Exotis ISSN 2398-2985

Guinea Pigs

Gastric dilatation and volvulus

Synonym(s): GDV, Gastric torsion, Twisted stomach

Contributor(s): Cathy Johnson-Delaney

Introduction

  • Cause: not fully understood; proposed that stasis, pain, sudden diet change, dysbiosis, overeating may contribute.
  • Signs: acute onset of depression, abnormal body posture indicating abdominal pain, gas-filled/tympanic cranial abdomen, dyspnea, reluctance to move, cyanotic or pale mucous membranes, signs consistent with hypovolemic shock, sudden death.
  • Diagnosis: physical examination, diet/eating history, abdominal radiographs, full blood workup including hematology/clinical chemistries.
  • Treatment: stabilize hypovolemia first: IV or IO fluids, analgesics. Attempt gastric decompression with orogastric tube or by percutaneous trocharization - both carry risks. Once stabilized and gastric decompression achieved, surgery to reduce volvulus.
  • Prognosis: generally poor. 

Pathogenesis

Etiology

  • The exact cause in the guinea pig is unknown.
  • It is speculated that gastrointestinal stasis Gastrointestinal stasis, any cause of pain, or sudden diet change may contribute.
  • Overeating such as gorging on fresh vegetables may play a role.

Predisposing factors

General

  • Any cause of pain.
  • Any cause of gastrointestinal motility interruption or dysbiosis.

Pathophysiology

  • Because guinea pigs cannot vomit (due to a well-developed cardiac sphincter):
    • If there is mechanical or physical outflow obstruction from the stomach:
      • All swallowed food, saliva, gastric fluids accumulate.
      • Fermentation of the stomach content will produce large amounts of gas.
    • Gas accumulation precedes volvulus. Rotation of the stomach on its mesenteric axis from 180-540 degrees has been reported.
    • Distention of the stomach leads to decreased venous return to the heart because of compression of the vena cava and portal veins. This leads to decreased cardiac output, decreased arterial blood pressure, myocardial ischemia.
    • Due to reduced perfusion of the stomach wall, the stomach may become ischemic and it is predisposed to necrosis and perforation.
    • Pressure on the diaphragm leads to decreased ventilation. The reduced cardiac output contributes to decreased lung perfusion, leading to general tissue hypoxia.
    • Cardiovascular shock may also be caused by endotoxemia as the bacterial imbalance (dysbiosis) occurs. In particular, Clostridium overgrowth.

Timecourse

  • Likely fairly rapid - hours for the event to cause volvulus.
  • Once the stomach is torsed, clinical progression is rapid.

Epidemiology

  • No age, sex, breed, or genetic link has been found for this.
  • This is an individual problem.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • DeCubellis J & Graham J (2013) Gastrointestinal disase in guinea pigs and rabbits. Vet Clin North Am Exot Anim Pract 16 (2), 425-435 PubMed.
  • Lee K J, Johnson W D & Lang C M (1977) Acute gastric dilatation associated with gastric volvulus in the guinea pig. Lab Anim Sci 27 (5 Pt 1) 685-686 PubMed.
  • Dudley E S et al (2011) Gastric volvulus in ginea pigs: comparison with other species. J Am Assoc Lab Anim Sci 50 (4) 526-530 PubMed.

Other sources of information

  • Pignon C (2013) Gastric Dilatation and Volvulus. In: Clinical Veterinary Advisor Birds and Exotic Pets. Eds: Mayer J & Donnelly T M. Elsevier. pp 258-259.


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