GASTROENTEROLOGI VETERINER :

DILATASI GASTRIUM KOMPLEKS

PADA ANJING

Oleh :
GUSTAF EIFEL SILALAHI
PUTU SUANDHIKA

MAGISTER SAINS VERTERINER

UNIVERSITAS GADJAH MADA YOGYAKARTA
 Dilatasi
 Gastrium : lambung
 Kompleks -> komplikasi

Gastric
Dilatation Kembung/Bloat
Volvulus (GDV)
PERMASALAHAN YANG BERKAITAN DENGAN
DILATASI LAMBUNG
 Akumulasi gas
 Memakan benda asing
 Volvulus/Tortio
GASTRIC DILATATION, AS THE CONDITION
GETS WORSE, THEY MAY:
 Collapse
 Have pale gums
 Have a rapid heartbeat
 Be short of breath
 Feel weak
GASTRIC DILATATION
VOLVULUS
 Lambung mengembang berisi gas dan
terpuntir
 Gastric Dilatation Volvulus (GDV) merupakan syndrom akut dan
berpotensi menyebabkan kematian yang terutama mempengaruhi
anjing ras besar.
 GDV biasanya juga disebut sebagai penyakit kembung atau bloat.
 Penyakit ini dapat menyebabkan perubahan patologis yang fatal
pada berbagai sistem organ. GDV memiliki persentase kejadian
pada masing-masing ras besar dan raksasa adalah 24% dan 21%
dari masa hidupnya.

EMERGENCY
!!!
ETIOLOGI

3, makan cepat
2; deep chested, long dan banyak,
chests -> more space ukuran besar,
dogfood
mengembang di
lambung

1; predisposisi: giant
dog

4; gelisah, stres, sesak nafas,

shock
THE CAUSES OF DOG BLOAT
Short term causes of bloat;
 Stress. Some dogs become stressed around feeding time,
especially when there are multiple pets at home.
 Quick eating -> accidentally consume an excess of air
while they eat -> increased bloating.
 Limited eating -> makan 1x sehari dalam jumlah banyak
 Over-exercising around meal time
 Drinking lots of water while or after eating -> dapat
menyebabkan dogfood mengembang di dalam lambung
 THE CAUSES OF DOG BLOAT
Long term causes of bloat
 Old age. Aging causes increased weakness and less ability
for a dog’s body to hold organs in place.
 Genetics. Dogs with older relatives who bloated are more
likely to bloat.
 Gender. Male dogs are more likely to experience bloating
due to their naturally bigger size than females. Bloat is not
caused by neutering.
PATOFISIOLOGI
DIAGNOSIS

 Gejala klinis
 X-ray -> to confirm the
twisted stomach.
 Blood test
 EKG
 GDV has a characteristic
appearance (“double bubble”
or “Popeye’s arm”) on
radiographs (compare Figures
1 and 2).
KOMPLIKASI
 Lambung besar -> tekanan tinggi -> sesak
 Pengurangan darah pada lambung
menyebabkan jaringan akan kekurangan
darah dan oksigen, jika tidak segera
ditangani akan menyebabkan dinding
lambung ruptur
KOMPLIKASI
 Supply darah ke jantung turun
 Cardiovaskular colapse
 Peritonitis
 When a dog’s stomach experiences distension,
it puts pressure on other arteries and restricts
blood flow.
 Blood supply can cut off completely, leading to
tissue death in the stomach and a buildup of
toxic elements.
 If it ruptures, pets become septic.
 When an organ like the pancreas does not
receive blood, very dangerous toxins can
accumulate in the dog’s body.
TERAPI DAN PENANGANAN GDV
 Tujuan terapi bedah GDV meliputi tindakan pengurangan gejala.
 Stabilisasi pasien -> treatment shock
 A fluid drip - dogs with a GDV tend to go into shock and develop dangerously
low blood pressure, a fluid drip helps to keep blood pressure up.
 Koreksi malposisi lambung
 Attempts to reduce bloat -> release some of the gas from the dog’s
stomach before operation
 Gastrotomy, gastrectomy, gastropexy
 also check the dog’s spleen because it sits very close to the stomach and can
get caught in the twist. The spleen may need to be removed if it’s been
badly damaged.
 Pasca operasi
  Sebelum melakukan sedasi, anjing dengan GDV sebaiknya
distabilkan terlebih dahulu kondisi tubuhnya dengan pemberian
cairan secara intravena (IV).

Kondisi pasien MAP/SAP Infus cairan

Hipovolemia, hipotensi < 60 mmHG/90 mmHG Isotonik kristaloid (RL) 50-90 mL kg

IV. dopamine atau norepinephrine

Tanpa dehidrasi < 60 mmHG/90 mmHG Isotonik kristaloid (RL) diberikan 20

mL kg IV.

Pasien dalam kondisi kritis - hypertonic saline solution 5% (6-10

mL kg) atau 7.5% (4-8 mL kg) dapat
diberikan 1 mL kg min IV
GASTROPEXY
 Gastropexy bertujuan untuk mencegah terulangnya GDV. Tujuan
gastropexy yaitu untuk menciptakan adhesi permanen antara
antrum pylorus dan dinding perut sebelah kanan.
 Penentuan teknik gastropexy paling penting untuk mengevaluasi
kekuatan gastropexy
 Incisional (muscular flap)-G, Tube-G, Circumcostal-G, Belt-loop-
G, Incorporating-G, Laparoscopic-G.
PERAWATAN PASCA OPERASI GDV
Terapi cairan dan analgesik dilanjutkan paling sedikit 24 jam pertama pasca
operasi, dan kemudian sesuai situasi klinis

Air umumnya diberikan dalam waktu 12 jam dan jumlahnya sedikit,

makanan yang lembut dan rendah lemak dapat segera diberikan jika tidak
terjadi muntah

Metoclopramide (0,25-0,5 mg/kg IV atau subkutan 1-4 kali sehari, atau 1-2
mg/kg/hari) pasca operasi untuk meningkatkan motilitas lambung.

Anjing dipantau mengenai status aritmia jantung dan tanda-tanda klinis

peritonitis sekunder akibat perforasi lambung dan dapat diobati dengan
tepat jika dibutuhkan
PERAWATAN PASCA OPERASI GDV
 Blood electrolyte levels are monitored and corrected when
abnormal
 Abnormal cardiac rhythms are very common after GDV
surgery
 Once home, strict exercise restriction is required to allow
the incisions time to heal appropriately.
 Additionally, small, frequent meals are recommended to
decrease the stress on the stomach in the immediate post-
operative period.
POTENTIAL COMPLICATIONS POST
OPERATION

 If parts of the stomach were dead at the time of surgery,

and required resection, there is a potential for stomach
contents to leak into the abdominal cavity and cause a
condition called septic peritonitis.
 Septic peritonitis is a dangerous, and life threatening
complication.
PROGNOSIS POST SURGERY
 If surgery was uncomplicated (the GDV was
caught early, surgery was performed quickly, and
all of the stomach tissue was healthy), prognosis
for survival is good.
 If surgery was complicated (stomach tissue was
dead and required resection), prognosis for
survival is poor, and the dog may not survive.
exchange ideas.