Gastric dilatation-volvulus: decompression by tube or trocar
6-year-old Great Dane with unproductive retching and a distended, tympanic cranial abdomen for 2 hours. He is tachycardic with weak pulses. Catheters are already in both cephalic veins and fluids are running. An orogastric tube is gently attempted but will not advance into the stomach.
What do you do now?
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A. Push the tube harder until the resistance is overcome
Forcing the tube can perforate the distal oesophagus or cardia, which are already compromised by the volvulus.
B. Give metoclopramide and wait for the stomach to empty
With the stomach rotated, emptying is mechanically impossible; distension also compresses the caudal vena cava and worsens shock.
C. Trocarise the stomach with a large-bore catheter at the point of maximum tympany, checking that the spleen is not in the way, and then retry the tube
Correct. Percutaneous trocarisation, with aseptic preparation and ideally ultrasound guidance, decompresses quickly and often allows the tube to be passed afterwards. It improves venous return and ventilation before anaesthesia.
D. Induce anaesthesia immediately and operate without decompressing to save time
Inducing with a distended stomach increases the risk of severe hypotension and hypoventilation. Prior decompression and resuscitation greatly improve anaesthetic stability.
lightbulb Key takeaway
In GDV, place catheters in the forelimbs (distension compresses the caudal vena cava), resuscitate with fluids, give opioid analgesia and decompress by tube or trocar. Decompression does not correct the volvulus: GDV is always surgical.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.