A gastropexy is a preventative procedure to “tack” the stomach in place to prevent it from twisting in the abdomen. If the st
omach bloats and twist in an animal, it is an EMERGENCY and LIFE or DEATH situation. A gastropexy is also done if a dogs stomach does bloat/twist while during the life-saving surgical correction to prevent the problem from happening again in the future.
HOW DOES THE STOMACH TWIST?
In the dog, the esophagus enters the stomach more on the left side of the body and connects the the intestines on the right side. The portion of the stomach that connects to the esophagus is called the fundus and where it attaches to the intestines (duodenum) is called the pylorus. So, the esophagus attaches to the fundus on the left side of the body and the pylorus attaches to the intestines on the right (see picture).
So, when the stomach twists (in most cases), the pylorus moves down and to the left side of the body and the fundus moves up and to the right side. If you’re looking at the dog from behind, the stomach moves in a clockwise rotation.
Once twisted, the stomach will begin to dilate because gas and liquid cannot leave the stomach. The dilation of the stomach can start before or after the stomach is twisted. This is called a GASTRIC DILATION and VOLVULUS (GDV).
WHY IS IT A BIG DEAL?
Now this is where things get really complicated. The distended stomach can compress super important blood flow - like blood flow to the heart. This can cause life threatening arrhythmias and changes in blood pressure. The twist, also may disrupt blood flow to the stomach and/or spleen. This can cause parts of the stomach wall or spleen to start to die. Breakdown of the stomach wall can also allow bacteria from the stomach to get into the bloodstream. The dilated stomach also puts pressure on the diaphragm and lungs which can make it very difficult for the animal to breath.
The longer the stomach is twisted, the worse prognosis the dog has. This is an emergency and should not be taken lightly!
WHAT DOES A GASTROPEXY INVOLVE?
Often, we will do the surgery while the animal is under general anesthesia for their spay/neuter. There are multiple different ways to perform a gastropexy but I like to do an incisional gastropexy. This involves making a small incision in the outside of the stomach wall (it is not full thickness into the stomach) and another small incision in the muscle on the inside of the right rib cage in the abdomen. I then use a suture that will dissolve and place 2 simple continuous patterns to attach the right side of the stomach to the right body wall (see image). The stomach is now sutured to the body wall so it can't twist.
WHAT ARE THE RISK FACTORS?
Certain types types of dogs are more predisposed to developing a twisted stomach. The risk factors include having a narrow and deep chest, stress, being underweight, once daily feeding, feeding large volumes of food, activity right after feeding, eating from a raised bowl, etc. Breeds that are at are over represented include Great Danes, German shepherds, Weimaraners, Saint Bernards, Old English sheep dogs, Irish setter, Doberman pinschers, gordon setters, and standard poodles.
This is a procedure that can be done when your dog is ‘fixed’ (spayed/neutered). Talk to your vet about getting a gastropexy done to prevent an emergency situation in the future.