Acid-base problems in 100 dogs with stomach twisting (GDV)

Abstract

OBJECTIVE: To describe traditional and semiquantitative acid-base analyses of dogs with gastric dilatation-volvulus (GDV) presenting to an emergency department. DESIGN: Retrospective study. SETTING: University teaching hospital. ANIMALS: One hundred client-owned dogs with a diagnosis of GDV between 2003 and 2018. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Dogs were included if a diagnosis of GDV was confirmed by abdominal radiographs or surgical visualization, and measurement of venous blood gas, electrolyte, and plasma lactate concentration was performed within 1 h of presentation. Traditional acid-base analysis was normal in 37% of dogs. A mixed disorder of concurrent respiratory and metabolic acidosis (22%) was the most common disorder identified, and primary metabolic acidosis occurred in 13% of animals. Hyperlactatemia was evident in 89% of all dogs, while an increased anion gap was present in only 8%. All 54 dogs included in the semiquantitative analysis had one or more abnormalities identified. The predominant acidotic processes identified were associated with hyperlactatemia (87%), unmeasured anions (50%), and hyperchloremia (28%). Alkalotic processes included hypoalbuminemia (59%) and contraction alkalosis (39%). CONCLUSIONS: Dogs with GDV with venous blood work evaluated within 1 h of presentation have a variable acid-base balance, and traditional acid-base analysis was frequently normal. The anion gap did not reliably indicate the presence of hyperlactatemia. Semiquantitative acid-base analysis revealed that most dogs had multiple coexisting alkalotic and acidotic acid-base processes. Given the variability of acid-base balance in dogs with GDV, assessing each patient individually is essential.