Page 497 - Small Animal Internal Medicine, 6th Edition

CHAPTER 30 Disorders of the Stomach 469

PARTIAL OR INTERMITTENT CHRONIC curative. Pexy will also help prevent classic GDV from
GASTRIC VOLVULUS occurring.
VetBooks.ir Etiology Prognosis

The causes for partial and intermittent chronic gastric vol-
and surgically corrected.
vulus are probably the same as for classic GDV. The prognosis is usually good once the problem is identified
Clinical Features
Dogs with chronic volvulus do not have the life-threatening IDIOPATHIC GASTRIC HYPOMOTILITY
progressive syndrome characterizing classic GDV. Although
occurring in the same breeds as GDV, chronic gastric vol- Etiology
vulus usually produces a chronic, intermittent, potentially Idiopathic gastric hypomotility refers to an anecdotal syn-
difficult-to-diagnose problem. It may occur repeatedly and drome characterized by poor gastric emptying and motility
spontaneously resolve; dogs may appear normal between despite the lack of anatomic obstruction, inflammatory
bouts. Some dogs have persistent nondistended volvulus and lesions, or other causes.
are asymptomatic.
Clinical Features
Diagnosis Idiopathic gastric hypomotility has primarily been diag-
Plain radiographs are usually diagnostic (Fig. 30.4), but diag- nosed in dogs. Affected dogs usually vomit food several
nosis may require repeated radiographs and/or contrast hours after eating but otherwise appear well. Weight loss
studies. Chronic volvulus will rarely be diagnosed endoscop- may or may not occur.
ically. In rare cases one may cause a temporary gastric vol-
vulus by manipulating a gastroscope in an air-distended Diagnosis
stomach, so the clinician must differentiate spontaneous Fluoroscopic studies document decreased gastric motility,
from iatrogenic volvulus. but diagnosis requires ruling out gastric outlet obstruc-
tion, infiltrative bowel disease, inflammatory abdomi-
Treatment nal disease, and extraalimentary tract diseases (e.g.,
If partial or intermittent chronic gastric volvulus is diag- renal, adrenal, or hepatic failure; severe hypokalemia or
nosed, surgical repositioning and gastropexy are usually hypercalcemia).

FIG 30.4
Lateral abdominal radiograph of an Irish Setter with chronic vomiting caused by gastric
volvulus that did not cause dilation. A “shelf” of tissue (arrows) demonstrates that the
stomach has twisted.