This dog has a gastric dilation/volvulus (GDV) and, based on the lactate level, he has a good prognosis for survival with surgery.
Plasma lactate concentration is the most important prognostic indicator in dogs with GDV. Dogs with a lactate < 6 mmol/L on presentation have a 99% survival rate with surgery. A lactate > 7.4 mmol/L at presentation predicts gastric necrosis and decreasing prognosis with high accuracy.
However, comparing pre- and post-treatment lactate levels may be more predictive of survival than an initial one-time lactate measurement. A 50% or greater reduction in lactate within 12 hours of presentation carries an improved prognosis.
GDV is an acute enlargement and rotation of the stomach, mostly seen in large- and giant-breed dogs. The enlarged stomach compresses the caudal vena cava, leading to hypovolemia; pushes on the diaphragm, causing respiratory dysfunction; and puts pressure on GI contents, leading to bacterial translocation and endotoxemia.
Lactate increases secondary to systemic hypotension, inflammation, and tissue necrosis.
Diagnosis relies on clinical findings plus abdominal radiographs, in which the gas-filled pylorus cranial and dorsal to the fundus of the stomach creates the classic « double bubble » sign.
Click here to see a good summary on GDV with images, courtesy of the American College of Veterinary Surgeons (ACVS).
Image courtesy of Joel Mills.
