Feline Gastric Dilatation-Volvulus

July 14, 2018
Natalie Stilwell, DVM, MS, PhD

Dr. Natalie Stilwell provides freelance medical writing and aquatic veterinary consulting services through her business, Seastar Communications and Consulting. In addition to her DVM obtained from Auburn University, she holds a MS in fisheries and aquatic sciences and a PhD in veterinary medical sciences from the University of Florida.

Two recent cases highlight potential risk factors for GDV development in cats.

Gastric dilatation-volvulus (GDV), a disease characterized by distention and rotation of the stomach, typically occurs in large, deep-chested canine breeds. Only 8 feline cases have been reported in the literature, but a recent article in Journal of Veterinary Emergency and Critical Care highlights 2 additional cases.

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The 2 cats presented separately to emergency referral centers for increased respiratory effort. Case #1, a 7-year-old spayed female Persian, displayed open-mouthed breathing that had worsened over the previous day. Case #2, a 12-year-old spayed female Persian, had an acute onset of vocalization, respiratory distress, and foaming at the mouth after jumping off the owner’s bed.

Both cats had the following physical examination findings:

  • Painful, distended abdomen
  • Pale, tacky mucous membranes
  • Prolonged capillary refill time
  • Stenotic nares
  • Tachypnea
  • Increased lung sounds
  • Grade II or III/VI systolic heart murmur

Case #2 was also hypothermic with thready peripheral pulses and had a third-degree atrioventricular block on echocardiogram.

Whole-body radiographs for both cats confirmed that the stomach was distended with gas. Case #1 also had gas-filled intestines, while Case #2 had megaesophagus. Both cats were stabilized with intravenous fluid resuscitation, and Case #1 also received flow-by oxygen and oxymorphone to treat tachycardia.

Bloodwork and blood gas analysis for Case #1 revealed hyperglycemia, hypochloremia, and increased partial pressure of carbon dioxide, while Case #2 had hyperlactatemia, hyperglycemia, and increased creatinine. A red rubber catheter placed into the esophagus recovered 120 mL of air in Case #1, while attempts to pass a nasogastric tube for Case #2 were unsuccessful.

In both cases, abdominal exploratory laparotomy revealed clockwise rotation of the stomach. De-rotation failed to resolve gastric distention in Case #1, so a red rubber catheter was used for decompression. After de-rotation in Case #2, a large hairball was palpated and removed from the gastric lumen. Gastropexy was performed in both cases. Blood gas and electrolyte levels in both cats stabilized after surgery.

While gastric biopsies were not obtained, underlying gastrointestinal (GI) pathology was suspected in Case #1 due to persistent gastric dilatation and decreased GI motility for several days after surgery. Postoperative management included a nasogastric tube, continuous pain medication, and prokinetic therapy with metoclopramide. An echocardiogram was also performed to rule out cardiac disease. The cat was discharged 8 days after surgery, and follow-up examination revealed only mild stertor and gastric distention.

Case #2 recovered well and was discharged 36 hours after surgery. Four days later, the AV block was no longer present but the cat remained bradycardic. Findings at 6-month follow-up were unremarkable.

While dogs with GDV typically present with acute GI signs, cats more commonly present with respiratory distress developed over 24 hours or more. Most cats with protracted clinical signs have survived to discharge, while prognosis in dogs decreases after 6 or more hours of clinical signs. GI dysmotility and gastric foreign bodies, both known predisposing factors for canine GDV, may have contributed to GDV development in Cases #1 and #2, respectively.

Dr. Stilwell received her DVM from Auburn University, followed by a MS in fisheries and aquatic sciences and a PhD in veterinary medical sciences from the University of Florida. She provides freelance medical writing and aquatic veterinary consulting services through her business, Seastar Communications and Consulting.