Death three days post op...

Re: Death three days post op...

emvn80 — Thu, 04 Feb 2010 16:21:15 GMT

Arrythymias (mainly ventricular- VPCs or V-tach are very common in the post-op period and a common cause of death around that time frame. Def worth doing ECGs if you can, or at kleast feeling peripheral pulses and checking for pulse deficits.

other causes could have been peritonitis and sepsis as already said.

Increased lactate indicates poor perfusion and if not corrected causes acidosis and death but the patient would probably deteriorate and die as the perfusion decreases and acidosis worsens noot get better then die.

The causes of arrhythmias after GDVs are unknown but is likely to be due to poor perfusion, either to the heart causing myocadial damage/ hypoxia or poor stomach perfusion causing toxins to be released from the necrotic tissue which once the patient is reperfused circulate in the blood, irrating the heart causing the arrythmias.

I guess you'll never know for sure but if poss def put an ECG on for at least 24-48 hours (at least intermittantly) and have lidocaine to hand to treat them if nec!

Re: Death three days post op...

Jo Mackenzie — Tue, 02 Feb 2010 15:45:04 GMT

[quote user="Doolally"]This was attributed to the fact that as the stomach twists,the greater the deprivation of oxygen supply to the tissues and the more extensive the necrosis of the stomach wall becomes....It should be appreciated that, for these dogs with GDV, the peak plasma lactace concentration may not occur at first admission'[/quote]

That's interesting, the vet operating did say that there was a lot of necrosis of the stomach wall.

Re: Death three days post op...

Doolally — Tue, 02 Feb 2010 13:58:10 GMT

[quote user="Caro Laithwaite"]

If the patient had a high lactic acid count over l think it is 7 (but you need to check that as l am tired) then it is said that the outcome is negative. So it could well be that was the base problem

[/quote]

I was thinking something about lactate too....Just dug out an old copy of VNT cpd mag -

'a strong association between plasma lactate concentration and outcome/survival for dogs with GDV has been reported'

'The higher the peak lactate value the less likely the dog was to survive. This was attributed to the fact that as the stomach twists,the greater the deprivation of oxygen supply to the tissues and the more extensive the necrosis of the stomach wall becomes....It should be appreciated that, for these dogs with GDV, the peak plasma lactace concentration may not occur at first admission'

'Whatever the underlying cause, if the plasma lactace concentration remains above 10mmol/L, despite aggressive and appropriate treatment the prognosis is hopeless'

'...most staff in veterinary practice will be familiar with dogs that, following "heroic GDV surgery", slowly deteriorate towards death'

So, if the lactace level is too high in a case of GDV surgery won't help, as the damage is already done

Re: Death three days post op...

ginny — Tue, 02 Feb 2010 09:59:30 GMT

I have only seen one collapse and die in front of me in the manner you describe and it was so stressful ive never forgotten it! It was an 8yr old doberman bitch, she was under treatment for arrhythmias. Wagging stump, eating happily then flopped down and died.

Re: Death three days post op...

Caro Laithwaite VN — Mon, 01 Feb 2010 17:53:10 GMT

well all l can say is that l disaree with 3 days and that is from very firsthand exp.

Re: Death three days post op...

Claire Cameron — Mon, 01 Feb 2010 17:23:41 GMT

[quote user="Nick Shackleton"]

[quote user="daisy"]

i was always told death a few days post op is very common and usually due to DIC, we always monitored for this with regular full blood tests.

[/quote]

nickname of Death Is Coming!!! Am sure they were having when they were thinking up names for conditions!

[/quote]

Yup! Not nice

Re: Death three days post op...

Sal the 1st — Mon, 01 Feb 2010 17:14:53 GMT

- yes have heard of Death Is Coming and also Dog In Cooler

Re: Death three days post op...

Nick Shackleton — Mon, 01 Feb 2010 17:09:59 GMT

[quote user="daisy"]

i was always told death a few days post op is very common and usually due to DIC, we always monitored for this with regular full blood tests.

[/quote]

nickname of Death Is Coming!!! Am sure they were having when they were thinking up names for conditions!

Re: Death three days post op...

daisy — Mon, 01 Feb 2010 16:17:31 GMT

i was always told death a few days post op is very common and usually due to DIC, we always monitored for this with regular full blood tests.

Re: Death three days post op...

Cat Woman — Sat, 30 Jan 2010 12:57:10 GMT

Peritonitis?

Re: Death three days post op...

Caro Laithwaite VN — Sat, 30 Jan 2010 08:29:48 GMT

If the patient had a high lactic acid count over l think it is 7 (but you need to check that as l am tired) then it is said that the outcome is negative. So it could well be that was the base problem.

As to that l disagree with the comment of them being common to die at 3days. (Pvt message sent)

Re: Death three days post op...

Sal the 1st — Fri, 29 Jan 2010 19:01:34 GMT

endotoxic shock?

Re: Death three days post op...

Nick Shackleton — Fri, 29 Jan 2010 18:27:32 GMT

check this document for details of arrhythmias that can occur:

http://www.vetnurse.co.uk/wikis/veterinary-nurse/ventricular-arrhythmia-assoc-with-gdv.aspx

Re: Death three days post op...

Nick Shackleton — Fri, 29 Jan 2010 18:20:46 GMT

GDV surgery is not always successful. Potential complications include the following:

Arrhythmias (irregular heartbeat) due to the decreased blood flow back to the heart
Belching
Death
Disseminated intravascular coagulation (DIC), a blood clotting disorder that leads to diffuse bleeding, pain, and seizures
Intermittent vomiting
Postoperative gastric ulceration, open sores on the mucous membrane of the stomach caused by accumulated gastric juices (Gastric ulcers may occur—usually within 5 to 7 days following surgery—and may rupture, causing septic peritonitis, an infection and inflammation of the peritoneum, the membrane that lines the abdomen.)
Recurrence of gastric dilatation

Re: Death three days post op...

Kathryn Welsh — Fri, 29 Jan 2010 18:18:43 GMT

We had a GDV on a GSD Weds night - currently doing ok ish, but it is only 5months since her spleenectomy and been on chemo since then - fingers crossed for her. Sadly the 3day ditch is common x x x x

Re: Death three days post op...

Vicky RVN — Fri, 29 Jan 2010 18:10:58 GMT

So sorry to hear that Thankfully i've only seen 2 GDV's so far (a great dane and a flat coat), both were ok.