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Evaluation of lidocaine treatment and risk factors for death associated with gastric dilatation and volvulus in dogs: 112 cases (1997–2005)

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  • 1 School of Veterinary Medicine, Faculty of Agricultural, Food & Environmental Quality Sciences, The Hebrew University of Jerusalem, Rehovot 76100, Israel.
  • | 2 Department of Animal Sciences, Faculty of Agricultural, Food & Environmental Quality Sciences, The Hebrew University of Jerusalem, Rehovot 76100, Israel.
  • | 3 School of Veterinary Medicine, Faculty of Agricultural, Food & Environmental Quality Sciences, The Hebrew University of Jerusalem, Rehovot 76100, Israel.
  • | 4 School of Veterinary Medicine, Faculty of Agricultural, Food & Environmental Quality Sciences, The Hebrew University of Jerusalem, Rehovot 76100, Israel.
  • | 5 School of Veterinary Medicine, Faculty of Agricultural, Food & Environmental Quality Sciences, The Hebrew University of Jerusalem, Rehovot 76100, Israel.
  • | 6 School of Veterinary Medicine, Faculty of Agricultural, Food & Environmental Quality Sciences, The Hebrew University of Jerusalem, Rehovot 76100, Israel.

Abstract

Objective—To determine clinical features, outcome, risk factors for death, and efficacy of IV administration of lidocaine as a prophylactic treatment for ischemic reperfusion injury in gastric dilatation and volvulus (GDV) in dogs.

Design—Retrospective case series.

Animals—112 dogs with GDV.

Procedures—Data pertaining to breed; time lag to admission; clinical, clinicopathologic, and surgical findings; lidocaine treatment; and postoperative complications were assessed for association with outcome.

Results—German Shepherd Dogs (28.6%) and Great Danes (17%) were significantly over-represented. Risk factors for death included time lag (≥ 5 hours vs < 5 hours) from onset of clinical signs to admission (46.0% vs 11.3%), rectal temperature (≤ 38°C vs > 38°C [< 100.4°F vs > 100.4°F]) at admission (40.0% vs 14.9%), presence or absence of ARF (67.0% vs 23.3%), presence or absence of suspected gastric wall necrosis (59.3% vs 16.0%), and untreated gastric wall necrosis, compared with treated gastric wall necrosis (100% vs 47.6%). Overall mortality rate was 26.8%; no significant differences were detected in mortality rate or postoperative complications between dogs that received lidocaine IV prior to surgical intervention (52.0%) and dogs that did not (48.0%). Mean ± SD hospitalization time was longer in the lidocaine treatment group (3.5 ± 1.9 days vs 2.5 ± 1.4 days).

Conclusions and Clinical Relevance—Presence of the identified risk factors should warrant aggressive treatment. Lidocaine treatment was not associated with mortality rate or postoperative complications, but was associated with prolonged hospitalization time.

Abstract

Objective—To determine clinical features, outcome, risk factors for death, and efficacy of IV administration of lidocaine as a prophylactic treatment for ischemic reperfusion injury in gastric dilatation and volvulus (GDV) in dogs.

Design—Retrospective case series.

Animals—112 dogs with GDV.

Procedures—Data pertaining to breed; time lag to admission; clinical, clinicopathologic, and surgical findings; lidocaine treatment; and postoperative complications were assessed for association with outcome.

Results—German Shepherd Dogs (28.6%) and Great Danes (17%) were significantly over-represented. Risk factors for death included time lag (≥ 5 hours vs < 5 hours) from onset of clinical signs to admission (46.0% vs 11.3%), rectal temperature (≤ 38°C vs > 38°C [< 100.4°F vs > 100.4°F]) at admission (40.0% vs 14.9%), presence or absence of ARF (67.0% vs 23.3%), presence or absence of suspected gastric wall necrosis (59.3% vs 16.0%), and untreated gastric wall necrosis, compared with treated gastric wall necrosis (100% vs 47.6%). Overall mortality rate was 26.8%; no significant differences were detected in mortality rate or postoperative complications between dogs that received lidocaine IV prior to surgical intervention (52.0%) and dogs that did not (48.0%). Mean ± SD hospitalization time was longer in the lidocaine treatment group (3.5 ± 1.9 days vs 2.5 ± 1.4 days).

Conclusions and Clinical Relevance—Presence of the identified risk factors should warrant aggressive treatment. Lidocaine treatment was not associated with mortality rate or postoperative complications, but was associated with prolonged hospitalization time.

Contributor Notes

Dr. Bruchim's present address is Emergency and Critical Care Unit, School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot 76100, Israel.

Presented at the European Emergency and Critical Care Association Conference, Edinburgh, June 2006.

Address correspondence to Dr. Bruchim.