Page 102 - 2023 SMOG Digital

MILITARY WORKING DOG (MWD)

MWD Gastric Dilation-Volvulus

GDV is a rapidly life-threatening condition common in MWDs. In GDV, the stomach rapidly dilates (gastric
dilation) with fluid, food, and air, and then rotates along the long axis (volvulus) and causes shock by
interfering with venous return from the abdomen and pelvic limbs.
Clinical Signs:
- varying degree of abdominal distention/tympany, non-productive retching, attempted
vomiting without result; signs of pain (grunting when palpating stomach); signs of anxiety;
inability to lay comfortably; and signs of compensatory shock (tachycardia, tachypnea)
Initiate Monitoring:
ECG, NIBP, SpO₂, EtCO₂, Evaluate for dysrhythmias,
hypotension, hypoxemia, hypo- or hypercapnia
Treat Shock
- Give supplemental O₂
- Place at least 2 IV/IO catheters in the forelimbs (preferably one central)
- Give IV or IO crystalloid therapy utilizing the 10-20-10-10 fluid guideline
- Give hydroxyethyl starch (HES) boluses (10-20mL/kg) IV or IO as
needed to maintain normal blood pressure. Repeat this bolus if no
response to therapy.
- Give hypertonic saline (HTS) IV bolus of 4mL/kg over 5 minutes (if
7-7.5% HTS is available) for MWDs that fail to respond to two or three
quarter-shock boluses of crystalloids and/or one or two boluses of HES.
Decompress the Tympanic Stomach
- Position self on left side, or lay dog on left side
- Locate Insertion point: Palpate last rib, move hand two inches caudal to the last rib, midway between the spine
and the ventral border of the abdomen on the right side, auscultate the lateral abdominal wall at most distended
area while percussing the wall with a finger. Loudest “ping” is the site of insertion.
- Clip hair over a 6-inch area over the area.
- Prepare area with a surgical scrub.
- Forcefully insert 14-18 gauge 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. .
(DO NOT ATTEMPT SECOND INSERTION if first is unsuccessful)
- Apply gentle external pressure to abdominal wall to assist exiting air.
- Remove catheter once air is evacuated.
Provide analgesia utilizing analgesia guideline

Clinical Pearls:
Goal is to treat for shock, decompress stomach, and transport for surgical intervention.
Monitor for ventricular arrhythmias, persistent shock and recurrent dilation
Surgery is REQUIRED for definitive treatment to derotate the stomach.

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