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Evaluation of a novel technique involving ultrasound-guided, temporary, percutaneous gastropexy and gastrostomy catheter placement for providing sustained gastric decompression in dogs with gastric dilatation-volvulus

Authors :
Ashley C. Joyce
Beau B. Toskich
W. Alexander Fox-Alvarez
Daniel Lewis
J. Brad Case
Kirsten L. Cooke
Source :
Journal of the American Veterinary Medical Association. 255:1027-1034
Publication Year :
2019
Publisher :
American Veterinary Medical Association (AVMA), 2019.

Abstract

OBJECTIVE To evaluate the feasibility of ultrasound-guided, temporary, percutaneous T-fastener gastropexy (TG) and gastrostomy catheter (GC) placement for providing sustained gastric decompression in dogs with acute gastric dilatation-volvulus (GDV) and to compare findings with those of trocarization. ANIMALS 16 dogs with GDV. PROCEDURES Dogs were randomly assigned to undergo gastric decompression by means of percutaneous trocarization (trocar group; n = 8) or temporary TG and GC placement (TTG+GC group; 8) with ultrasound guidance. The gastric volvulus was then surgically corrected, and the decompression sites were examined. Outcomes were compared between groups. RESULTS The proportion of dogs with successful decompression did not differ significantly between the TTG+GC (6/8) and trocar (7/8) groups; median procedure duration was 3.3 and 3.7 minutes, respectively. After the failed attempts in the TTG+GC group, the procedure was modified to include ultrasound guidance during T-fastener placement. The decrease in intragastric pressure by 5 minutes after trocar or GC insertion was similar between groups. For dogs in the TTG+GC group, no significant difference in intragastric pressure was identified between 5 and 60 minutes after GC insertion. Complications included inadvertent splenic or jejunal placement in 2 dogs (TTG+GC group) and malpositioned and ineffective trocar placement in 1 dog (trocar group). All dogs survived for at least 2 weeks. CONCLUSIONS AND CLINICAL RELEVANCE Ultrasound-guided, temporary, percutaneous TG and GC placement was safe and effective at providing sustained gastric decompression in dogs with GDV, suggesting that this technique would be ideal for dogs in which surgical delays are anticipated or unavoidable.

Details

ISSN :
00031488
Volume :
255
Database :
OpenAIRE
Journal :
Journal of the American Veterinary Medical Association
Accession number :
edsair.doi.dedup.....34a07c71026fbb7dadb8e11f2a7d60fe