Gastric dilatation–volvulus associated with diaphragmatic hernia in three cats: Clinical presentation, surgical treatment and presumptive aetiology

Surgical Anatomy of the Gastrointestinal Tract in Cats

In cats, the gastrointestinal tract is one of the regions in which surgical procedures are most frequently performed by veterinary surgeons; therefore, knowledge of the surgical anatomy of the feline gastrointestinal tract is of high importance. The main surgical procedures performed include gastrotomy, gastrectomy, enterotomy, and enterectomy, as well as procedures in the liver and pancreas. There are also anatomical differences between dogs and cats, increasing the need for deep knowledge of the anatomy treated in the different surgical approaches. The aim of the present review is to describe in detail the anatomy of the gastrointestinal tract in cats highlighting the anatomical regions of significant importance in different surgical procedures.

Identification of Genetic Susceptibility Factors Associated with Canine Gastric Dilatation-Volvulus

Canine gastric dilatation-volvulus (GDV) is a common life-threatening condition occurring primarily in large and giant breeds with a 3.9% to 36.7% lifetime risk. The genetic correlates of GDV have not previously been systematically explored. We undertook an inter-breed genome-wide association analysis (GWAS) of 253 dogs from ten breeds including 106 healthy dogs and 147 dogs with at least one GDV episode. SNP array genotyping followed by imputation was conducted on 241 samples to identify GDV-associated single-nucleotide polymorphisms (SNPs) and copy number variations (CNVs). A subset of 33 dogs (15 healthy dogs and 18 GDV patients from the three most represented breeds) was characterized by whole genome sequencing (WGS). After genome-wide Bonferroni correction, we identified a significant putatively protective intergenic SNP (rs851737064) across all breeds. The signal was most significant in Collies, German Shorthaired Pointers, and Great Danes. Subsequent focused analysis across these three breeds identified 12 significant additional putatively protective or deleterious SNPs. Notable significant SNPs included those occurring in genes involved in gastric tone and motility including VHL, NALCN, and PRKCZ. These data provide important new clues to canine GDV risk factors and facilitate generation of hypotheses regarding the genetic and molecular underpinnings this syndrome.

A Prospective Evaluation of a Modified Belt-Loop Gastropexy in 100 Dogs with Gastric Dilatation-Volvulus

Gastropexy is a surgical technique performed to prevent and decrease the recurrence rate of gastric dilatation and volvulus (GDV). The objective of this prospective, a descriptive cohort study on 100 client-owned dogs who were presented with GDV, is to describe a modified belt-loop gastropexy and determine its intraoperative complications and long-term efficacy. The transversus abdominis muscle was used to make an oblique belt-loop. A seromuscular antral fold, instead of a seromuscular antral flap, was passed through the belt-loop, and then, the passed portion of the antral fold was sutured to the dissected edge of the abdominal wall. Intraoperative complications related to gastropexy were recorded, and the incidence of GDV recurrence was determined a minimum of 1 yr postoperatively via telephone with the referring veterinarians and the owners. There were no intraoperative complications related to the modified belt-loop gastropexy technique. Based on follow-up conversations, none of the dogs presented signs of GDV recurrence during the follow-up period. Based on the results, there is strong clinical evidence that a modified belt-loop gastropexy prevents recurrence of GDV in dogs surviving an acute episode.

Spontaneous gastric dilatation-volvulus in two cats

OBJECTIVES

To describe 2 cases of gastric dilatation-volvulus (GDV) in cats. To describe 2 unique clinical settings in which the disease occurs in cats, and to highlight the differences between GDV in cats and dogs.

CASE SERIES SUMMARY

Two neutered female Persian cats were presented for evaluation of respiratory distress. Initial physical examination revealed tachypnea, dyspnea, and a markedly distended and painful abdomen in both cats. Radiographs revealed a gas-dilated stomach and gastrointestinal (GI) tract in both cats but were only diagnostic for GDV in 1 case. Gastric dilatation-volvulus was confirmed during exploratory laparotomy and gastropexy was performed in each case. Both cats were successfully discharged from the hospital.

NEW AND UNIQUE INFORMATION PROVIDED

Gastric dilatation-volvulus in cats is a rare event and appears to occur in 2 clinical settings: in combination with traumatic diaphragmatic hernia (as previously reported) and without a history of trauma or diaphragmatic hernia, as in the 2 cases reported here. Clinicians should consider GDV in the list of differentials for cats with respiratory distress and abdominal distension, even if classic radiographic findings are not present.

The impact of surgical timing and intervention on outcome in traumatized dogs and cats

OBJECTIVE

To review the relevant human and veterinary literature regarding the timing of surgical intervention for trauma patients and the impact on outcome.

DATA SOURCES

Original research, clinical studies, and review articles with no date restrictions from both human and veterinary literature.

HUMAN DATA SYNTHESIS

Despite extensive research into the ideal timing of surgical intervention for human trauma victims, debate is ongoing and views are still evolving. Prior to the 1970s, the standard of care consisted of delayed surgical treatment, as these patients were considered too ill to undergo surgery. Beginning in the 1970s, and continuing for nearly 2 decades, early definitive surgical treatment was recommended. The most recent evolution of human trauma management incorporates the concept of damage control surgery, which acknowledges the importance of early skeletal stabilization or laparotomy for reducing morbidity while attempting to avoid complications such as acute respiratory distress syndrome or multiple organ dysfunction syndrome.

VETERINARY DATA SYNTHESIS

Despite a relatively large amount of literature available regarding veterinary trauma, no evidence exists to provide the clinician guidance as to the ideal timing of surgery for trauma patients. With the exception of diaphragmatic hernia, no studies were identified that attempted to evaluate this variable.

CONCLUSIONS

Veterinary-specific studies are needed to evaluate the impact of surgical timing on outcome following trauma. The information that can be obtained from studies in this area can improve veterinary trauma care and may be used as models for human trauma care through translational applications.

Gastric dilitation-volvulus in a Red Panda (Ailurus fulgens)

A 10-year-old male red panda presented acutely with symptoms of shock due to acute abdominal distress and respiratory compromise. Abdominal ultrasound confirmed a severely distended stomach for which passage of an orogastric tube for relief was unsuccessful. Intra-operatively, the stomach was found to be distended and torsed around its long axis supporting the diagnosis of Gastric dilitation-volvulus (GDV). The animal arrested and died intra-operatively and was submitted for necropsy with lesions supportive of the diagnosis of GDV. No risk factors for GDV were found to correlate between the panda and those described in domestic dogs. This case suggests that red pandas can be susceptible to this condition in captive settings.

Mechanisms, causes, investigation and management of vomiting disorders in cats: a literature review

Vomiting is a common presenting complaint in feline practice. This article differs from previous reviews in that it is an evidence-based review of the mechanisms, causes, investigation and management of vomiting in the domestic cat. Published evidence was reviewed, and then used to make recommendations for clinical assessment, diagnosis, antiemetic drug treatment, dietary management and monitoring of cats presenting with vomiting. The strength of the evidence on which recommendations are made (and areas where evidence is lacking for cats) has been highlighted throughout.