Gastroduodenostomy in Cats

A gastroduodenostomy is performed by your veterinarian to create a surgical connection between your cat's stomach and the first portion of the small intestine which is called the duodenum. This procedure may be required if stomach cancer, peptic ulcers, or other gastric obstruction occurs preventing stomach contents from entering the duodenum through the normal channel. The connection may also need to be created if the pyloric valve between the stomach and the duodenum is not functioning correctly or if a gastrectomy has been performed in which the portion of the stomach adjacent to the tract leading to the small intestine is removed and a new route for gastrointestinal contents to pass to the small intestine needs to be connected. It is also known as a Billroth I procedure. This surgical procedure is performed under general anesthetic by a qualified veterinary surgeon.

The requirement for this procedure may be ascertained during exploratory surgery or as a result of endoscopy when a tube with a camera and light is passed into the digestive system through the esophagus to view the gastrointestinal structures and any disorders that exist.

If gastroduodenostomy is required, your cat may be given antibiotics prior to surgery and will be administered intravenous fluids during and after the procedure. Your cat will be required to fast several hours before surgery. Prior to surgery, a physical examination will be performed to ensure the cat is fit for surgery and not at risk for undue complications. A sedative, intravenous anesthetic, and gaseous anesthetic via an esophageal tube will be administered. Your cat's abdomen will be shaved and cleaned antiseptically. Surgical drapes to ensure a sterile site will be used. 

An incision will be made in your cat's abdomen and tissue manipulated to provide an unobstructed view of the stomach and duodenum. If a gastrectomy is being performed, a portion of the stomach will be removed. Gastric veins and arteries will be tied off as well as blood supply to the duodenum. Diseased tissue is removed as required and an incision will then be made in the remaining stomach and duodenum and a connection, anastomosis, established and sutured or stapled to join the stomach and the upper part of the small intestine. Before closing the abdominal cavity the anastomosis will be observed to ensure leakage and hemorrhage is not occurring. 

Postoperative hospitalization for 24 to 48 hours is required for veterinary observation and provision of supportive care through the administration of intravenous fluids, painkillers, and antibiotics.

When cancerous tumors are the source of obstruction, this procedure is not favored as there is a strong chance of tumor recurrence at the surgical site. If possible, peptic ulcers are treated with medication prior to surgical intervention. For benign obstructions, a gastroduodenostomy is the preferred method as it leaves the most natural tissue intact including allowing pancreatic and biliary functions to remain largely unaffected. The procedure results in fewer complications and surgical alteration then the alternative gastrojejunostomy, (Billroth II), in which the stomach is joined to a lower loop of the small intestine.

Post-operatively, cage rest, an E-collar to prevent interference with abdominal incision, painkillers, antibiotics, and IV fluids will be required. Medication prescribed by your veterinarian should be administered after hospitalization as instructed. Your cat should have limited activity for at least two weeks post surgery and a modified diet to reduce gastrointestinal distress will be recommended by your veterinarian. Monitor your cat's incision for signs of hemorrhage or infection. Observe your cat’s food intake and elimination, energy level, and body temperature. If any concerns arise, address with your veterinarian immediately. Your veterinarian will schedule a follow-up appointment to remove sutures or staples as necessary and examine your cat post-operatively.

This procedure, including tests, anesthetic, surgery and postoperative care and medication ranges from $1,000 to $3,000 depending on your location and the medical condition of your cat. Medication for cancer treatment may be required post operatively in addition to this procedure.

General anesthetic concerns, hemorrhaging, and risk of infection exist for this surgical procedure as with any surgical procedure. Specific risks associated with gastroduodenostomy in cats are:

• Reflux resulting in vomiting
• Hypoglycemia
• Malabsorption of nutrients
• Abdominal pain and gastrointestinal symptoms after a meal (dumping syndrome)

Discuss these concerns with your veterinarian, and what means can be taken to address these conditions if they occur.

Address any gastrointestinal concerns you observe in your cat with your veterinarian so intervention and medical treatment can be established at an early stage. Ensuring your cat has a healthy, appropriate diet and exercise will reduce the incidence of your pet requiring gastrointestinal surgery.