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Lhuillery et al: Outcomes of dogs undergoing surgery for gastric dilatation volvulus after rapid versus prolonged medical stabilization
Veterinary Surgery 5, 2022

🔍 Key Findings

  • Survival rates did not differ between immediate (90 min) and delayed (≥5 h) surgical stabilization groups at discharge or 1-month post-op (approx. 80% survival in both).
  • Hyperlactatemia at 24 hours post-fluid therapy was significantly associated with in-hospital and 1-month mortality (P = .01 and P = .02).
  • Persistent tachycardia during hospitalization was linked to increased 1-month mortality (P = .015).
  • Partial gastrectomy was required in ~6–10% of cases, with high associated mortality.
  • Preoperative stabilization protocols (trocarization, nasogastric tube) allowed safe surgical delays up to 13.7 hours without impacting survival.
  • Degree of gastric torsion differed between groups; more 0° torsions in delayed cases, potentially due to decompression-induced derotation.
  • No difference in post-op complications such as arrhythmias, hypotension, or AKI between groups.
  • More intra-anesthetic deaths occurred in immediate surgery group, highlighting importance of adequate pre-op stabilization.

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← Articles

Lhuillery et al: Outcomes of dogs undergoing surgery for gastric dilatation volvulus after rapid versus prolonged medical stabilization
Veterinary Surgery 5, 2022

🔍 Key Findings

  • Survival rates did not differ between immediate (90 min) and delayed (≥5 h) surgical stabilization groups at discharge or 1-month post-op (approx. 80% survival in both).
  • Hyperlactatemia at 24 hours post-fluid therapy was significantly associated with in-hospital and 1-month mortality (P = .01 and P = .02).
  • Persistent tachycardia during hospitalization was linked to increased 1-month mortality (P = .015).
  • Partial gastrectomy was required in ~6–10% of cases, with high associated mortality.
  • Preoperative stabilization protocols (trocarization, nasogastric tube) allowed safe surgical delays up to 13.7 hours without impacting survival.
  • Degree of gastric torsion differed between groups; more 0° torsions in delayed cases, potentially due to decompression-induced derotation.
  • No difference in post-op complications such as arrhythmias, hypotension, or AKI between groups.
  • More intra-anesthetic deaths occurred in immediate surgery group, highlighting importance of adequate pre-op stabilization.

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Multiple Choice Questions on this study

In Lhuillery 2022 et al., on GDV stabilization timing, which variable was significantly associated with increased in-hospital and 1-month mortality?

A. Plasma creatinine at admission
B. Hyperlactatemia 24 hours post-fluid therapy
C. Severity of gastric torsion
D. Delayed surgical timing
E. Age at presentation

Answer: Hyperlactatemia 24 hours post-fluid therapy

Explanation: Elevated lactate at 24h was the only variable significantly linked to worse survival outcomes.
In Lhuillery 2022 et al., on GDV stabilization timing, what was noted about degree of gastric torsion between immediate and delayed groups?

A. Torsion degree was uniform across both groups
B. Delayed group had more 360° torsions
C. Immediate group had more 0° torsions
D. Delayed group had more 0° torsions
E. Delayed group had higher incidence of necrosis

Answer: Delayed group had more 0° torsions

Explanation: Delayed cases had fewer 180°/270° torsions, likely due to spontaneous derotation post-decompression.
In Lhuillery 2022 et al., on GDV stabilization timing, which preoperative intervention was key to enabling delayed surgery without compromising outcomes?

A. Pre-anesthetic blood transfusion
B. Use of corticosteroids
C. Trocarization and nasogastric tube placement
D. Early administration of antibiotics
E. Total parenteral nutrition

Answer: Trocarization and nasogastric tube placement

Explanation: These methods effectively decompressed the stomach and prevented redilatation during delay.
In Lhuillery 2022 et al., on GDV stabilization timing, which intraoperative finding had a high mortality rate regardless of timing group?

A. Foreign body presence
B. Splenic rupture
C. Gastric wall necrosis requiring partial gastrectomy
D. Hemorrhagic gastric lavage contents
E. Liver lobe torsion

Answer: Gastric wall necrosis requiring partial gastrectomy

Explanation: Partial gastrectomy was associated with poor outcomes in both immediate and delayed groups.
In Lhuillery 2022 et al., on GDV stabilization timing, what was the observed difference in survival between immediate and delayed surgical groups?

A. Survival was significantly higher in the delayed group
B. Survival was significantly higher in the immediate group
C. Survival was higher in dogs with partial gastrectomy
D. There was no significant difference in survival between groups
E. Survival differed based on breed

Answer: There was no significant difference in survival between groups

Explanation: Survival outcomes were similar between groups, with approx. 80% survival in both.

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