Dogs from 16 breeds that were referred to the Department of Small Animal Clinical Sciences, Norwegian College of Veterinary Medicine, between March 1991 and November 1992.

Selection criteria: only dogs diagnosed with gastric dilatation and volvulus (GDV) that had not experienced another acute attack of GDV in the last 5 months were included in the study. All breeds, ages, and both sexes were allowed. The time between the acute stage of the disease and arrival at the referral clinic had to be less than 10 days.

31 dogs. The dogs were split into 2 groups: initially, group A had 21 dogs. From this group, 2 dogs were euthanised during surgery due to severe gastric necrosis, therefore 19 dogs were available for the study. Initially, group B had 10 dogs. Five dogs died 1–18 days postoperatively due to GDV-related complications (3 from group A, 2 from group B). Thus 24 dogs were available for follow-up evaluation.

• Group A (n = 16) received decompression and anatomical repositioning of the stomach and a circumcostal gastropexy.
• Group B (control group: (n = 8)) received the same treatment without gastropexy.

Prospective open, randomised controlled clinical trial.

• Recurrence rate of GDV.
• GDV-related complication rate.
• Death rate in each group within the first year post-GDV.
• Median survival time.

• In group A, 3/16 (19%) dogs died due to GDV-related complications versus 2/8 (25%) in group B.
• No recurrences in group A (0%).
• The recurrence rate in dogs that died from group B was 50% (3/6). There was a statistically significant association (P = 0.01) between gastropexy status and risk of recurrence as the dogs that did not have a gastropexy were significantly more likely to have GDV recurrence (50%, 3/6 dogs) than dogs that did (0%, 0/10 dogs) by the end of the study.
• There was also a statistically significant association (P = 0.04, 95% confidence interval 0.14–0.95) between gastropexy status and survival time as the dogs that had gastropexy performed had a longer median survival time (549 days for dogs in group A) compared to dogs that did not have gastropexy performed (107 days for dogs in group B).
• The overall death rates within the first year were 32% (6/19) in group A and 80% (8/10) in group B.

• The follow-up period was relatively short: the median follow-up time for group A was 397 days (mean 430 days) and 106 days (mean 228 days) for group.
• Small sample population.
• Three dogs in group A and 4 dogs in group B died within 6 months.
• The early withdrawals represented by dogs who were euthanised during surgery or died postoperatively reduced the median follow-up time considerably.
• The sample size of group B was limited due to ethical reasons.

Dogs that previously had been recruited to participate in a case-control study of risk factors for gastric dilatation and volvulus (GDV) from emergency clinics in the United States (27 clinics in total). All dogs were diagnosed with GDV, based on clinical, radiographic, and surgical findings.

136 dogs were initially recruited. 18 were lost to follow-up, so they were excluded from the study. 33 dogs died or were euthanised within the first 7 days after presentation.

85 dogs remained and were included in the study.

The dogs received shock treatment and gastric decompression, and then were split into 2 groups:

• Group 1: dogs that had gastropexy performed (n = 74).
• Group 2: dogs that did not havegastropexy performed (n = 11).

Prospective cohort study.

• Recurrence rate of GDV;
• Age, weight, sex, breed, and neutering status predilection.
• Median survival time in the two groups.
• Probability of surviving, respectively dying within the first seven days following an acute GDV episode.
• Groups of dogs at high risk of GDV relapse following an acute GDV incident.

• Group 1: the incidence of recurrence was 4.1% (3/74).
• Group 2: the recurrence rate was 54.6% (6/11 dogs).
• The dogs that had gastropexy performed for an acute GDV were much less likely to have a GDV recurrence compared to dogs that did not have a gastropexy (P < 0.001, odds ratio 0.05, 95% confidence interval: 0.01–0.25).
• The probability of a relapsing episode of GDV was not correlated to the age, weight, sex or neutering status of the dogs.
• The dogs that had gastropexy had a median survival time of 547 days, whereas in the dogs without gastropexy this was 188 days (P = 0.0001). This is likely related to the high recurrence rate of GDV in dogs from group 2 compared with the dogs from group 1.
• Most of the dogs presented with GDV to the veterinary clinics were adult (mean of 5.7 years old ±2.8 standard deviation) male entire Great Dane dogs.
• The probability of surviving the first seven days following an acute GDV episode was not influenced by either the age, weight, sex, neuter status of the cases, the time from onset of clinical signs until presentation to the clinic, or the time from presentation to the time of surgery.
• The dogs at the highest risk of dying within the first 7 days following an acute episode of GDV were male dogs older than 7 years old, recumbent, depressed or comatose, with gastric necrosis.
• The dogs at the highest risk of having a recurrence of GDV following treatment of acute GDV were male dogs over 8.9 years of age, between 79–103 lbs that did not have a gastropexy surgery performed.

• 33/136 dogs (24.3%) died or were euthanised within the first seven days.
• 18/103 surviving dogs (17.5%) were lost to follow-up.
• There are no details on how the dogs were split into the 2 groups.
• There is no report of the number of dogs that died from each category in a set amount of time.

Medical records of dogs with gastric dilatation and volvulus (GDV), treated from January 1988 to April 1991 at the School of Veterinary Medicine’s Clinic of Small Animals in Hanover, Germany were reviewed.

134 dogs were admitted with GDV. Of these, 13 died or were euthanised prior to treatment, therefore 121 dogs were available for the study.

The remaining 121 dogs were split into 2 groups:

• Group 1 (n = 88) were treated surgically (gastropexy). Gastropexy was performed by fixing the pyloric antrum to the abdominal wall by incorporating the stomach into the main suture of the linea alba for approximately 5 cm. This suture line included the muscularis of the stomach, without entering the stomach lumen.
• Group 2 (n = 33) were treated medically (decompression via a gastric tube, without coeliotomy).

Retrospective case-control study.

• Death rate in each group due to GDV or GDV-related complications.
• Recurrence rate in dogs with GDV that had medical interventions versus dogs that had surgical interventions.
• Discharge rate in each group.

• In group 1, 14.8% (13/88) of dogs died due to GDV or GDV-related complications and 13.6% (12/88) dogs died due to other causes. The overall death rate in this group was (25/88) 28.4%.
• In group 2, 18.2% (6/33) of dogs died due to GDV or GDV-related complications and 6.1% (2/88) of dogs died due to other causes. The overall death rate was 24.3% (8/33 dogs).
• Two owners were not available for a follow-up check in group 1, therefore the recurrence rate in this group was 6.6% (4/61 dogs), whereas in group 2 it was 76% (19/25 dogs).
• In group 1, the 4 dogs that had a GDV relapse had a death rate of 100%.
• In group 2, the 19 dogs that had a GDV relapse had a death rate of 68.43% (13/19 dogs). Therefore, the death rate in this group was 63.63% (21/33 dogs).
• Discharge rate was 71.6% (63/88 dogs) in group 1, whereas in group 2 it was 75.75% (25/33 dogs).

• The author was not specific about the type of surgery one dog in group 1 had but included it in this ‘surgical treatment’ group.
• In group 2 it is not stated when the GDV relapsed in the 19 dogs.

87 dogs with gastric dilatation and volvulus (GDV) syndrome were included in the retrospective study of recurrence. These animals were seen at either the Animal Medical Center in New York City, the  Small Animal Hospital of the University of Georgia, or the Small Animal Hospital of the University of Missouri.

87 dogs, from which 43 died perioperatively with no GDV recurrence. Thus, 44 dogs were available for recurrence assessment.

The 44 dogs had a total of 101 surgical procedures performed. The dogs were split into groups depending on the type of surgery they had. Surgical treatment for GDV included gastropexy (35/44 dogs, 79.6%), pyloric surgery (25/44 dogs 56.9%), gastrectomy (6/44 dogs, 13.7%), splenectomy (19/44 dogs, 43.2%), gastric repositioning alone (5/44 dogs, 11.4%), pharyngostomy tube placement (6/44 dogs, 13.6%), and a group where the technique employed was not noted (5/44 dogs, 11.4%).

Retrospective cohort study.

The success rate correlated to each type of surgical procedure used to correct a GDV was assessed, where success was referred to the percentage of cases that did not have an episode of GDV relapse during the first 5 months postsurgery.

• The dogs that had gastropexy performed had a success rate of 77.2% (27/35 surgeries), thus a 22.9% recurrence rate (8/35).
• The dogs that had pyloric surgery performed had a success rate of 80% (20/25 surgeries), thus a 20% recurrence rate (5/25).
• The dogs that had gastrectomy performed had a success rate of 100% (6/6 surgeries), thus no recurrence.
• The dogs that had splenectomy performed had a success rate of 78.9% (15/19 surgeries), thus a recurrence rate of 21.1% (4/19).
• The dogs that had gastric repositioning alone performed had a success rate of 20% (1/5 surgeries), thus an 80% recurrence rate.
• The dogs that had a pharyngostomy tube placed had a success rate of 83.3% (5/6 surgeries), thus a recurrence rate of 17%.
• The dogs that had surgery for GDV which was not noted had a success rate of 80% (4/5 surgeries), thus a recurrence rate of 20% (1/5).

• Small number of cases.
• It is not clear in what treatment categories the 43 dogs that died perioperatively were placed.
• It is not stated what surgery was done in each patient, as some of the dogs might have had one surgery performed, whereas other dogs might have had multiple surgeries at one time.
• 23/87 dogs (26.4%) died postoperatively, with no specification if they had or had not a recurrence of GDV at the time of death.

CAB Abstracts on the OVID interface 1973–May 2024
PubMed accessed via the NCBI website 1973–May 2024

Cab Abstracts:

1. (dog or dogs or canine or canines or bitch or bitches) or exp dogs/ or exp bitches/
2. (gastric dilatation or gastric dilatation volvulus or GDV or gastric torsion or stomach volvulus)
3. (gastropexy or ((stomach or gastric) and sutur*))
4. ((stomach or gastric) and (decompression or deflation or replacing or reposition))
5. 1 and 2 and 3 and 4

Pubmed:

1. dog OR canine OR bitch
2. gastric dilatation OR gastric dilatation volvulus OR GDV OR gastric torsion OR stomach volvulus
3. gastropexy
4. (stomach OR gastric) AND suture
5. (stomach OR gastric) AND (decompression OR deflation OR replacing OR reposition)
6. 1 AND 2 AND (3 OR 4) AND 5

23 May 2024

• Foreign language papers.
• Irrelevant to the PICO question.

Any relevant primary veterinary research in English which assessed the recurrence of gastric dilatation and volvulus in dogs after being treated medically and with gastric repositioning, compared to dogs who additionally had gastropexy performed.