gastric dilatation

Gastric Dilatation: A Description

Gastric dilatation, also known as bloat, occurs when the stomach becomes over-distended with gas or food. This can lead to a condition where the stomach twists around on itself, known as gastric volvulus (GDV) [7]. In its early stage, the stomach fills with gas, causing a simple gastric dilatation or "bloat" [1].

Characteristics of Gastric Dilatation

• The stomach becomes enlarged and may twist in a clockwise direction [6].
• The condition can occur in any dog and is quite common [9].
• It can be a life-threatening emergency if not treated promptly [4, 5].
• Symptoms include an enlarged abdomen, rapid or shallow breathing, increase in heart rate, cold body temperature, unsuccessful attempts to vomit, and excessive saliva production [8].

Key Features

• Gastric dilatation is characterized by the radiological finding of a massively enlarged stomach as seen on plain film X-ray or computerized tomography scan of the abdomen [11].
• It can occur due to mechanical obstruction of the gastrointestinal tract, neuromuscular atony of the GI wall, increased intraluminal pressure, and other pathophysiologic mechanisms [13].

Importance of Prompt Treatment

Gastric dilatation is a rapidly progressing condition that requires immediate medical attention. If left untreated, it can lead to severe complications and even death. Therefore, prompt treatment is essential to prevent further damage and ensure the dog's survival.

References: [1] - Context 1 [4] - Context 3 [5] - Context 5 [6] - Context 6 [7] - Context 7 [8] - Context 8 [9] - Context 9 [11] - Context 11 [13] - Context 13

Common Signs and Symptoms of Gastric Dilatation

Gastric dilatation, also known as bloat, can manifest in various ways, depending on the severity and underlying cause. Here are some common signs and symptoms to look out for:

• Enlarged abdomen: The stomach becomes distended, which can be painful and uncomfortable for the animal.
• Rapid or shallow breathing: As the stomach fills with gas, it can put pressure on the diaphragm, leading to rapid or shallow breathing.
• Increase in heart rate: The body's stress response can cause an increase in heart rate, which can be a sign of distress.
• Cold body temperature: In severe cases, the animal may experience hypothermia due to decreased blood flow and metabolism.
• Unsuccessful attempts to vomit: As the stomach becomes distended, it can be difficult for the animal to vomit, leading to feelings of nausea and discomfort.
• Excessive saliva: Some animals may drool or produce excessive saliva as a sign of distress.
• Pale mucous membranes: In severe cases, the animal's skin and mucous membranes may become pale due to decreased blood flow.

Early Warning Signs

It's essential to recognize these signs and symptoms early on, as gastric dilatation can quickly progress to more severe complications. If you notice any of these symptoms in your pet, it's crucial to seek veterinary attention immediately.

• Restlessness: Animals with gastric dilatation may become restless or agitated due to discomfort.
• Pacing: Some animals may pace back and forth, indicating distress.
• Swollen or distended abdomen: A visibly enlarged stomach can be a clear sign of gastric dilatation.
• Painful abdomen: The animal may exhibit signs of abdominal pain, such as whining or showing the affected area.

References

• [1] Signs & Symptoms. Initial signs are often associated with abdominal pain. These can include but are not limited to: an anxious look or looking at the abdomen (Source: #15)
• [2-5] Common symptoms of gastric dilatation, including enlarged abdomen, rapid breathing, increased heart rate, and cold body temperature (Sources: #6, #11, #12, #13)
• [7] Symptoms of acute gastric dilatation, including emesis (vomiting) in >90% of cases (Source: #8)

Please note that these symptoms can vary depending on the individual animal and the severity of the condition. If you suspect your pet has gastric dilatation, it's essential to seek veterinary attention immediately.

Diagnostic Tests for Gastric Dilatation

Gastric dilatation, also known as gastric distension, can be diagnosed through various diagnostic tests. Here are some of the common tests used to diagnose this condition:

• Abdominal radiography: This is a simple and non-invasive test that uses X-rays to visualize the stomach and its contents. A healthy dog typically has no gas in the pylorus (the region where the stomach meets the small intestine). However, in cases of gastric dilatation, there will be an accumulation of gas in this area, making it visible on the X-ray [10].
• Right lateral projection: This is a specific type of abdominal radiography that can help diagnose gastric dilatation. The right lateral projection is particularly useful as it allows for better visualization of the pylorus and the surrounding areas [10].
• Bloodwork: Blood tests can be used to determine if there are any underlying conditions, such as electrolyte imbalances or infections, that may be contributing to the gastric dilatation [12].
• Electrolyte levels: Checking the electrolyte levels in the blood can help identify any imbalances that may be causing the gastric dilatation [13].
• PCV (Packed Cell Volume) and total solids: These tests can help determine if there are any underlying conditions, such as dehydration or anemia, that may be contributing to the gastric dilatation [13].
• Abdominal ultrasound: This test uses high-frequency sound waves to create images of the internal organs. It can be used to visualize the stomach and its contents, helping diagnose gastric dilatation [14].
• Endoscopy: In some cases, an endoscope may be inserted through the mouth or rectum to visually examine the inside of the stomach and small intestine. This test can help identify any abnormalities in the lining of these organs that may be contributing to the gastric dilatation [9].

It's essential to note that a diagnosis of gastric dilatation is typically made based on a combination of clinical signs, physical examination findings, and results from one or more diagnostic tests.

References:

[10] Diagnostic Tests. Abdominal radiography, particularly the right lateral projection, is diagnostic for GDV. [12] Sep 12, 2022 — Bloodwork, blood pressure, and an EKG can help your veterinarian determine how severe the disease is and if there are other factors complicating ... [13]

Medications Used to Treat Gastric Dilatation

Gastric dilatation, also known as gastric dilatation-volvulus (GDV), is a medical emergency that requires prompt treatment. While surgical correction is often necessary, certain medications can be used to help manage the condition.

• Opioids: Opioids such as morphine and fentanyl are commonly used for pain management in dogs with GDV [3]. They can also help reduce stress on the heart.
• Lidocaine: Lidocaine is a local anesthetic that can be used to reduce opioid dosing and manage pain [5]. It can be administered as a bolus or continuous infusion.
• Metoclopramide: Metoclopramide is a medication that can help stimulate gut motility and relieve gastric distension [8].
• Metamizole: Metamizole is another medication that can be used to manage pain and inflammation in dogs with GDV [8].

Important Considerations

It's essential to note that while these medications can be helpful, they should not delay surgical correction of the GDV. Shock treatment must begin immediately using intravenous fluids and emergency medications, followed by surgical correction once the patient becomes stable [4].

Differential Diagnosis of Gastric Dilatation

Gastric dilatation, also known as acute gastric dilatation, is a rare and life-threatening condition that requires prompt diagnosis and treatment. The differential diagnosis for gastric dilatation includes several conditions that can present with similar symptoms.

• Splenic torsion: This is a condition where the spleen twists on its axis, cutting off blood flow to the organ. It can cause severe abdominal pain and vomiting, similar to gastric dilatation.
• Mesenteric volvulus: This is a condition where the small intestine twists around itself, causing obstruction of blood flow and leading to tissue death. It can present with symptoms such as abdominal pain, vomiting, and bloody stools.
• Peritonitis: This is an inflammation of the lining of the abdomen, often caused by infection or perforation of the stomach or intestines. It can cause severe abdominal pain, vomiting, and fever.
• Gastric outlet obstruction: This is a condition where the stomach is blocked, preventing food from passing into the small intestine. It can cause symptoms such as nausea, vomiting, and abdominal pain.

Other conditions to consider

• Hypertrophic pyloric stenosis: This is a condition where the muscle around the pylorus (the passage between the stomach and small intestine) becomes thickened, causing obstruction of food flow.
• Bezoar: A bezoar is a mass of food or other material that accumulates in the stomach or intestines. It can cause symptoms such as nausea, vomiting, and abdominal pain.

Key points to consider

• Gastric dilatation is a rare but life-threatening condition that requires prompt diagnosis and treatment.
• The differential diagnosis for gastric dilatation includes several conditions that can present with similar symptoms.
• A thorough physical examination, laboratory tests, and imaging studies are essential in diagnosing the underlying cause of gastric dilatation.

References

[1] Gastric volvulus leading to acute gastric dilatation is a surgical emergency that should be considered as a differential diagnoses in patients who present to the emergency department with severe epigastric pain and evidence of gastric outlet obstruction. (Search result 2) [3] The objectives of this presentation are to explain the normal peristalsis; describe the mechanisms of gastric dilatation; and discuss the differential diagnosis for this condition. (Search result 3) [8] Acute gastric dilation following trauma is an unusual event that can occur in different settings, and can cause gastric necrosis as a rare though fatal condition. Moreover, acute gastric dilation is recommended to be considered in the differential diagnosis of patients with multiple or abdominal trauma. (Search result 8)