Comparison of Surgically Treated Large Versus Small Intestinal Volvulus (2009–2014)

Abstract

The purpose of this retrospective study was to compare the outcome for dogs with surgically treated large versus small intestinal volvulus between October 2009 and February 2014. A total of 15 dogs met the inclusion criteria and underwent an abdominal exploratory. Nine dogs were diagnosed with large intestinal volvulus during the study period, and all nine had surgical correction for large intestinal volvulus. All dogs were discharged from the hospital. Of the seven dogs available for phone follow-up (74 to 955 days postoperatively), all seven were alive and doing well. Six dogs were diagnosed with small intestinal volvulus during the study period. One of the six survived to hospital discharge. Three of the six were euthanized at the time of surgery due to an extensive amount of necrotic bowel. Of the three who were not, one died postoperatively the same day, one died 3 days later, and one dog survived for greater than 730 days. Results concluded that the outcome in dogs with surgically corrected large intestinal volvulus is excellent, compared with a poor outcome in dogs with small intestinal volvulus. The overall survival to discharge for large intestinal volvulus was 100%, versus 16% for small intestinal volvulus.

Colonic or ileocecocolic volvulus in 13 dogs (2005‐2016)

“…The demographics of our population confirm that of earlier reports, as most dogs were adult, male, large‐breed dogs. Compiling all previously reported cases and present study, German Shepherds were overrepresented (15/43), Labrador Retrievers were represented 10 times, Great Danes 8 times, Collies and Bull Mastiffs twice; Irish Water Spaniel, German Shorthaired Pointer, Siberian Husky mixed‐breed, Vizsla, Cane Corso, and Russian Terrier were reported once. Our data support a possible breed predisposition for large‐breed dogs in general and especially for German Shepherds, Labrador Retrievers, and Great Danes, which is consistent with the literature .…”

“…The acute onset of clinical signs in our case series confirms previous publications, reporting a duration of signs ranging from 2 to 24 hours, with 1 dog being depressed for 4 days with 2 days of vomiting. However, the history of dogs was not always thoroughly recorded in these reports . Clinical signs were also similar in our patients, consisting of listlessness, vomiting, inappetence, abdominal distension or pain, diarrhea, tenesmus, and restlessness lasting from 10 minutes to 24 hours, except for dog 7 (48 hours) and dog 3 (72 hours).…”

“…Intestinal torsion describes the twisting of an intestinal segment around its long axis, while intestinal or mesenteric volvulus describes a rotation of a section of bowel around its mesenteric axis . The literature recognizes either torsion of the colon or cecal‐colic volvulus, but recent reports and surgical textbooks frequently use the terms volvulus and torsion interchangeably, irrespective of the location and type of twisting . The distinction between these terms and associated conditions therefore remains unclear.…”

“…Torsion or volvulus of the large intestine has been infrequently reported in small animals, with evidence limited to reports in 30 dogs and 1 cat . Previous authors reported clinical signs including depression, vomiting, abdominal distension, tenesmus and diarrhea, and radiographic evidence of nonspecific marked intestinal dilatation .…”

“…Prompt diagnosis and immediate surgical intervention are justified by the risk of vascular compromise, rapid build‐up and absorption of toxins, necrosis of the affected intestinal wall, and resulting peritonitis . Of the 30 published cases, 1 dog was euthanatized preoperatively, and 25 of the remaining dogs survived until discharge . The viability of the intestine was questioned at the time of surgery due to discoloration and/or changes in regional arterial pulsation in 4 cases that died perioperatively, 3 of those warranting intestinal resection and anastomosis .…”