CASE 18
 

SIGNALMENT: 5-year-old female Chow-Chow. HISTORY: Owner noted the dog vomiting after being fed a "T-bone" the night before. Taken to the referring veterinarian at 11:30 a.m. the next day. DIAGNOSIS: Radiographs (RT lateral and VD) of the abdomen were taken showing marked gastric dilation (Figure 1).

Figure 1 Ventrodorsal view of the dilated stomach. Compartmentalization is not evident.

Figure 2 Splenectomy has been done and the dilated stomach has been de-rotated. Note the marked congestion of the region of the fundus, in particular the greater curvature is involved.   Figure 3 Gastric decompression has been achieved. Gastric motility is evident and the color of the stomach improved after observation for 15-20 minutes.

Radio-opaque foreign bodies (bone) are noted. A presumptive diagnosis of gastric dilatation with volvulus was made and the dog referred for immediate surgery. An i.v. catheter had been placed and fluids administered. Decompression was not successful as a stomach tube could not be passed. TREATMENT: Abdominal exploratory revealed a markedly distended, congested stomach with a 360 degree volvulus. The spleen was not distended but the splenic vessels appeared to be torsed greater than 360 degrees. Splenectomy was done in order to allow de-rotation of the enlarged stomach (Figure 2). A stomach tube was subsequently passed and the stomach decompressed (Figure 3). Circumcostal gastropexy was done. The stomach was judged to be viable based upon clinical criteria and partial gastrectomy was not done. Cardiac arrhythmias developed within 24 hours and a constant rate lidocaine drip was required. The dog was able to be discharged on oral procainamide 48 hours after surgery.

DIAGNOSIS: Gastric Dilatation-Volvulus with secondary cardiac arrhythmias.   ACKNOWLEDGEMENT: Thank you to Dr. Rodney Robards, Southern Hills Veterinary Hospital, for this referral.     CASE ARCHIVES: Click on Case Archives to access a list of past case features.