Preoperative and Antemortem Radiographic Findings in Dogs with 360 Degrees Gastric Dilatation and Volvulus.
Gastric dilatation and volvulus (GDV) is a life-threatening emergency that requires urgent intervention. 360-GDV has been rarely reported in veterinary medicine and to the authors knowledge studies describing the radiographic features of 360-GDV are lacking. Studies reporting and agreement and accuracy of radiologists describing pyloric position in the canine abdomen are not available in veterinary medicine. The aim of this project is to report agreement rates between radiologists and sensitivity and specificity of radiographs to diagnose 360-GDV. Radiographic features and clinical variables associated with 360-GDV are also reported. Confirmed 360-GDV cases were retrieved, and the radiographic findings were compared to dogs presenting with gastric dilatation (GD) and 180-GDV. Images were reviewed and graded by three blinded board-certified radiologists. A total of 16 dogs with confirmed 360-GDV were identified (surgically confirmed n=12; necropsy confirmed n = 4). The median age was 10 years old (2 -11 years). Mean weight was 41.59 kg (SD +/- 11.8). 28 GD and 37 180-GDV were included for comparison. The sensitivity for detection of 360-GDV ranged between 43.7% and 50% and the specificity between 84.6% and 92.1%. Interobserver agreement on final diagnosis was substantial (Kappa = 0.623; 0.487 -0.760, 95% CI). The highest agreement rate was in cases of 180-GDV (87%) followed by the GD cases (72%) and 360-GDV (46%). Esophageal gas distension and lack of small intestinal dilation were the only radiographic features associated with 360-GDV. Similar pyloric position was found between GD and 360-GDV. Additional radiographic variables that could help differentiate GD from 360-GDV include degree of gastric distension and the peritoneal serosal contrast. Two cases with 360-GDV were misdiagnosed by the three radiologists as GD. In conclusion, radiographically 360-GDV cases can reassemble GD and vice versa. Radiologists and clinicians should be aware of the low sensitivity of radiographs for detection of 360-GDV.