Current evidence supporting simultaneous prophylactic gastropexy in canine patients undergoing complete splenectomy

Olivia Harris

doi:10.18849/ve.v6i4.443

Abstract

PICO question In dogs that have undergone a complete splenectomy, does performing a concurrent gastropexy decrease the risk of future gastric dilatation-volvulus (GDV) development when compared to not performing a concurrent gastropexy?  Clinical bottom line Category of research question Risk The number and type of study designs reviewed Five papers were critically reviewed which included one retrospective case series, one retrospective case-control study, and three combined retrospective cohort and cross-sectional survey studies Strength of evidence Weak Outcomes reported In dogs that have had a complete splenectomy, there is no conclusive evidence that prophylactic gastropexy decreases the risk of lifetime GDV development Conclusion Based on the limited information available, it is difficult to conclude if prophylactic gastropexy should be recommended routinely at the time of complete splenectomy  How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. 

Highlights

Medical records of dogs were reviewed for patient history and follow-up information
There was no significant difference in incidence of Gastric dilatation-volvulus (GDV) between the splenectomy and control groups
Gastric dilatation-volvulus (GDV) is a life-threatening condition in which the stomach dilates and rotates on its mesenteric axis. While this disease process is more commonly recognised in large- to giant-breed dogs, a study performed by Maki et al (2017) revealed that GDV development is a documented post-surgical complication in some patients that have undergone a splenectomy

Summary

Summary of the evidence

Population: Dogs that underwent exploratory laparotomy with suspected primary splenic torsion (PST) between August 1992 and May 2014 at seven referral hospitals. The percentage of dogs surviving to hospital discharge. The proportion of dogs undergoing splenectomy for PST that develop GDV in later life. Of the 64 dogs that follow-up information was available, 49 (77%) had a concurrent gastropexy at the time of splenectomy. In the dogs that had a concurrent gastropexy (49 dogs), one dog (2%) developed GDV 3 years after surgery. In the dogs that did not have a concurrent gastropexy (15 dogs), one dog (2%) developed GDV 4 months after surgery. The percentages of dogs with and without gastropexy that developed GDV were not significantly different.

Limitations:

Findings

Methodology Section