CASE STUDY OF LEO WITH GDV OR BLOAT

What is Bloat?

Gastric dilatation (GDV), or bloat, is a quickly progressing and devastating condition that can develop in different breeds of dogs. The condition happens when the stomach dilates, and food and gas cannot be expelled. As the stomach dilates and expands, the pressure in the stomach begins to increase, causing inadequate blood return to the heart from the abdomen, loss of blood flow to the lining of the stomach, and rupture of the stomach wall. In some cases, the stomach can become dilated enough to rotate in the abdomen, a condition called volvulus. This can lead to blockage of the blood supply to the spleen and the stomach wall, and without immediate surgical correction of volvulus and removal of the dead tissues, the patient can die.

Case Study of Leo

Leo is an eight-year-old male golden doodle that presented to CARE ER for post-operative care following a gastric dilatation-volvulus (GDV) as a referral from Dr. Derek Wilson at Old Farm Veterinary. GDV is a life-threatening condition that can occur in large deep chested breed dogs. The stomach twists on itself causing food, fluid and gas to be trapped in the stomach. The distention of the stomach causes compromise of the blood supply to the stomach leading to tissue death and ultimately patient death if not treated with aggressive surgical intervention.

Leo was taken to Dr. Wilson’s clinic in grave condition and was diagnosed with a GDV. Dr. Wilson performed Leo’s initial lifesaving surgery – he derotated the stomach and tacked it down (gastropexy). Dr. Wilson was very concerned about the viability of Leo’s stomach, yet he was very unstable. He finished the surgery and transferred Leo’s case to CARE for post-operative monitoring and evaluation. Dr. Kim Bencivenga one of CARE’s ER Doctors, continued Leo’s life-saving supportive care overnight and transferred him to CARE’s board-certified surgeon Dr. Kelly Gellasch due to the concern about his stomach viability. Leo was treated for a heart arrhythmia, prolonged clotting times one-day post operation, however over 36-48 hours post operation he started to decline again. Since CARE is a multi-specialty clinic Dr. Gellasch was able to consult with Dr. Jim McConnell, one of CARE’s internal medicine doctors, who performed an ultrasound to rule out a splenic infarct, none was identified. At this time Leo had developed a large amount of abdominal fluid, clinically was very weak and with given a significant concern for stomach tissue death, causing leakage, Dr. Gellasch advised a second surgery or Leo was most likely not going to survive.

At the second surgery, a sizable portion of Leo’s stomach was black and there was a small hole leaking gastric fluid into the abdomen causing peritonitis (infection). The non-viable tissue was removed surgically and a stomach tube for feeding was placed into the stomach. Leo was aggressively monitored and treated in an ICU setting for the next several days. He continued to get stronger every day. Leo has made a full recovery and has had his stomach tube removed and is back to his sweet wonderful self!

This case is an awesome example of the collaboration it takes to save the dogs in our community. Dr. Wilson, Leo’s primary care doctor was able to provide the initial surgery and get him to CARE where a team of doctors were able to continue life-saving measures/support which results in a wonderful outcome!