Cardiovascular monitoring of the canine gastric dilatation volvulus patient

Gastric dilatation volvulus (GDV) is an acute, life-threatening disease with a predisposition in the large breed dog (Bruchim and Kelmer, 2014). The presence of a large gas-filled stomach compromises organ blood supply, resulting in tissue necrosis (Self, 2016). Pressure from a dilated stomach compresses the caudal vena cava resulting in reduced venous return to the heart and a subsequent reduction in cardiac output (Self, 2016). The treatment option for GDV is urgent surgical intervention, but due to the complex aetiology and pathophysiology, cardiovascular stability is crucial to patient outcome (Broome and Walsh, 2003).

Initial therapy is aimed at stabilisation prior to general anaesthesia, although a prolonged surgical delay is not recommended due to worsening gastric and splenic ischaemia (Broome and Walsh, 2003). Improved cardiovascular and pulmonary function is the objective prior to surgery, but this may not always be possible. Surgical delay may result in arrhythmia and/or myocardial depression and acid–base disturbances potentially being present prior to, during, and following anaesthesia (Broome and Walsh, 2003). Pre-operative gastric decompression is recommended (Figure 1) to improve cardiovascular and respiratory function (Broome and Walsh, 2003), and to stabilise the patient prior to surgical correction.