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A gastrotomy is a surgical procedure in which the stomach is opened up. It is done fairly routinely, usually in an emergency situation, to remove foreign bodies that have become lodged inside the dog. It is necessary to surgically remove these items if they are sharp, obscure, or too large for endoscopic extraction. The procedure may also be used to relieve bloat in dogs whose stomach has rotated. A gastrotomy may be used electively to collect biopsies for diagnostic purposes or to extract growths in and on the stomach. An ACVS board-certified veterinary surgeon should perform the operation.
Before undergoing this surgical procedure, full blood work on the dog will need to be run to ensure the animal will survive being under general anesthesia. An electrocardiogram may also be run to verify the strength of the dog's heart prior to the operation. Ultrasounds may be used to locate the foreign body or mass within the stomach or gastrointestinal area. If the animal has passed all testing successfully, surgery will be booked. In the case of an emergency, it is likely surgery will be attempted either way, as the dog's survival is at stake.
To start the procedure, an abdominal incision is made. The surgeon will then explore the abdominal cavity and palpate for masses or objects. The stomach will then be opened. Pads should be placed around the opening to prevent contamination. All contents of the stomach will be removed by suction or by manual manipulation. To remove any foreign bodies, the incision may need to be enlarged. If biopsies are being taken, they can be collected with dissecting scissors. Some lodged items will need to be grabbed and pulled down through the stomach to be removed. The stomach incision should then be closed, using great care to prevent leakage. The abdominal opening can be closed using sutures or staples.
While using an ultrasound or an endoscopy can provide some diagnostic information, there are no alternative methods for removing objects or masses in the stomach other than a gastrotomy. In emergency situations, there often is not time for many diagnostic measures and surgery may be attempted as soon as possible. This surgery is a permanent solution for removing lodged items but it cannot prevent the regrowth of cancerous tumors. Unless a gastrotomy is being used for diagnosing gastrointestinal issues, it generally is the only option in emergency interventions for bloat and foreign body removal.
After the surgery has been performed, the dog should be closely monitored for vomiting, as this may indicate that tissue is obstructing the digestive tract or that more foreign items are present. If the dog consumed a harmful substance or metal, a severe decline may be noted after the operation due to toxic effects of the item. If this is seen, chelation therapy may be used to remove metal particles.
Pain medication will be administered for several days post-surgery. A bland diet will be given to the dog for up to two days after the procedure, with a gradual return to normal food. Activity should be greatly reduced during the healing process. The incision site should be regularly checked for signs of infection. A follow-up appointment will be needed two weeks after the surgery has been completed.
The cost of a gastrotomy can range from $800 up to $7,000. This is because the procedure is often paired with other surgeries and usually performed in an emergency situation. Diagnostic imaging is often needed prior to surgery and many medications may be prescribed following the operation. In most cases, there is no alternate form of treatment other than opening up the stomach.
Gastrotomy is performed regularly enough that complications from the procedure are rare. If the dog has an underlying disease such as cancer, the surgery may be more dangerous. Most of the issues associated with this surgery stem from bad reactions to the general anesthetic. Because of the high amount of blood that goes to the stomach, it generally heals well. While surgery does carry risks, there are often no alternatives to remove masses, air, or foreign bodies from a dog's stomach.
The best way to prevent items from getting stuck in your dog's digestive tract is to never allow your dog to chew on things unsupervised. Sticks can splinter and should not be given to dogs. Once a toy begins to break it should be immediately discarded. Check toys regularly to ensure they are intact and do not leave your dog unattended with them.
Dogs who are deep chested and large in size are prone to bloat and gastric torsion. If you have a high-risk breed, do not allow it to run before or after eating meals. Promote slow eating and provide small meals multiple times throughout the day. A surgical procedure in which the stomach is tacked to the abdominal wall, called a gastropexy, can be performed as a preventative measure to secure the stomach in susceptible breeds.
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Our standard poodle – Mila – ate a cooked corncob at 9:30pm Friday night. It’s unclear if she ate it whole or chewed it up a little. This morning at 8am she vomited up her food she had eaten post corncob the night before. We took her to the vet, xrays showed possible obstruction and they immediately proposed gastrotomy and/or entereotomy if needed (approx $4000-$5500 they said). We are now 8 hours from then and she is at home, she is a little more lethargic than normal and is bloated, but otherwise pretty much the same continues to drink and has vomited only once more (and that was after she drunk a lot more water – which is fairly standard for her). What do you think the warning signs would be for needing surgery and would we have enough time to drive to you if this was necessary?
May 26, 2018
Typical warning signs would be vomiting after eating (you’ve seen that already), abdominal pain, straining to defecate, increased respiratory rate, increased heart rate, restlessness among other symptoms as not all cases present the same way. I would return to your Veterinarian for another x-ray to see if there has been any movement of the obstruction, if not, I would recommend the surgery to have the obstruction removed. Regards Dr Callum Turner DVM
May 27, 2018
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