Elective gastropexy in a great dane

RE: Elective gastropexy in a great dane

Rob Loxley — Sun, 02 Feb 2020 19:38:58 GMT

A quick google throws up lots of vets offering (and presumably performing) elective gastropexy in the UK

RE: Elective gastropexy in a great dane

Sarah Keir — Sat, 01 Feb 2020 15:52:25 GMT

[quote userid="4501" url="~/001/veterinary-clinical/small-animal/sa-soft-tissue-surgery/f/discussions/28811/elective-gastropexy-in-a-great-dane/219103"]'I ran your enquiry past the Recognised Veterinary Practice (RVP) sub-committee, who were of the opinion that it would not be an issue for the surgery to be done at the same time as a treatment for gastric torsion or bloat as a preventative treatment, however it would not be RVP for the surgery to be done as an elective measure in a dog with no history of previous problems of torsion or bloat.''[/quote]

Is an example of the RCVS setting some kind of standard but not letting practising vets know what that standard is until they reach PIC or even DC? Like using blankets to move animals, or the latest is that all animals need to have a clinical examination by a vet before they have a GA.

RE: Elective gastropexy in a great dane

Dinu Catilina — Thu, 30 Jan 2020 23:24:08 GMT

What a strange response. Why are we allowed to spay then?

RE: Elective gastropexy in a great dane

Alistair Graham-Evans — Thu, 30 Jan 2020 21:32:26 GMT

I know some specialists would disagree !

When I do them it is via a small R paramedian incision so minimally invasive. If I get any problems I guess I can get a world recognised leading specialist to support me and sit back while they argue about it and wait for a decision on the recklessness of my surgery on the balance of probabilities.

RE: Elective gastropexy in a great dane

Edward Jones — Thu, 30 Jan 2020 17:49:10 GMT

Thank you for this update. Am I the only one never to have heard of this sub-committee?

I was already on the side of 'no if a castrate' and 'probably no if a spay', but it's definitely a no now.

RE: Elective gastropexy in a great dane

Bob Russell — Thu, 30 Jan 2020 10:06:06 GMT

That is not what I would have expected them to say!

We mainly see smaller dogs so the issue has not really arisen but I was under the impression that in higher risk breeds this might be considered a sensible thing.

There you go!!

RE: Elective gastropexy in a great dane

Cool — Thu, 30 Jan 2020 10:01:06 GMT

Dear all,

I contacted the RCVS regards this issue and got a response few days ago. Their advice is quoted below:

''I ran your enquiry past the Recognised Veterinary Practice (RVP) sub-committee, who were of the opinion that it would not be an issue for the surgery to be done at the same time as a treatment for gastric torsion or bloat as a preventative treatment, however it would not be RVP for the surgery to be done as an elective measure in a dog with no history of previous problems of torsion or bloat.''

So, what do we all think now?

RE: Elective gastropexy in a great dane

Thomas Johnson — Mon, 27 Jan 2020 11:12:49 GMT

[quote userid="4501" url="~/001/veterinary-clinical/small-animal/sa-soft-tissue-surgery/f/discussions/28811/elective-gastropexy-in-a-great-dane"]I will just like to seek your opinion on elective gastropexy in Great Danes. We had a client approach us recently who wants his dog neutered but also wants to have elective gastropexy performed. I have a conservative ethical position on this and I will like to know your opinions. Rang the RCVS about it and they could not help me much as I was told by the lady who answered the phone that we do not have vets on our advice team. Some vets will happily perform this procedure while some will not. I am aware it is commonly done in the USA.[/quote]

I have done it once in a Bernese Mountain Dog that was being spayed (I found a corn on the cob in the stomach at the same time!), I did an incisional gastropexy. When I looked in to it at the time I decided that I would be happy to do it at the same time as a spay in an at risk breed as the abdomen was open, but would be reluctant to do it at the same time as a castration.

RE: Elective gastropexy in a great dane

Gillian Mostyn — Sat, 25 Jan 2020 14:45:18 GMT

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/sa-soft-tissue-surgery/f/discussions/28811/elective-gastropexy-in-a-great-dane/218930"]Didn't charge anywhere near as much as Dinu, just need a slightly bigger hole.[/quote]

There are obviously different methods of doing a pexy though. A belt-loop would take more skill and time than simply grabbing chunks of stomach with your midline closure ... which I have seen, and was concerned re future abdo surgery and iatrogenic stomach wall incision.

RE: Elective gastropexy in a great dane

Michael Woodhouse — Wed, 22 Jan 2020 19:28:23 GMT

I've done a couple. Happy to if in the abdomen anyway. Open Sx. Didn't charge anywhere near as much as Dinu, just need a slightly bigger hole.

(will charge more next time)

RE: Elective gastropexy in a great dane

Julian Earl — Wed, 22 Jan 2020 19:07:42 GMT

I think it most important to emphasise that it does not prevent gastric dilatation but might prevent torsion, tat is all.

I do not see preventive surgery as the first option for this reason. First has to be strong advice about dietary control to prevent bloat is the most important action. If effective, gastropexy should not be needed anyway. Probably! The other side of the coin is that elective gastropexy is much safer than the GA etc., etc done immediately as a response to a torsion if and when it happens. Which is In the middle of the night usually IME as well!!

RE: Elective gastropexy in a great dane

Mark Hedberg — Fri, 17 Jan 2020 19:50:15 GMT

I'm cautious. I was very pro prophylaxis until about two months ago, when my sister's Great Dane went in for spay and pexy. Dog developed sepsis and died. (In the United States.)

Anecdote, I know. Stuff happens, I know.

But if complication develops, it's pretty bad. (I wasn't the vet, I don't touch family pets.)

RE: Elective gastropexy in a great dane

Dinu Catilina — Fri, 17 Jan 2020 10:43:59 GMT

I would. We also offer it as a a side to laparoscopic ovariectomy but we did perform them for open spays as well. There is no doubt that a gastropexy will decrease the risk of gastric torsion but it will not reduce it to zero and the dog can still have gastric dilation. Communication is the key. We charge an extra 150 pounds for the pexy if done at the time of ovariectomy.

RE: Elective gastropexy in a great dane

Jill Butterworth — Fri, 17 Jan 2020 10:31:39 GMT

A practice local to me used to do this, I think as a side (excuse the pun) to a laparoscopic ovariectomy. Just warn them that occasionally the pexy can fail and have inherent complications of its own, as no doubt they want a cast iron guarantee the dog will never get a GDV. It's a risk benefit thing, if you aren't comfortable doing the surgery, it might be wise the refer the dog to someone who does it more frequently.