Last week, Surgery Expert Aidan McAlinden explained the extremely serious and life-threatening condition of Gastric Dilatation and Volvulus (GDV), also known as ‘Bloat’. This week he tackles two commonly asked questions by those who have at risk breeds. “What is tummy tacking and should my dog have this done?”.
The correct term for tummy tacking is gastropexy. Gastro refers to the stomach and ‘pexy’ means to surgically fix in position.
What is the purpose of the gastropexy?
In the emergency situation, the GDV patient usually has surgical exploration to de-rotate the stomach and to assess and treat any stomach wall damage. At this point, a gastropexy is always performed. By fixing the stomach in position we aim to prevent it rotating should it become dilated again in the future. This means that any future episodes of dilatation can usually be managed with a stomach tube to release all the gas without the need for the patient to have a major surgery. It can therefore simplify treatment by preventing the stomach rotating as a consequence of the dilation.
The picture below was taken at one of these surgeries. The pyloric region of the stomach has been sutured (‘stitched’) to the inside muscle layer of the body wall.
Gastropexy performed following emergency de-rotation of the stomach in a dog with Gastric Dilatation and Volvulus
Just to illustrate how valuable a procedure this can be, in one study of 68 dogs with bloat, all survived with initial medical treatment but a massive 81% of those that did NOT have a gastropexy died with 1 year due to a recurrence of GDV.
What is a prophylactic gastropexy?
Prophylactic means preventative and, as well as being performed as part of the emergency surgical management of GDV, the gastropexy can be performed electively to prevent the occurrence of GDV in at risk patients. There is no way to predict if an individual dog will suffer with this condition in the future but because of the life threatening nature of it, preventative surgery is considered to reduce the chances of a grave outcome should they succumb to it. At risk patients may still experience episodes of bloat but importantly the surgery prevents the devastating volvulus or rotation of the stomach making it less serious and simplifying management of the patient.
No surgical procedure is without some degree of risk and so you wouldn’t want to put your pet through a prophylactic gastropexy unless it was absolutely necessary.
Currently, this preventative surgical procedure is recommended in any patient that has:
1 Had an episode of simple bloat or
2. Has a close relative such as parent or sibling that has had an episode of bloat.
3. Is one of the breeds with a high risk of this condition (see previous article),
Is it a big surgery?
Nowadays some veterinary centres can offer keyhole surgery to perform the prophylactic gastropexy. These techniques have reduced operating time, post-operative discomfort and hospitalisation for the patient whilst providing the same strength of stomach fixation as with the traditional ‘open’ surgery. Given these advantages it could be considered in any patient with one or more of the risk factors listed above. It can be combined with other elective procedures such as neutering to reduce the number of anaesthetics the patient undergoes. The only disadvantage is that the procedure is not yet widely available in every veterinary practice because of the expense of the equipment and the additional training required. Therefore referral to a specialist veterinary surgeon may be needed.
So, a prophylactic gastropexy or tummy tack can be a life saving procedure but it is only considered in dogs that are judged to have a high risk of developing a GDV.