Port City Veterinary Referral Hospital
Introduction
Riggins, a vibrant 7-year-old Bernese Mountain Dog, faced a serious medical emergency that brought him to the skilled team at Port City Veterinary Referral Hospital. This case study highlights the critical and timely interventions made by our hospital, demonstrating our commitment to advanced veterinary care. The emergency team was led by Rachel Orlowski, DVM and the Surgical Team was led by Robert Hillman, DVM, MS, DACVS. Case Study: Emergency GDV Treatment Saves Riggins at Port City Veterinary Referral Hospital Introduction
Background and Initial Presentation
Riggins was transferred to our emergency room from a local veterinary clinic with symptoms indicative of Gastric Dilatation-Volvulus (GDV), commonly known as "bloat." His condition was potentially lifethreatening, characterized by an abnormal distension and rotation of the stomach, which could lead to rapid clinical deterioration.
Symptoms and Diagnosis
Upon arrival, Riggins displayed several alarming signs:
Regurgitation of water without the presence of food
Loss of Appetite: Skipped his morning meal
Dehydration: Exhibited 6-8% dehydration with tacky mucous membranes
Cardiovascular Distress: Presented with bounding pulses and tachycardia
A comprehensive physical examination by Dr. Rachel Orlowski and subsequent diagnostic tests led to a swift diagnosis of Gastric Dilatation-Volvulus (GDV). X-rays were critical in confirming GDV, revealing the classic "double bubble" sign, a definitive indicator of this condition, where the stomach appears divided into separate gas-filled segments. This x-ray finding was essential in diagnosing the severity of the gastric torsion and underlined the urgent need for surgical intervention.
Treatment Protocol
The urgency of Riggins' condition required immediate and aggressive treatment to prevent further deterioration. Our medical team executed a multi-faceted treatment approach:
Stabilization: Administered IV fluids and medications such as Methadone, Fentanyl, Cerenia and Ondansetron to manage pain and prevent nausea.
Imaging: Thorax imaging was performed to evaluate the overall health of the chest and rule out other complications that could render Riggins a less suitable candidate for surgery, such as severe cardiopulmonary issues that could complicate anesthesia and recovery. issues that could complicate anesthesia and recovery.
Crossmatch & Blood Transfusion while blood transfusions are not common practice in straightforward GDV cases, Riggins’ situation was particularly critical. Riggins sustained significant blood loss into his abdomen due to torn short gastric arteries. Consequently, a crossmatch was performed to ensure compatibility before proceeding with the blood transfusion.
Surgical Intervention
Upon confirming the diagnosis of Gastric Dilatation-Volvulus (GDV) through comprehensive diagnostics, the veterinary team at Port City Veterinary Referral Hospital swiftly transitioned Riggins to the operating room for immediate surgical intervention. This critical procedure was spearheaded by Dr. Robert B. Hillman.
The surgery commenced with a precise ventral midline incision, extending from the xiphoid process to the caudal abdomen. This strategic approach provided optimal access to the affected organs and allowed for an efficient assessment and correction of the gastric torsion.
Surgical Intervention (continued)
Upon opening the abdomen, Dr. Hillman identified the stomach in a typical GDV position, with the omentum unnaturally draped across the front. With expert care, the stomach was gently maneuvered back into its correct anatomical position. An orogastric tube was then inserted to decompress the stomach, relieving the built-up pressure and mitigating the risk of further vascular compromise.
Notably, the surgery also revealed significant damage to the spleen, marked by darkened, congested tissues indicative of hemorrhage. This necessitated a splenectomy, performed to ensure complete removal of the spleen while preserving surrounding structures.
Following the successful repositioning and stabilization of the stomach, an incisional gastropexy was executed. This procedure involved suturing the stomach wall to the abdominal wall to prevent future occurrences of torsion—a preventative measure crucial for GDV-prone breeds like Bernese Mountain Dogs.
The closure of the surgical sites was performed with equal precision, using layers of sutures that would promote optimal healing while minimizing discomfort.
Post Surgical Care and Monitoring
Post-surgery, Riggins was placed under intensive care where he received continuous monitoring to assess his recovery and ensure stability. His postoperative management included pain control, fluid therapy to support blood circulation and organ function, and close monitoring for any signs of infection or complications.
Post-discharge, Riggins' owner was thoroughly briefed on home care instructions, including medication management, diet recommendations, and activity restrictions. Follow-up visits were scheduled to ensure proper healing and to manage any potential complications.
Conclusion and Implications
Riggins' case is a testament to the importance of rapid response and the high level of care provided at Port City Veterinary Referral Hospital. This successful outcome not only saved Riggins' life but also highlighted the effectiveness of our emergency protocols and our team's ability to manage complex surgical cases. His recovery adds to our ongoing commitment to excellence in veterinary medicine and emergency care, ensuring that all pets like Riggins receive the best possible chance at a full and healthy life.
About Port City
Port City Veterinary Referral Hospital is a 24-hour emergency/critical care and specialty veterinary hospital dedicated to providing compassionate medical care to the dogs and cats entrusted to our care. We understand that your pet is a part of your family, and we strive to treat you and your pet with the utmost empathy and respect for your relationship and bond.
Our veterinary team is committed to maintaining regular and open lines of communication with yourselves – the pet owner – and your family veterinarian. We are proud to provide our clients with timely access to the most advanced veterinary specialists and emergency services available today. At Port City, you can rest assured that your pet is always in the reliable care of an experienced veterinarian. Together, our team works to ensure that patients receive the best care and follow-up treatment possible by maintaining communication with your referring veterinarian.
Open 365 days a year, 24 hours per day, we offer state-of-the-art technology and exceptional patient care in Portsmouth, New Hampshire.
For more information on how we handle emergency cases or to schedule a visit, contact Port City Veterinary Referral Hospital at (603) 433-0056.
