Dr Abdul Mateen

➢ Colic refers to abdominal pain or discomfort

➢ The pain is usually due to a build-up of gas.
➢ Dogs and cats can suffer from this condition,
just like humans. Pets of all ages and breeds
can be affected, but young animals are
especially prone.
 Bloat
 Stomach ulcer
 Parasitic infection
 Digestive injury
 Twisted stomach(Gastric dilatation volvulus)
 Tumors
 worms
 Eating spoiled food
 Eating poisonous chemicals
 Common symptoms include:
 Abdominal pain that leads to crying or
whining
 Bloated stomach
 Hard belly
 Arched back with feet tucked in
 Weakness or sluggishness
 Loss of appetite
 Restlessness and thrashing around on the
floor
 ➢ Bloathappens when a dog's stomach fills with
gas, food, or fluid, making it expand.
➢ The stomach puts pressure on other organs.so
due to extended stomach
1. No blood flow to their heart and
stomach lining
2. A tear in the wall of their stomach
3. A harder time breathing
➢ In some cases, the dog's stomach will rotate or
twist, a condition that vets call gastric dilatation
volvulus
 Bloat is more common in deep-chested,
large breeds, like Akitas, Boxers, Basset
Hounds, and German Shepherds. Some are
at a higher risk than others, including
Great Danes, Gordon Setters, Irish
Setters, Weimaraners, and St. Bernards.
 Act restless
 Drool
 Have a swollen stomach
 Look anxious
 Look at their stomach
 Try to vomit, but nothing comes up
 Stretch with their front half down and rear
end up
Vets aren't sure what causes bloat, but
there are some things that raise a dog's
risk for it, including:
 Eating from a raised food bowl
 Having one large meal a day
 Eating quickly
 A lot of running or playing after they eat
 Other dogs they are related to have had
bloat
 Eating or drinking too much
 stress
 It depends on condition of dog
 First pass gastric tube to release gas
 If dog is in shock, use fluid therapy and
antibiotics
 Bloat can be scary, but there are ways you
can keep it from happening to your dog:
 Don't use a raised bowl unless your vet says
your dog needs one.
 Don't let them run or play a lot right before
or after meals.
 Feed them a few small meals throughout the
day instead of one or two large ones.
 Make sure they drink a normal amount of
water.
 For predisposed breeds, your vet will
sometimes tack the stomach when your dog
gets spayed or neutered
 Also known as Gastric Dilatation-Volvulus or
gastric torsion.
 It is a medical condition that affects dogs in
which the stomach becomes overstretched
and rotated by excessive gas content.
 GDV is a life-threatening condition in dogs
that requires prompt treatment. It is
common in certain dog breeds; deep-chested
breeds are especially at risk.
 The dog can appear quite normal one
minute but once symptoms start they
very quickly get worse. The most
common symptoms are
 Restlessness, anxiety
 Discomfort, followed by worsening
pain
 Arched back, reluctance to lie down
 Drooling saliva or froth
 Attempts to vomit (retching) with little
being brought up
 Swollen abdomen, often feels hard and if
tapped feels like a balloon
 dyspnoea
 Pale coloured gums and tongue
 Collapse
 Shock, possible death
The exact cause are unknown but it may be
 mainly due to bloat
 increased age
 breed having a deep and narrow chest,
 Eating same feed
 eating foods such as kibble that expand in
the stomach, overfeeding,
 too much water consumption in a small
period of time before or after exercise
 it diagnosed by history&clinical signs
Diagnostic imaging
 Affected animals should be decompressed
before radiographs are taken.
 Right lateral and dorsoventral
radiographic views are preferred in order
to facilitate filling the abnormally
displaced pylorus with air so that it can
be easily identified.
 The pylorus is normally located ventral to
the fundus on the lateral view and on the
right side of the abdomen on the
dorsoventral view
 On aright lateral view of a dog with GDV,
the pylorus lies cranialto the body of the
stomach and is separated from the rest
ofthe stomach by soft tissue (“reverse C
sign” or “double bubble”). On the
dorsoventral view, the pylorus appears as
a gas-filled structure to the left of
midline
Right lateral abdominal radiograph of a dog
with gastric dilatation-volvulus showing a distended, gas-filled
stomach. Note the reverse C sign or double bubble caused
by the shelf of soft tissue (arrows). The pylorus is located
dorsal to the shelf of tissue
Dorsoventral radiograph of a dog with
gastric dilatation-volvulus. The pylorus appears as a
gas-filled structure to the left of the midline (black arrows).
Notice the duodenum coursing from the pylorus toward the
right abdomen (white arrows
 Firststablize the animal from shock and
bloat
 Fluid therapy
 Broad spectrum Antibiotics such as cefazolin
(22 mg/kg given intravenously [IV]) or a
combination of enrofloxacin (Baytril),7-15
mg/kg IV (give diluted and slowly, over 30
minutes) plus ampicillin at 22 mg/kg IV
 during managing shock also manage bloat
 For this purpose use TROCAR or stomach tube
may be passed.
 Surgery should be performed as soon as the
animal’s condition has been stabilized, even
if the stomach has been
decompressed.Rotation of an undistended
stomach interferes with gastric blood flow
and may potentiate gastric necrosis.
 AnECG should be monitored to detect
cardiac arrhythmias, which should be treated
with lidocaine before surgery
 Ifthe animal has been decompressed and its
condition is stable without significant cardiac
arrhythmias,then hydromorphone and
diazepam may be given intravenously and
the patient induced with etomidate,
thiobarbiturates,or propofol
 Midazolam (0.2 mg/kg IV, IM) or
 Diazepam (0.2 mg/kg IV)
 If the animal is depressed,
 premedication is probably not needed.
 Preoxygenation followed by a rapid induction with either
ketamine and a benzodiazepine (e.g.,midazolam, diazepam) or
etomidate should be done.
 Etomidate is a good choice for induction if the animal’s
condition has not been well stabilized because it maintains
cardiac output and is not arrhythmogenic.
 Lidocaine and thiobarbiturate may be used if arrhythmias are
present; 9 mg/kg of each is drawn up, and half is given
initially intravenously.
 Additional drug is given to effect to allow the dog to be
intubated.
 Generally, no more than 6 mg/kg of lidocaine is given
intravenously to prevent toxicity
 If bradycardia occurs, anticholinergics
(e.g., atropine or glycopyrrolate) may be
given. Nitrous oxide should not be used in
dogs with GDV . Isoflurane or sevoflurane
are the inhalation agents of choice.
 the pylorus is located on the dog’s right side,
and the greater omentum arises from the
greater curvature of the stomach and covers
the intestines.
 The gastric (lesser curvature) and
gastroepiploic (greater curvature) arteries
supply the stomach and are derived from the
celiac artery. The short gastric arteries arise
from the splenic artery and supply the
greater curvature.
 The dog is placed in dorsal recumbency.
 the abdomen is prepared for a midline
abdominal incision. The prepped area should
extend from midthorax to the pubis.
 Remove hair
 The goals of surgical treatment are threefold
(1)to inspect the stomach and spleen so as to
identify and remove damaged or necrotic
tissues,
(2) to decompress the stomach and correct any
malpositioning, and
(3) to adhere the stomach to the body wall to
prevent subsequent malpositioning.
 Upon entering the abdominal cavity of a
dog with GDV, the first structure noted is
the greater omentum, which usually
covers the dilated stomach.
 Decompress the stomach before
repositioning by using a large-bore needle
(i.e., 14 or 16 gauge) attached to suction.
 If the needle becomes occluded with
ingesta, have an assistant pass an
orogastric stomach tube and perform
gastric lavage.
 For a clockwise rotation, once the stomach has been
decompressed, rotate it counterclockwise by grasping
the pylorus (usually found below the esophagus) with
the right hand and the greater curvature with the
left.
 Push the greater curvature, or fundus, of the
stomach toward the table while simultaneously
elevating the pylorus toward the incision.
 Check to make sure the spleen is normally positioned
in the left abdominal quadrant.
 If there is splenic necrosis or significant infarction,
perform a partial or complete splenectomy.
 Remove or invaginate necrotic gastric
tissues. Avoid entering the gastric lumen if
possible.
 If you are uncertain whether gastric tissue
will remain viable, invaginate the abnormal
tissue.
 Verify that the gastrosplenic ligament is not
torsed,and before closure palpate the intra-
abdominal esophagus to ensure that the
stomach is derotated.
 Perform a permanent gastropexy. Gastropexy
usually is curative for dogs with partial or
chronic GDV
 Electrolyte,fluid, and acid-basis status
should be monitored.
 Many dogs with GDV are hypokalemic
postoperatively and require potassium
supplementation.
 Small amounts of water and soft,low-fat
food should be offered 12 to 24 hours after
surgeryand the patient observed for
vomiting.
 Sepsis and peritonitis may be caused by
gastric necrosis or perforation if devitalized
tissue is not adequately removed.
 Cardiac arrhythmias are common in dogs
with GDV (45.5%)
 Withtimely surgery the prognosis is fair.
Mortality rates 45% and higher have been
reported; however, mortality rates as low as
10% are becoming more common
 Gastropexy techniques are designed to
permanently adhere the stomach to the body
wall.
 The most common indications are GDV
(pyloric antrum to right body wall) and hiatal
herniation (fundus to left body wall).
1. Tube gastropexy
2. Circumcostal gastropexy
3. Muscular flap gastropexy
4. Belt loop gastropexy
5. Gastrocolopexy
6. Laparoscopic prophylactic gastropexy
7. Endoscopically Assisted Gastropexy
8. Laparoscopic Sutured Gastropexy
9. Intracorporeally Sutured Laparoscopic
Gastropexy
10. Mini-laparotomy prophylactic gastropexy
 Tube gastropexy (gastrostomy) is quick and relatively
simple. Also, it allows postoperative gastric
decompression and placement of medications directly
into the stomach in inappetent animals.
 The tube should be left in place 7 to 10 days to form
a permanent adhesion.
 Although this may lengthen the postoperative
hospitalization period compared with other
techniques, the tube can be capped and secured
against the trunk and the patient sent home on oral
feeding.
 The risk of leakage is minimal if proper technique is
used; however, improper placement may result in
 Make a stab incision into the right
abdominal wall caudal to the last rib and
4 to 10 cm lateral to the midline.
 Place a Foley catheter (18 to 30 French)
through the stab incision.
 Select a site in a hypovascular region of
the seromuscular layer of the ventral
surface of the pyloric antrum where the
balloon of the catheter will not obstruct
gastric outflow.
 Place a purse-string suture of 2-0
 Make a stab incision through the purse-string
suture and insert the Foley catheter tip into the
gastric lumen.
 Inflate the bulb of the Foley catheter with
saline (not air), and secure the purse-string
suture around the tube.
 Preplace three or four absorbable sutures
between the pyloric antrum and the body wall
where the tube exits.
 Avoid penetrating the catheter or balloon when
placing the sutures. Draw the stomach to the
body wall by placing traction on the catheter,
and tie the preplaced sutures.
 Secure the tube to the skin with a Roman sandal
suture pattern , but avoid penetrating it with a
suture.
 Place a bandage around the dog’s abdomen
and over the tube to prevent premature
removal (use an Elizabethan collar if
necessary).
 Leave the tube in place 7 to 10 days, then
deflate the balloon and remove it.
 Leave the skin incision open to facilitate
drainage.
 Place a light bandage over the open wound if
desired.
Tube gastropexy
 The Roman sandal suture pattern is preferred over
friction sutures tied to the skin along the course of
the tube.
 Monofilament absorbable suture material is preferred
for gastrointestinal surgery. These sutures are strong,
have minimal tissue drag, and maintain tensile
strength for longer than 10 days.
 Absorbable (polydioxanone or polyglyconate) or
nonabsorbable (polypropylene) suture material may
be used for the gastropexy (0 or 2-0)
 Electrolytes, especially potassium, should be
monitored
 Analgesics should be provided as needed.
 Intravenous fluids are continued until the
patient is drinking adequate amounts to
maintain hydration.
 If prolonged vomiting or anorexia is
anticipated, enteral hyperalimentation
should be provided by means of a
gastrostomy or enterostomy tube .
 Food can be offered 12 hours
postoperativelyif there is no vomiting.
 Complications associated with gastric surgery
may include
 vomiting,
 anorexia,
 peritonitis secondary to intraoperative
 postoperative leakage,
 ulceration at anastomotic sites,
 gastric outlet obstruction, and pancreatitis.