Gastric Dilatation Volvulus (GDV) in Cats

Gastric Dilatation Volvulus is so rare in cats that information about it must be extrapolated from data about dogs. No cause for GDV has been identified, but in dogs several factors may contribute, including large meals, heavy exercise after meals, and being related to individuals that have had GDV.

Severity of clinical signs can vary and depends on the amount of stomach distension, if the blood flow to the tissues is compromised, and the duration of the volvulus without medical or surgical intervention.

GDV is a time-sensitive, life-threatening emergency that requires immediate veterinary attention. Time is of the essence; longer spans of time before intervention may be associated with higher mortality. Without treatment, death is certain, and may occur even with treatment.

Surgery and related treatment is expensive, sometimes difficult to access, and the rate of postoperative complications is very high. GDV treatment is an emotionally and financially challenging decision that must be made very rapidly. Euthanasia may be considered due to the uncertain prognosis. GDV is very rare in cats, most commonly affecting dogs.

A definitive cause for GDV has not been identified in either dogs or cats, but risk factors may include:

• Gastric foreign bodies
• Motility disorders
• Large meals (rather than smaller, more frequent meals)
• Exercise after a meal
• Middle or older age
• Close genetic relationship with other individuals that have had GDV

GDV is always a medical emergency and carries a poor prognosis. If GDV is suspected, immediate emergency veterinary hospital intervention is required.

Veterinarians presented with a case of possible GDV need to move quickly to get ahead of the patient’s rapidly worsening condition. Patients often present in a critical state, and may have to be stabilized.

Diagnostics include a physical exam while working to stabilize the patient with intravenous fluids and oxygen therapy. Blood work is often performed concurrently to evaluate the severity of metabolic disturbance caused by the GDV.

Surgical exploration of the abdomen is necessary to assess the stomach and abdominal organs for any compromised tissue, and to correct the gastric torsion.

Abdominal distension can sometimes be decompressed by passing a tube into the stomach through the nose or mouth, or by inserting a needle through the abdomen into the stomach, but surgery is often necessary.

Analgesics and anti-arrhythmics are often administered to stabilize patients prior to surgery. Intravenous antibiotics are usually administered during surgery to help prevent sepsis. Sometimes the spleen, which rotates along with the stomach, may need to be removed due to prolonged oxygen deprivation. In most cases, veterinarians tack the stomach to the abdominal wall to prevent recurrence of torsion.

There is a high incidence of post-surgical complications, including cardiac arrhythmias, reperfusion injury (release of toxins from blood-deprived organs), shock, infection, organ failure, and death. The patient must be closely monitored on all parameters. Post-operative medications may include analgesics, antibiotics, antiarrhythmics, and gastroprotectant drugs.

There is insufficient data on prognosis in cats, but in dogs the overall mortality rate of GDV is 10-45%. Some patients are euthanized prior to treatment due to poor prognosis. Prognosis after GDV surgery varies depending on the extent of damage incurred during the torsion event. Those surviving to discharge had a good prognosis, although gastric dilatation recurred in some.

GDV is not contagious. Data on GDV in cats is so scarce that no preventative measures are identified. There are many widely circulated and often unsupported notions about GDV prevention in dogs, but the following may help for prevention:

• Prophylactic gastropexy performed at time of spay/neuter surgery (usually only recommended in large-breed, deep-chested dogs)
• Not breeding animals that have have had GDV or are closely related to them
• Feeding smaller meals twice a day (rather than a single large meal)
• Not exercising the pet after a meal
• Not using raised food dishes
• Preventing rapid eating
• Adding canned food to kibble
• Not feeding high fat/oil dry foods
• Feeding kibble with a calcium-rich meat meal listed in the first four ingredients

Gastric dilatation volvulus is extremely rare in cats.

• IV Fluids
• Oxygen supplementation
• Pain medications
• Surgery
• Intensive post-operative care
• Antiarrhythmics
• Antibiotics
• Gastroprotectants