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, investigations of the potential pathophysiologic mechanisms may improve our understanding of the complex pathogenesis of this condition. ABBREVIATIONS FB Foreign body GDV Gastric dilatation and volvulus gFB Gastric foreign body giFB
Gastric dilatation and volvulus is an acute, lifethreatening syndrome that requires immediate medical and surgical treatment as well as intensive postoperative care. 1 Rapid accumulation of gas in the stomach, gastric displacement, increased
Abstract
OBJECTIVE
To determine if clinician experience influenced the euthanasia rate in 2 common surgical emergencies.
ANIMALS
142 dogs with nontraumatic hemoabdomen (NTH) due to suspected ruptured splenic mass and 99 dogs with gastric dilatation-volvulus (GDV) where the owner either elected surgery or euthanasia.
PROCEDURES
Medical records were reviewed for dogs that had either NTH or GDV. For each patient, the owner’s decision to pursue euthanasia versus surgery was recorded. The primary clinician was categorized as an intern, defined as a clinician with < 12 months experience, or a non-intern, defined as a clinician with more than 12 months experience. The euthanasia rates were compared used a Fisher exact, and the 95% CI was calculated for the risk of euthanasia if the primary clinician was an intern compared with a non-intern. If a difference was identified, subgroups comparing time of day, referral status, age, Hct, total solids, lactate, and heart rate were evaluated using a t test with a Bonferroni correction for the continuous variables and a Fisher exact for categorical variables.
RESULTS
For dogs with NTH, the euthanasia rate for cases primarily managed by non-interns (52%) was significantly lower than that of interns (76%; P = .005). The relative risk of euthanasia associated with NTH when the case was treated by an intern was 1.44 with a 95% CI of 1.1229 to 1.8567. For 99 dogs with GDV, the rate of euthanasia was not different between interns and non-interns.
CLINICAL RELEVANCE
The euthanasia rate for dogs with NTH may be impacted by the level of experience of the clinician. Support of new clinicians during challenging conversations should be provided.
GDV Gastric dilatation and volvulus GERD Gastroesophageal reflux disease PEG Percutaneous endoscopic gastrostomy a. Iams Response Diet KO, The Iams Co, Dayton, Ohio. b. Olympus GIF-VET PQ 140 gastroscope, Center Valley, Pa. c. Purina
volvulus. 2 Splenic torsion may result from gastric dilatation and volvulus, allowing splenic hypermotility 3,4 or congestive splenomegaly secondary to gastric dilatation and volvulus. 2,3 Radiographic signs of splenic torsion include displacement of
for exploratory laparotomy in this patient was driven by the suspicion of free abdominal gas or gastric wall necrosis. Gas inclusions in the gastric wall (gastric pneumatosis) seen in dogs with gastric dilation and volvulus only have a positive
gastrointestinal tract leiomyosarcomas appeared to be different from the biological behavior of gastrointestinal stromal tumors. See PAGE 1329 RETROSPECTIVE STUDY Evaluation of lidocaine treatment in dogs with gastric dilatation and volvulus The
antimicrobial administration had negative results after antimicrobial administration. There was no difference in culture results (positivity and bacterial type) between groups. See page 1185 Gastric foreign body as a risk factor for gastric dilatation
Gastric dilatation and volvulus is common and often fatal in large- and giant-breed dogs, 1 and gastropex y, per formed with various techniques, has been used for many years to prevent recurrence of gastric dilatation and volvulus. Currently
