A Tale of Two Torsions

A Tale of Two Torsions

    A few weeks ago, Patton Veterinary Hospital treated two different patients with twists in their gastrointestinal tracts.  One was a Great Dane who was very lethargic, vomiting and not eating.  A large amount of gas was visible in the intestinal tract on x-ray.  Dr. Spencer and I suspected she had a foreign object in her intestine, so she was admitted to the hospital and taken to surgery.  On inspection of the bowel, I found no foreign object, but there was a huge, dilated, dark red gas filled colon and the colon was displaced to the right side of the abdomen instead of hanging out on the left where it is supposed to be (the abnormal colon is shown in the picture above). The stomach and small bowel were pink and healthy.  It was discovered that the tissues and blood vessels that support the colon had somehow become twisted and the blood supply was temporarily cut off.  Once the colon was moved back to the normal position, the color improved though it remained very “flabby” and dilated.  A small hole was made in the colon to release the trapped gas (that made for one smelly surgery suite!) and to remove a small piece of tissue to send to the lab to make sure the condition was not caused by cancer.  The colon was then sutured or “pexied” to the left body wall so that it could not twist or migrate again.  Luckily, minimal damage occurred to the colon, and the patient recovered well.  Colonic torsion is thankfully relatively rare.

                That same week, a Golden Retriever was admitted for late night emergency surgery to correct the more common gastric (stomach) dilatation and volvulus more commonly referred to as “bloat.”  This patient had eaten a large amount of dog food then started to act very uncomfortable and began retching without actually vomiting.  X-rays showed a large gas-filled stomach and gas-filled intestines.  Though the patient was relatively stable, he needed immediate surgery.  Due to the owner’s quick response in bringing their dog to our hospital, this case had a very happy outcome.  The stomach was dark red and distended with gas when the abdomen was opened but, after passing a tube down the esophagus to remove the air from the stomach, Dr. Edwards was able to untwist the stomach and it almost immediately became pink again.  Just as with the colon, the stomach was “pexied” to the body wall so it could not twist again. 

                These two pets were extremely lucky.  Many cases of bloat do not end so well.  Severe damage and death to the tissue occur frequently and recovery can be fraught with complications especially if dead bowel needs to be resected.  If your dog is retching or gagging without producing any vomit, has a visibly distended abdomen, and is painful or cannot lie down, please bring him to see us or contact the local emergency clinic immediately.  Bloat is a life-threatening condition!

                For large or giant breed dogs at high risk such as Great Danes, German Shepherds, and other deep-chested breeds, Patton Veterinary Hospital offers prophylactic gastropexy or “stomach tacking” which is typically done in young patients at the same time they are being spayed or neutered.  If you have an at risk breed, please talk to our staff or doctors about this procedure.