Endoscopy-assisted prophylactic gastropexy for prevention of GDV

Gastric dilution and volvulus (GDV) is a common, life-threatening emergency that is typically seen in large, deep chested dogs. Despite early and aggressive treatment, the mortality rates, post-operative morbidity and financial costs associated with treatment are high.

Prophylactic gastropexy, to prevent a future volvulus, may be considered in high-risk breeds such as Great Danes, Weimaraners, Irish Wolfhounds, St Bernards, and Irish Setters or in patients with risk factors for development of GDV. This includes deep chested dogs, those with a history of gastric dilation/bloat, first-degree relative with a history of GDV, increasing age, and dogs of a nervous disposition.

Prophylactic gastropexy has typically been performed during ovariohysterectomy in young female dogs or as a laparoscopic or ‘open’ surgical procedure in male or older dogs. Endoscopy-assisted prophylactic gastropexy has recently been described in dogs and we are very happy to offer this procedure at SCVS. Endoscopy-assisted gastropexy is minimally invasive, avoids complete opening of the abdomen and appears to be as effective as the traditional ‘incisional gastropexy’ at preventing GDV.

Key facts

• Minimally invasive procedure to prevent GVD in high-risk dogs
• Avoids midline coeliotomy and complete opening of the abdomen
• Very rapid recovery time and procedure can be performed on an outpatient basis.

Balloon dilation, balloon oesophagostomy tube management and oesophageal stenting

Benign oesophageal strictures cause recurrent regurgitation in cats and dogs which results in significant patient morbidity and mortality. We offer multiple treatment options for oesophageal strictures including balloon dilation and balloon-oesophagostomy tube placement for at-home dilation. We also offer percutaneous, low-profile gastrostomy and gastrojejunostomy tube placement for patients with oesophageal strictures and megaoesophagus.

Key facts

• Balloon dilation and at-home dilation using balloon-oesophagostomy tubes are available for treatment of patients with benign oesophageal strictures. Oesophageal stenting can be considered in patients with strictures refractory to balloon dilation or those with oesophageal neoplasia
• Advanced investigation (including fluoroscopy for diagnosis of lower oesophageal sphincter achalasia-like syndrome) and minimally invasive management options such as low-profile gastrostomy and gastrojejunostomy tubes are available for dogs with ‘idiopathic’ megaoesophagus.

Endoscopic oesophageal and gastric foreign body removal

Ingestion of foreign bodies commonly results in oesophageal or gastric outflow obstruction. Clinical signs typically consist of acute onset regurgitation or vomiting. Rapid intervention is warranted to prevent potentially life-threading consequences such as oesophageal perforation or stricture and aspiration pneumonia. Many foreign bodies such as bones, rawhide chews, stones, fishhooks (to name but a few) can be removed endoscopically, thus avoiding surgical intervention.

Key facts

• Foreign bodies, particularly oesophageal should be considered an emergency and rapid removal is indicated
• Endoscopic removal of gastric and oesophageal foreign bodies avoids surgical intervention
• We are happy to receive any foreign body case as an emergency for endoscopic retrieval