From episode 156 on the ECC Feed. With Dr. Simon Cook.
If there’s one thing I learned about GDVs back at uni, it’s that you need to stabilise and then get in there to flip things back into place ASAP. But this study questions that assumption:
• GDV patients at a specialist emergency hospital were randomized into two groups: emergency surgery after stabilisation (within 2 hours), and then stabilisation with placement of a naso-gastric tube for decompression, with surgery delayed until the next day (average 9 hours later).
• The study reported no change in outcome between the two groups.
• Also notable from the study was that many of the patients from the delayed surgery group had a significantly lesser degree of torsion at the time of surgery compared to the immediate surgery group, with a significant number of them having no rotation at all. I.e., the stomach seems to partially or completely de-rotate if it stays empty for an extended period of time.
My Takeaway: I don’t think I’ll be recommending waiting for surgery if I have the choice, but it does mean that I’d be less rigid in my ‘surgery now, or euthanasia’ approach if clients need to delay surgery for whatever reason. (Usually money, right?)
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