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.
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