Come Spend a Night in the ER

Case #5

Patient Profile: "Duke", an 8-year old, castrated male, Doberman.

History: "Duke" was apparently normal this evening at feeding time.  The owner heard "Duke" moaning on the back porch and found "Duke" recumbent, retching, and unable to vomit.  His cranial abdomen was quite distended and "Duke" was having difficulty breathing.

Physical Examination:  Heart and pulse rate = 120/minute. Respiratory rate = 77 breaths/minute.  Body weight = 30.2 kg. "Duke" was in respiratory distress and had an enlarged cranial abdomen.  The abdomen was moderately sensitive to palpation.  Percussion of the abdomen provided a resonating sound.  The capillary refill time was normal, the mucous membrane color was slightly pale, and the pulse character was weak.

Laboratory Findings:  Arterial blood gases (breathing room air):   pH = 7.440, PCO2 = 29.2, PO2 = 54.8, HCO3 = 19.1, ABE = -2.1, Sat O2 = 91.6, Barometric Pressure = 642 (Fort Collins = 1500 Meters!). Serum glucose = 130 mg/dl;  potassium = 2.9 mEq/L.

Abdominal Radiographs:

Click on the radiograph to see an enlargement

Questions:

• List the pros and cons of radiography for the diagnosis of gastric dilatation-volvulus.
• Describe your emergency priorities for "Duke".
• Interpret the blood gas results taken from "Duke" prior to treatment.
• Describe where would you insert the IV catheter in "Duke". 
• Name the surgical procedure which results in the fewest recurrences of gastric volvulus.
• Describe the postoperative complications seen with gastric dilatation-volvulus.

Answers and Discussion:

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Copyright Wayne E. Wingfield, DVM, Colorado State University, 2000. All rights reserved.
This page was last edited:  08/24/00