Prophylactic gastropexy

Re: Prophylactic gastropexy

nikki — Tue, 19 Jun 2012 20:39:07 GMT

yes, op done 10days ago now. Dog recovered well and has healed fine. Did a belt loop gastropexy and routine spey. length of incision was ridiculous. stapled the skin to save some time closing up and it's all healed up fab - no probs.

Thank-you to everyone who took time to reply. Have been reading all the responses via e-mail.

Re: Prophylactic gastropexy

Neil Wheadon — Tue, 19 Jun 2012 18:31:20 GMT

[quote user="nikki"]Have got a Great Dane coming in next week for spay[/quote]

Have you done the op yet?

My only thought is that to do a spay and a gastropexy, the length of incision would be enormous to get good access, though accept that they heal side to side rather than end to end.

Guess that

1) Referral for laparoscopy

2) Remove just the ovaries on the spey could be an option

3) Develope arms like Mr Tickle and wear a snorkel

Interested to hear back on how you managed.

Good luck

Neil

Re: Prophylactic gastropexy

Rajat — Tue, 19 Jun 2012 18:07:38 GMT

Interestingly the Wikipedia stub for Silken windhounds states "Bone and joint ailments like hip dysplasia are generally not a problem, nor is bloat."

Re: Prophylactic gastropexy

Rajat — Tue, 19 Jun 2012 17:36:21 GMT

[quote user="Alet Engelbrecht"]I attended a CPD talk a year or so ago where the speaker preferred a ventral gastropexy which involved incorporating the stomach wall in the cranial 5cm of the abdominal incision. The obvious advantage was time, the concern was that the stomach could be incised during subsequent ex laps[/quote]

I've often heard this mentioned in talks as the 'pexy which one should not do' for the obvious reason you mention. i suppose all warning systems can fail, and it is argued there are so many different techniques with lower risk, so best to choose those than this.

Re the breed- yes it is a Pedigree, and one that is recognised by petplan at that! But between friends, it is a nice cross between a borzoi and a whippet

Re: Prophylactic gastropexy

Alet Engelbrecht — Tue, 19 Jun 2012 16:19:15 GMT

[quote user="Alastair Franklin"]

[quote user="Michael Woodhouse"]

I'm surprised someone hasn't come up with a quick pexy system in a similar way to placing a PEG tube. I'd have thought it could be a 10 minute job.

[/quote]

I'm sure someone has, but probably not the best solution

[/quote]

I attended a CPD talk a year or so ago where the speaker preferred a ventral gastropexy which involved incorporating the stomach wall in the cranial 5cm of the abdominal incision. The obvious advantage was time, the concern was that the stomach could be incised during subsequent ex laps. Apparently it was published in JAVMA in 2003. According to the speaker, he impresses the importance of this on the owners and instructs them to inform any future vets as well as using popup warning windows on his computer. So far, he has never had problems and saw the concern as theoretical mainly, as it is so far cranial to only really interfere with hepatic surgery apparently.

I would be interested to hear if anyone is familiar with or using the technique.

Re: Prophylactic gastropexy

Jo Cobbett — Tue, 19 Jun 2012 15:54:34 GMT

[quote user="Michael Woodhouse"]

[quote user="Rajat"]Interesting breed, btw, a 'Silken Windhound'![/quote]

You mean a cross-bred?

[/quote]

But probably a "pedigree crossbreed"!!

Re: Prophylactic gastropexy

Michael Woodhouse — Tue, 19 Jun 2012 15:03:57 GMT

[quote user="Rajat"]Interesting breed, btw, a 'Silken Windhound'![/quote]

You mean a cross-bred?

Re: Prophylactic gastropexy

Rajat — Tue, 19 Jun 2012 14:58:29 GMT

[quote user="Neil Wheadon"]

Stop the GDV discussions now!

This week

Neil Wheadon 2 ( Irish Wolfhound and Great Dane)

Sarah Wheadon 1 (Boxer)

[/quote]

Lol , ok. Personally, I like the GDVs, but they always seem to come at night which is a pain. I wish they came on a nice quiet day when we had lots of staff and time ..hey ho!

Anyways dog is having a pexy, other surgery specialists I have read on it today recommend it strongly in this setting..

Interesting breed, btw, a 'Silken Windhound'!

Best

Raj

Re: Prophylactic gastropexy

Alan Tevendale — Tue, 19 Jun 2012 07:35:27 GMT

Hey hang on. I drew Greece in our sweepstake. I'll not stand for any of that thank you very much.

Re: Prophylactic gastropexy

Neil Wheadon — Tue, 19 Jun 2012 01:53:28 GMT

Stop the GDV discussions now!

This week

Neil Wheadon 2 ( Irish Wolfhound and Great Dane)

Sarah Wheadon 1 (Boxer)

Before this turns into a higher score than Germany against Greece!!

Thankyou and goodnight (hopefully)

Re: Prophylactic gastropexy

Rajat — Tue, 19 Jun 2012 01:21:17 GMT

Hi folks

I followed this thread with some interest and would like your opinion

So tonight I was presented with a 11month old 'Silken Windhound' a cross between a Borzoi and a whippet (from USA...) He is a very lean hound, looks like a smallish Borzoi, and very deep chested.

Presented for abdominal pain, non productive retching and lethargy. Dog is on BARF diet and ate goose poo earlier in the day. PE showed abdo pain, and hyperdynamic pulses, mild tachycardia sl fast CRT so interpreted as compensatory stage of shock.

No obvious 'bloat' on palpation but rads show a dilated air +fluid filled stomach. Smallish cava, rest wnl. No torsion. NG tube placed and removed 450-500mls air and 180ml fluid. 1 hour later removed further 180ml air. Treated as for shock also started prokinetics and other meds.

So given bloat, at 11 months, with signs of hypovolemic shock I am probably going to recommend a gastropexy to the owner. What would you do? Anyone aware of evidence to show that dogs who bloat but don't have volvulus are definitely at greater risk of volvulus later in life?

Best

Raj

Re: Prophylactic gastropexy

Julian Earl — Mon, 11 Jun 2012 14:54:17 GMT

[quote user="Malcolm Ness"]

My comments were written in the knowledge of that information which is already a decade old and relates to a foreign population. The assumption that prophylactic gastropexy works at all has not been convincingly demonstrated and the possibility that the risks associated with the surgery (acute and chronic) might outweigh any benefits should be considered.

The suggestion that a pexy following GDV is the same as a pexy in a dog at increased risk of GDV is flawed.

I am not saying that prophylactic pexy is a bad thing, merely that it has not yet been shown to be a good thing.

[/quote]

I must be missing something here; why would a prophylactic gastropexy in an at-risk dog be any less effective than a 'pexy in a dog post-GDV? I can see that there might be a lack of evidence for prophylactic G-p in that it might not be any research papers, but the principle and effect(s) will be the same in both cases won't they? Clearly, a gastropexy won't prevent dilatation in either case but it should prevent twisting in both cases.

Re: Prophylactic gastropexy

Rob Loxley — Mon, 11 Jun 2012 13:24:13 GMT

[quote user="Malcolm Ness"]I am not saying that prophylactic pexy is a bad thing, merely that it has not yet been shown to be a good thing.[/quote]

Your input is always appreciated; in the light of the evidence that we do have, what would your advice to the client be?

Re: Prophylactic gastropexy

Malcolm Ness — Sun, 10 Jun 2012 23:08:34 GMT

[quote user="robloxley"]

[quote user="Malcolm Ness"]What we really need to know is 1. what the numerical risk of GDV is a particular dog/breed/line, 2. how much that risk is reduced by our "prophylactic gastropexy" and 3.what are the risks/costs associated with the proposed surgery.[/quote]

For the risks and a basic cost-benefit analysis http://www.ncbi.nlm.nih.gov/pubmed/12941556

[/quote]

The suggestion that a pexy following GDV is the same as a pexy in a dog at increased risk of GDV is flawed.

I am not saying that prophylactic pexy is a bad thing, merely that it has not yet been shown to be a good thing.

Re: Prophylactic gastropexy

Acrobat77 — Sun, 10 Jun 2012 21:37:50 GMT

[quote user="Mark Holmes"]

On call this weekend so refuse to enter any further into this discussion.

[/quote]Ditto

Re: Prophylactic gastropexy

Rob Loxley — Sun, 10 Jun 2012 19:58:23 GMT

[quote user="Malcolm Ness"]There is an assumption here that prophylactic gastropexy actually works.[/quote]

Would anyone argue that a dog that has had a GDV should not be 'pexy-ed' when operated on? If so then the same rationale would apply to a dog that has a high risk of GDV? Albeit you're operating on a lot of dogs that will never get a GDV, and therefore an ethical debate exists.

For the risks and a basic cost-benefit analysis http://www.ncbi.nlm.nih.gov/pubmed/12941556

Re: Prophylactic gastropexy

Rachael Winder — Sat, 09 Jun 2012 18:05:27 GMT

Fair enough I suspect I may have jinxed the next 2 weekends, of which I am working both...

Re: Prophylactic gastropexy

Mark Holmes — Sat, 09 Jun 2012 14:52:53 GMT

On call this weekend so refuse to enter any further into this discussion.

Re: Prophylactic gastropexy

Rachael Winder — Sat, 09 Jun 2012 14:48:25 GMT

Do people think GDV is on the decrease/increase? It was a topic of which much was made at college and yet in 8years in small animal practice I have only ever seen a handful of cases, despite working in an area where mastiffs/gsd/various other deep chested dogs are very popular. I get the impression that many owners of such dogs are increasingly careful about feeding/exercise practices etc. Or am I just lucky at being in the right place at the right time?!

Re: Prophylactic gastropexy

David Mills — Sat, 09 Jun 2012 13:05:19 GMT

[quote user="Mark Rowland"]Would people do it for a castrate if asked? Just curious as I'm quite happy to change my stance if a client comes w ith the question.

[/quote]

Without hesitation. Castration is an elective procedure, carried out generally on a young, fit animal, with an excellent GA profile.

Re: Prophylactic gastropexy

Malcolm Ness — Sat, 09 Jun 2012 13:03:41 GMT

[quote user="robloxley"]On the one hand you've turned a simple, non-abdominal surgery into a more complicated one; however given the risks and consequences of a GDV, then I'd do it.[/quote]

There is an assumption here that prophylactic gastropexy actually works.

What we really need to know is 1. what the numerical risk of GDV is a particular dog/breed/line, 2. how much that risk is reduced by our "prophylactic gastropexy" and 3.what are the risks/costs associated with the proposed surgery.

Without that information, we have nothing more than a theoretically good idea to speculate about.

Re: Prophylactic gastropexy

Rob Loxley — Sat, 09 Jun 2012 12:53:42 GMT

[quote user="Mark Rowland"]Would people do it for a castrate if asked?[/quote]

On the one hand you've turned a simple, non-abdominal surgery into a more complicated one; however given the risks and consequences of a GDV, then I'd do it.

Re: Prophylactic gastropexy

Mark Rowland — Sat, 09 Jun 2012 11:54:13 GMT

Would people do it for a castrate if asked? Just curious as I'm quite happy to change my stance if a client comes w ith the question.

Re: Prophylactic gastropexy

Rajat — Sat, 09 Jun 2012 11:29:19 GMT

100% with Alistair- if you're opening up a healthy young GD, it makes sense to do a prophylactic gastropexy. No point waiting, especially as you may not see the bloat before the twist..as well all know too well!

Re: Prophylactic gastropexy

patrick murphy — Thu, 07 Jun 2012 13:40:18 GMT

at a talk I went to I understood that the American army prophy's all of their dogs (laproscopically)