Gastric dilatation-volvulus, common in dogs, typically presents as an acute, potentially life-threatening condition. In contrast, chronic gastric volvulus (CGV), which is rarely described in dogs, presents with more subtle nonspecific signs: weight loss, chronic vomiting, lethargy, bloating, and abdominal pain. CGV was examined in 7 dogs; clinical signs were present between 2 weeks and 2.5 years of age (median, 5 weeks). Diagnostic tests varied but included hematology and serum biochemistry profile, fecal analysis, urinalysis, trypsin-like immunoreactivity, pancreatic lipase immunoreactivity, and abdominal radiography. Radiographic abnormalities included gaseous distention of and soft tissue band across the stomach, resulting in compartmentalization and displacement of the pylorus. Endoscopic abnormalities included difficulty in entering the cardiac sphincter and abnormal positioning of normal gastric landmarks. Each dog underwent exploratory laparotomy and prophylactic gastropexy.
Intraoperative findings included 90° clockwise rotation (n = 4), 90° counterclockwise rotation (n = 1), and normal gastric positioning (n = 2). Six dogs dramatically improved over a period of 2 weeks to 2 years (median, 12 months); 1 dog died postoperatively following aspiration pneumonia.
Instability of gastric position should be considered in dogs with chronic vomiting, weight loss, and apparent abdominal pain. Over a 15-year period these dogs had various concurrent conditions, including 3 with esophageal dilation. GI histopathology was abnormal in most dogs in which biopsies were obtained. All dogs underwent surgical gastropexy and 6 of 7 reportedly had marked clinical improvement, although the follow-up period varied. Despite these limitations, this report raised the visibility of this infrequently described syndrome.—P. Jane Armstrong, DVM, MS, MBA, DACVIM
Chronic gastric instability and presumed incomplete volvulus in dogs. Paris JK, Yool DA, Reed N, et al. J SMALL ANIM PRACT 52:651-655, 2011.