Dogs with deeper and narrower thorax may have the anatomical relationship between stomach and oesophagus such that dog’s ability to eructate is impaired. Feeding dogs from a raised feed bowl may increase the risk of GDV because it may promote aerophagia . Present communication reports two cases of gastric dialatation in dogs.
A five year old Labrador dog was referred to the Teaching Veterinary Clinical Complex, Proddatur with distended abdomen, retching, vomitions from the day before. Occasionally blood was noticed in the vomitus. Upon examination, the dog showed belching, excessive salivation, non productive retching, nausea, lethargy, restlessness, generalized weakness, respiratory distress, dullness, unstable walking, frequent lying down, ballottement of the anterior abdomen and tucked up appearance of the posterior abdomen (Figure 1). Rise in body temperature (102.8ºF), heart rate (136 bpm) with arrythmia, respiratory rate (45/min), congested mucus membranes were noticed. Pain was evinced by the dog while palpating over the abdominal region. Based on the clinical symptoms it was suspected to be gastric dialatation and radiography of the lateral abdomen was advised. Whole blood with EDTA, serum, peripheral blood smear, faecal samples was collected for laboratory examination. Electrocardiographic parameters were carried out to know about the arrhythmia.
Haematology revealed, reduced hemoglobin (10.2 g/dL), RBC (4.82x106/µL), PCV (36%) levels, Higher leucocyte count (15640/ cumm) with neutrophilia (77%). Serum biochemical analysis had normal levels of glucose (82 mg/dl), serum albumin (2.45 g/dL), serum total protein (6.80 g/dL), blood urea nitrogen (36 mg/dL), creatinine (1.1 mg/dL). Upon electrocardiographic examination, mean amplitudes of the P, QRS and T waves were 0.15 mV, 1.25 mV and 0.18 mV. Mean duration of P, QRS and T waves were 0.04 sec., 0.045 sec., 0.04 sec. recorded. Mean heart rate was 136 bpm (Figure 2). The right lateral radiograph revealed enlarged and dialated stomach with a large, distended, gas-filled gastric shadow (Figure 3).
An 8 year old Labrador dog was presented to the clinic with severe respiratory distress, dyspnoea from the last two days. Examination of the dog revealed fever, cardiac arrhythmia, tachycardia, tachypnoea, severe enlarged abdomen, salivation and stenal recumbence. Radiograph of the thorax and abdomen was advised to rule out the cardiac involvement or GDV. Radiograph of the abdomen revealed presence of the enlarged stomach with lot of air and pressure over the diaphragm.
Treatment was carried out for the case-1. In the second case, the dog collapsed before treatment could be initiated.
For case -1 initial gastric decompression was attempted by passing of stomach tube, followed by intravenous administration of inj. Ceftriaxone @ 5 mg/kg body weight, dexamethasone sodium phosphate @ 0.25 mg/kg body weight, inj. Ranitidine @ 0.5 mg/kg body weight, DNS @ 10 ml/kg body weight for five days. Oral administration of Sucralfate (Sparacid) @ 5ml before food, activated dimethicone, aluminium hydroxide, magnesium hydroxide, sorbitol (Gelusil plus) @ 5ml BID after the food, metoclopramide (emenil) @ 10 mg BID, iron supplements (sharkoferrol) @ 5 ml BID was advised for ten days. The owner was to advised feeding the dog with small quantity of food at increased intervals and to avoid exercising of the dog immediately after feeding.
Dogs are usually able to relieve the built-up pressure in their stomachs by vomiting or by belching. When belching and vomiting is not providing relief, emergency treatment is required. Diagnostic confirmation was accomplished by abdominal radiography with the patient in right lateral recumbency. Radiographs with gastric compartmentalization confirm the gastric dialatation. Absences of displaced gastric pylorous indicated absence of volvulus. Higher incidence of gastric dialatation reported in large and giant breed dogs 24 and 22%, respectively . In the present study both case belonged to the breed of Labrador weighing 28 and 40 kgs and were large size dogs.
Gastric dilatation occurs most frequently in large deep chested dogs and has been known to be a life threatening condition. Dialatation is just enlargement of the stomach. Volvulus is a twisting of stomach revolved along its longer axis like a baggie half filled with water and flipped. In the present case, volvulus was not noticed by radiography examination and it is only stretching of the stomach of trapped gasses. In this condition, the stomach often flips over on itself and expands with trapped swallowed air and fermentation gases that can no longer escape by belching or pass down the intestine .
Gastric decompression can be done by puncturing the stomach directly. But, there is chance of damage to the other visceral organs which may lay associate with the stomach (spleen). So, in this study gastric and decompression was attempted by passing the stomach tube. Gastropexy is a commonly recommended preventive procedure where the stomach wall is attached to the inside of the rib cage to prevent the stomach from flipping and which can prevent the gastric torsion. In the present case gastropexy was not performed as the owner did not consent for surgical intervention. After ten days of medical therapy, the dog was free from vomitions. The owner was advised to use ranitidine for occasional retching, if shown by the dog.
Gastric dailatation and volvulus leads to splenic rotation and often torsion of the splenic Pedicle. Due to electrolyte imbalance and cardiovascular collapse death may occur in severe cases. In GDV condition, the vascular compromise can result in stomach wall necrosis, shock, and death, with mortality rates ranging from 23%to 60% . Gastric dilatation and volvulus is characterized by cardiogenic shock, during which the entire body may be subjected to inadequate tissue perfusion and ischemia. The most serious complications of GDV are associated with IRI and consequent SIRS. These include hypotension, ARF, DIC, and cardiac arrhythmias. In the present study, case-2 the death of the dog might be due to cardiogenic shock.
The authors acknowledge the authorities of Sri Venkateswara Veterinary University, Tirupati for providing facilities to carry out this research.
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