Page 89 - 2026 SMOG

MWD GASTRIC DILATION-VOLVULUS
History Definition
• Abdominal distention/tympany • GDV (bloat) is a rapidly life-threatening
• Nonproductive retching condition common in MWDs. In GDV, the
• Attempted vomiting without result stomach rapidly dilates (gastric dilation)
• Pain when palpating the stomach/abdomen with fluid, food, and air. Then it rotates
• Inability/reluctance to lie comfortably along the long axis (volvulus), causing shock
• Pacing, anxious stares by interfering with venous return from the
• Signs of compensatory shock (tachycardia, abdomen and pelvic limbs.
tachypnea) • GDV is an Urgent Surgical emergency
Treatment
• Initiate Monitoring: ECG, NIBP, SpO , EtCO ; evaluate for arrhythmias, hypotension, hypoxemia,
2
2
hypo/hypercapnia
• Give supplemental oxygen and continue through the post-op period
• Attain (2) IV/IO sites—Forelimbs
˚ Remember: Venous return is impeded by pressure in the abdomen; hindlimb IVs will NOT
be effective.
• Initiate IV/IO crystalloid therapy first; repeat bolus q10–20min up to 4 times over the course of
an hour.
˚ Quick bolus calculation: Add a zero to the dog’s body weight in pounds to approximate a safe but
effective bolus volume (e.g., an MWD weighing 75lbs would need about 750mL of fluid bolus)
˚ If refractory to crystalloids, give hydroxyethyl starch (HES, “Hetastarch”, “VetStarch”) bolus
IV/IO (20mL/kg) to maintain normotension; repeat as needed.
˚ If refractory to HES: Give hypertonic saline (HTS 7–7.5%) IV bolus of 4mL/kg over 5min
For MWDs that fail to respond to two or three quartershock boluses of crystalloids and/or one
■
or two boluses of HES
• Decompress the stomach by percutaneous trocarisation of the stomach
˚ Position yourself on the left side of the MWD, or lay the MWD left side down (left lateral
recumbency)
˚ Palpate the last rib, move your hand two inches caudal to the last rib, midway between the spine
and the ventral border of the abdomen on the right side
˚ Forcefully insert a 10–14g trocar or 14–18g IV over-the-needle catheter through the skin,
abdominal wall, and stomach wall
˚ Note gas or air escaping through the needle from the stomach to signify a successful attempt.
If no gas or air, attempt once more (if still unsuccessful, do not attempt a third time)
˚ Gently apply external pressure to the abdominal wall to assist in decompressing air from
the stomach
˚ Once the majority of the air is evacuated, remove the trocar/needle, because leaving it inserted
may cause trauma to internal organs
• Provide analgesia
Notes, Cautions, Warnings
• GDV TX GOALS:
˚ Treat shock
˚ Decompress the stomach
˚ Stabilize for surgery
˚
Evacuate if possible; goal is to initiate surgery within 2–4hr
• Monitor for ventricular arrhythmias, persistent shock, and recurrent dilation
• Surgery is required for definitive treatment
Reference: K9 CPGs
2026 Standard Medical Operating Guidelines (SMOG) • 81