Teaching and learning about veterinary diagnostic imaging.
This week we have a 3-year-old male neutered Labrador Retriever that has been vomiting pink-tinged foam for several hours. Stomach is palpably distended with gas. Unable to pass a stomach tube.
[ngg src=”galleries” ids=”10″ display=”masonry” ngg_triggers_display=”always”]The stomach is distended with gas and fluid, however the fundus and pylorus are in their normal positions.
There are several loops of small intestine that are located cranial to the stomach. The most cranial loop, presumed to be the duodenum, is located left of midline on the v/d projection.The majority of the small intestine has been displaced dorsally and to the right.
The spleen appears caudally and ventrally displaced. There is good abdominal serosal detail. The esophagus is gas distended.
There is a focal alveolar pattern in the right middle lung lobe indicating aspiration pneumonia.
Typical findings in a GDV of less than 360 degrees are gastric dilation, displacement of the fundus and pylorus, and compartmentalization. When the stomach rotates a full 360 degrees the normal anatomic relationships of the stomach are maintained, and the radiographic appearance is not typical. Other features, such as megaesophagus, and the displaced duodenum, indicate that there is malposition of the stomach. Clinical findings such as inability to pass a stomach tube can help to support the diagnosis.
360 degree GDV is rare and often not diagnosed on radiographs. In a study of 220 dogs, 2.5% had a 360 degree rotation.¹
This dog’s stomach was derotated and a gastropexy was performed. There was no ischemia of the stomach or other organs.
Major findings: The stomach is distended with fluid and gas. The fundus of the stomach is in its normal anatomic position. There are multiple gas filled loops of small intestine in the right cranial abdomen. The spleen is caudally displaced but has a normal margin. Serosal detail is adequate. The liver, kidneys, urinary bladder appear normal, and colon appear normal. There is an interstitial to alveolar pattern in the right middle lung lobe
Minor findings: There is lumbosacral spondylosis on the right lateral image. A mild diffuse bronchial pattern is noted in the included caudodorsal lung fields.
Conclusions: 1) 360 GDV, concurrent splenic torsion unlikely, 2) aspiration pneumonia
I thought there was some caudal sternebral spondylosis – is this correct, and is it still normal for a dog at only 3 years of age?