M. Chandrasekar, Gastric dilation volvulus History and Clinical Signs: Commonly affecting the large breed deep chested breeds is gastric dilatation and volvulus syndrome which is the potential life threatening problem, Progressive gastric distension And volvulus leads to pressure and compromise of flow regarding the portal vein and vena cava. This leads to decreased venous return to the heart, inadequate preload and shock secondary to inadequate stroke volume. Pressure on the laphragm caused by a progressively dilating stomach may compromise lung exgiansion and lead to ventilatory ‘compromise. Vascular compromise of the circulation to the stomach itself may lead to tissue ischemia, release of endotoxins. into the circulation and ultimately to the release of cytokines and the development of systemic inflammatory response syndrome (SIRS). As this process continues the distributive, hypovolemic shock leads to 4 Gastrointestinal emergencies in Canine Associate ProfessorDept of Veterinary Clinical Medicine,Ethics® Jurisprudence, Madras Veterinary College,Chennai sepsis and multiple organ dysfunction syndrome (MODS), ‘and ultimately to multiple organ fallure (MOF) and death, Approximately 25% of the GOV cases also experience significant abdominal hemorrhage (greater than ¥2 ofthe Patient's blood volume) due to tearing ofthe short gastric vessels Causes: There are many inciting events that can “cause” GDV. GDV is often associated with a disease processes that involves ileus, anxiety, anatomy of alarge deep chest, ‘and age enough to see the suspensory apparatus of the stomach be “stretched * out. Most animals that have a GDV are middle aged (6year or greater). The disease of GDV was first described in humans Diagnosis: Suspicion of the syndrome is made by observing the following clinical signs: @ dog that is restless, attempting to vomit non-productively and rapid abdominal distension, Due tothe fact that the GDV mainly ‘occurs in the deep chested dog the abdominal distension ‘may not be evident nti late in the disease. n early cases the gas distended stomach may be detectable on percussion of the cranial abdomen. On examination the dog may bein hyperdynamic shock or may be in stage of decompensatory shock. As such findings are variable from tachycardia, tachypnea, bounding pulses and injected mucous membranes to collapse, respiratory distress, and weak thready pulses. Definitve diagnosis is made through emergency radiography and seeing characteristic “double bubble" on a right lateral film Treatment begins BEFORE the securing of radiographs Further radiographs (abdominal VD, and thoracic lateral and VD) are recommended while the patient is getting intial therapy to rule some inciting causes that may be present. These include heart disease, megaesophagus, thoracic or abdominal neoplasia etc. It is not uncommon that the GDV syndrome occurs secondary to some other systemic disease process. Treatment: Immediate treatment should consist of oxygen if the dog is showing any signs of shock, and volume replacement with crystalloids and synthetic colloids started, Recent studies point to the value of hypertonic saline mixed with a collaid and given at § -7 rmifkg as an IV bolus and then reassessing, Hetastarch or Oxyglobin (i itis stil available) should be considered to maintain BP and flow. Oxyglobin, because it provides oxygen to tissues very effectively isa very good colloid to use in GD cases Plasmalyte or Normosol R are then begun at very brisk rates (40-50 mi/kg given in the first Wo.1¥ | Issue. 3 | Sop 2014