Stephen J. Birchard DVM, MS, Diplomate ACVS

Thursday, January 23, 2014

What Was The Outcome On Frank, The Golden Retriever With GDV?

This is not Frank but he's a handsome old guy, isn't he?
For those just tuning in, this is a follow up to the blog about Frank, a 9-year-old neutered male dog who presented with a GDV. The blog was posted 1/19/14.

I decided not to do a partial gastrectomy on Frank. We performed an incisional gastropexy from the pyloric antrum to the interior right abdominal wall, and closed the abdominal incision routinely. Postoperatively, besides routine supportive care with intravenous fluids and analgesics, Frank was placed on antibiotics for pyoderma and omeprazole and sucralfate for his gastritis.

Frank did well in the hospital and was discharged 2 days postoperatively. He was sent home on antibiotics for the pyoderma, Tramadol for pain (5 day course), and omeprazole and sucralfate for 1 week.  The owners were advised to feed Frank small meals several times a day and to monitor his stool for evidence of melena.

Frank was seen at our clinic 9 days postoperatively and was doing reasonably well but the owner felt he was a bit lethargic. He was eating well but only canned food.  His stools were normal. A brief abdominal ultrasound exam revealed no peritoneal fluid. The owner was advised to keep Frank on his gastric medications for another week.

Frank was again examined at our clinic 14 days postoperatively. He was more active, eating both canned and dry food, and had normal stools. His abdominal incision had healed and staples were removed. His owner was happy with his progress.

On the poll where I asked what you would do with Frank's stomach, 32 people voted and 56% choose to not do a gastrectomy. Although his stomach was severely bruised, it did not fit the most important criteria for gastric necrosis. There was not a sharp demarcation between the normal and abnormal color of the gastric serosa, but rather a gradual change from the pink to the bruised area. Also, the tissue on palpation was thick, not paper-thin which is more typical of a necrotic stomach. In addition, although I did not mention this in the original blog on Frank, the color of the affected area slightly improved after the stomach was placed into its normal position.

Please do not hesitate to post any questions you have about Frank, or GDV in general.

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