Mortality and morbidity due to gastric dilatation-volvulus syndrome in pedigree dogs in the UK

Objectives : To estimate breed-specific risk of death due to, and prevalence of, gastric dilatation-volvulus (GDV) in UK pedigree dogs. Methods : Data were available on the reported cause of and age at death and occurrence of and age at diagnosis of disease from the 2004 purebred dog health survey. A total of 15,881 dogs of 165 breeds had died in the previous 10 years; GDV was the cause of death in 65 breeds. There were 36,006 live dogs of 169 breeds of which 48 breeds had experienced ≥1 episodes of GDV. Prevalence ratios were used to estimate breed-specific GDV mortality and morbidity risks. Results : Gastric dilatation-volvulus was the cause of death for 389 dogs, representing 2.5% (95% CI: 2.2-2.7) of all deaths reported and the median age at death was 7.92 years. There were 253 episodes in 238 live dogs. The median age at first diagnosis was five years. Breeds at greatest risk of GDV mortality were the bloodhound, Grand Bleu de Gascogne, German longhaired pointer and Neapolitan mastiff. Breeds at greatest risk of GDV morbidity were the Grand Bleu de Gascogne, bloodhound, otterhound, Irish setter and Weimaraner. Clinical Significance : These results suggest that 16 breeds, mainly large/giant, are at increased risk of morbidity/mortality due to GDV.     

Occurrence and recurrence of gastric dilatation with or without volvulus after incisional gastropexy

This study investigated recurrence of gastric dilatation without (GD) or with volvulus (GDV) after incisional gastropexy (IG) in dogs that underwent IG for prevention of GDV. Signalment, concurrent surgical procedures, presence of GD or GDV at the time of IG were obtained from medical records of dogs that underwent IG. Owners were contacted to determine whether the dogs experienced GD or GDV after IG, dates of postoperative GD or GDV episodes, survival status, date of death for deceased dogs. Gastric dilatation and GDV recurrence rates were calculated for 40 dogs that had at least 2 y follow-up from the time when IG was performed and for dogs that experienced GD or GDV during the follow-up period. No dogs experienced GDV after IG and 2 dogs (5.0%) experienced GD after IG. The results suggest that GD and GDV rates after IG may be comparable to recurrence rates after other methods of gastropexy.     

Gastric emptying of nondigestible radiopaque markers after circumcostal gastropexy in clinically normal dogs and dogs with gastric dilatation-volvulus.

Using radiopaque particles mixed with food, gastric emptying was assessed in healthy dogs not subjected to surgery, in healthy dogs 9 to 35 days after circumcostal gastropexy, and, in dogs 1 to 54 months after surgical treatment and recovery from gastric dilatation-volvulus (GDV). Circumcostal gastropexy surgery did not alter the 90% gastric emptying time for radiopaque particles in healthy dogs. However, 90% gastric emptying time was significantly (P less than 0.05) increased after circumcostal gastropexy in dogs with GDV, compared with healthy dogs after the same surgical procedure and recovery period. These results imply that dogs with GDV have delayed gastric emptying of solid particles. Whether delayed gastric emptying of markers detected in affected dogs after surgical treatment and recovery was the result or the cause of GDV was not determined. Results indicate that circumcostal gastropexy could be recommended as a prophylactic procedure for GDV in large breeds with deep thorax, because delayed gastric emptying of markers secondary to the surgical procedure is unlikely.     

Prospective evaluation of laparoscopic-assisted gastropexy in dogs susceptible to gastric dilatation

OBJECTIVE: To determine long-term outcome associated with laparoscopic-assisted gastropexy in prevention of gastric dilatation-volvulus (GDV) in susceptible dogs and to evaluate use of laparoscopy to correct GDV. DESIGN: Prospective study. ANIMALS: 25 client-owned large-breed dogs. PROCEDURE: 23 dogs susceptible to GDV were referred as candidates for elective gastropexy. These dogs had a history of treatment for gastric dilatation, clinical signs of gastric dilatation, or family members with gastric dilatation. Laparoscopic-assisted gastropexy was performed. One year after surgery, abdominal ultrasonography was performed to evaluate the attachment of the stomach to the abdominal wall. Two dogs with GDV were also treated with laparoscopic-assisted derotation of the stomach and gastropexy. RESULTS: None of the dogs developed GDV during the year after gastropexy, and all 20 dogs examined ultrasonographically had an intact attachment. Another dog was euthanatized at 11.5 months for unrelated problems. Two dogs with GDV successfully underwent laparoscopic-assisted gastropexy after the stomach was repositioned. CONCLUSIONS AND CLINICAL RELEVANCE: Laparoscopic-assisted gastropexy resulted in a persisting attachment between the stomach and abdominal wall, an absence of GDV development, and few complications. Dogs with a high probability for development of GDV should be considered candidates for minimally invasive gastropexy. Carefully selected dogs with GDV can be treated laparoscopically.     

Canine gastric dilatation-volvulus

Gastric dilatation-volvulus (GDV) is a dramatic and enigmatic disease of large and giant breed dogs characterised by the rapid accumulation of gas in the stomach. This causes gastric dilatation, twisting of the stomach about its long axis, compression of surrounding organs, hypovolaemic and cardiogenic shock, and if untreated, death. It has been estimated that the disease afflicts approximately 60,000 dogs in the USA each year with a mortality rate ranging from 7 to 60 per cent depending on accessibility to adequate veterinary care. The cause is unknown. While diet was at one time believed to be associated with the genesis of the disease, critical review of available data provides no evidence to support this hypothesis. A variety of predisposing or risk factors have been identified but none is suspected of being the cause, indeed, the disorder may have a multiple aetiology. Current thinking suggests that the final common pathway in the development of GDV may be an inhibition of gastric motility and emptying. This could come about through a primary disruption of normal gastric electrical patterns or through the effect of extraneous stressful events that disrupt gastric motility. After dilatation a series of potentially lethal events is unleashed which include compression of the caudal vena cava, pooling of blood in the microcirculation of the viscera and hindlimbs, metabolic acidosis, gastric necrosis, cardiac arrhythmias, disseminated intravascular coagulation, hypotensive and cardiogenic shock and death. Nevertheless, even advanced cases can survive if treated appropriately. If the cause could be identified logical prophylaxis might follow. Studies at the University of Florida have failed to demonstrate any effect of diet on gastric function in large breed dogs, suggesting that diet is probably not the cause of the disease. Researchers at Colorado State University also found no association with diet in clinical patients. Recent studies at the University of Florida have revealed distinct abnormalities in gastric electrical activity in GDV patients. In human patients these abnormalities, called dysrhythmias, have been associated with gastric distention, bloating, delayed emptying, nausea and retching. Unfortunately, dysrhythmias are also present, albeit to a lesser degree, in experimental GDV. These findings leave unanswered the question as to whether abnormalities in gastric motility play a role in the genesis of GDV.     

Comparison of the Recurrence Rate of Gastric Dilatation with or Without Volvulus in Dogs after Circumcostal Gastropexy Versus Gastrocolopexy

OBJECTIVE: To compare the recurrence rate of acute gastric dilatation with or without volvulus (GDV) after circumcostal gastropexy (CCGP) or gastrocolopexy (GCP) in dogs. STUDY DESIGN: A prospective, double-blind, multicenter, randomized, controlled, clinical trial with two groups (A and B). ANIMALS: Fifty-four client-owned dogs presented for treatment of GDV. METHODS: Dogs with acute GDV that had not previously had a gastropexy performed were included. The preoperative treatment before gastropexy was standardized. A CCGP was performed on dogs in group A, and a GCP was performed on dogs in group B. Postoperative treatment was standardized, but deviation did occur according to the special needs of particular patients. A minimal follow-up time of 180 days was required for dogs not excluded from the study. The median follow-up time in group A was 700 days; in group B, it was 400 days. The occurrence of abdominal pain and gastrointestinal problems after surgery were recorded by the owners. RESULTS: There was no significant difference in the recurrence rate of GDV between the two groups. At the end of the study, the recurrence rate was 9% and 20% in group A and in group B, respectively. CONCLUSIONS: Both surgical techniques are effective in preventing recurrence of GDV.     

Fundic gastropexy for prevention of recurrence of gastric volvulus

After non-surgical primary treatment (aspiration) of gastric torsion 189 dogs underwent fundupexy to prevent recurrence. The fundic surface of the stomach was subjected to diathermy spot coagulation after which the fundus was fixed in its normal position against the diaphragm using non-absorbable sutures in several rows. Of the 189 dogs operated on two died from intercurrent disease within eight days. Of the 187 dogs which were discharged from the clinic 144 (77 per cent) were available for follow-up. The median follow-up period was 31 months and 28 dogs had a follow-up of between five and eight years. Two of the dogs were destroyed within a year postoperatively because of recurring tympanism and a third dog after one-and-a-half years because of recurrent diarrhoea. The general condition was unaffected in the remaining 141 dogs.     

犬胃扩张-肠扭转的风险因子和预防

胃扩张-肠扭转(Gastric Dilatation-Volvulus--GDV)又称为"臌"、"胃扭转"。GDV是一个极其严重,并应视为严重威胁犬生命的紧急事件,是仅次于癌症导致犬死亡的第二大杀手。24%的犬臌是由胃膨胀引起的。但是大多数的情况(75%)是由于胃扭转,弯曲和切断胃内容物的流入和流出。由于胃部膨胀,可旋转90°至360°,固定附着在食道和十二指肠之间缠绕。膨胀的胃妨碍腹部静脉、减少血液返回到心脏,丧失血液供应,导致低血压、胃缺血、休克、脏器损害,要在育种,饲养和管理上加强监管,有效的降低形成和促发GDV风险因子的条件,加强对GDV风险因子的预警和识别,以及发生后的及时发现和立即处理治疗。     

Evaluation of splenectomy as a risk factor for gastric dilatation-volvulus

Objective-To evaluate whether dogs undergoing splenectomy had an increased risk of gastric dilatation-volvulus (GDV), compared with a control group of dogs undergoing enterotomy. Design-Retrospective case-control study. Animals-219 dogs that underwent splenectomy for reasons other than splenic torsion (splenectomy group; n = 172) or enterotomy (control group; 47) without concurrent gastropexy. Procedures-Medical records were reviewed for information on signalment, date of surgery, durations of surgery and anesthesia, reason for splenectomy, histopathologic findings (if applicable), whether gastropexy was performed, duration of follow-up, and date of death (if applicable). Follow-up information, including occurrence of GDV, was obtained via medical records review and a written client questionnaire. Results-Reasons for splenectomy included splenic neoplasia, nonneoplastic masses, infarction, traumatic injury, and adhesions to a gossypiboma. Incidence of GDV following surgery was not significantly different between dogs of the splenectomy (14/172 [8.1 %]) and control (3/47 [6.4%]) groups. Median time to GDV for the 17 affected dogs was 352 days (range, 12 to 2,368 days) after surgery. Among dogs that underwent splenectomy, sexually intact males had a significantly higher incidence of GDV (4/16) than did castrated males and sexually intact or spayed females (10/156). Incidence of GDV among sexually intact male dogs did not differ between groups. Conclusions and Clinical Relevance-Results did not support a recommendation for routine use of prophylactic gastropexy in dogs at the time of splenectomy. Other patient-specific risk factors should be assessed prior to recommending this procedure.     

Incidence of and breed-related risk factors for gastric dilatation-volvulus in dogs

OBJECTIVE: To compare incidence of and breed-related risk factors for gastric dilatation-volvulus (GDV) among 11 dog breeds (Akita, Bloodhound, Collie, Great Dane, Irish Setter, Irish Wolfhound, Newfoundland, Rottweiler, Saint Bernard, Standard Poodle, and Weimaraner). DESIGN: Prospective cohort study. ANIMALS: 1,914 dogs. PROCEDURE: Owners of dogs that did not have a history of GDV were recruited at dog shows, and the dog's length and height and depth and width of the thorax and abdomen were measured. Information concerning the dogs' medical history, genetic background, personality, and diet was obtained from owners, and owners were contacted by mail and telephone at approximately 1-year intervals to determine whether dogs had developed GDV or died. Incidence of GDV based on the number of dog-years at risk was calculated for each breed, and breed-related risk factors were identified. RESULTS AND CLINICAL RELEVANCE: Incidence of GDV for the 7 large (23 to 45 kg [50 to 99 lb]) and 4 giant (> 45 kg [> 99 lb]) breeds was 23 and 26 cases/1,000 dog-years at risk, respectively. Of the 105 dogs that developed GDV, 30 (28.6%) died. Incidence of GDV increased with increasing age. Cumulative incidence of GDV was 5.7% for all breeds. The only breed-specific characteristic significantly associated with a decreased incidence of GDV was an owner-perceived personality trait of happiness.     

Longevity of British breeds of dog and its relationships with sex, size, cardiovascular variables and disease

The results of a questionnaire provided data about owners' perceptions of the cause of death of over 3000 British dogs. The mean age at death (all breeds, all causes) was 11 years one month, but in dogs dying of natural causes it was 12 years eight months. Only 8 per cent of dogs lived beyond 15, and 64 per cent of dogs died of disease or were euthanased as a result of disease. Nearly 16 per cent of deaths were attributed to cancer, twice as many as to heart disease. Neutered females lived longer than males or intact females, but among dogs dying of natural causes entire females lived slightly longer. In neutered males the importance of cancer as a cause of death was similar to heart disease. Mongrels lived longer than average but several breeds lived longer than mongrels, for example, Jack Russells, miniature poodles and whippets. There was no correlation between longevity and cardiovascular parameters (heart rate, systolic, diastolic, pulse and mean arterial pressure, or the combination of heart rate and pulse pressure) but smaller dogs had longer lifespans. The results also include breed differences in lifespan, susceptibility to cancer, road accidents and behavioural problems as a cause of euthanasia.     

Significance of the Heineke-Mikulicz Pyloroplasty in the Treatment of Gastric Dilatation-Volvulus A Prospective Clinical Study

Twenty-six dogs with gastric dilatation-volvulus (GDV) were stabilized medically, followed by tube gastrostomy and gastropexy. In 13 dogs, a Heineke-Mikulicz pyloroplasty was also performed. Complications and recurrences were monitored during the immediate postoperative period and for 5 to 31 months thereafter. Barium gastrograms and contrast radiographs of the stomach were evaluated at week 1 and months 5 to 31. Significantly fewer dogs without pyloroplasty had complications during the immediate postoperative period. There were no differences in the long-term complication rates. Radiographic evaluations of the width of the pylorus, the size of the stomach, and the rate of gastric emptying showed no differences between dogs with and without pyloroplasty at any evaluation period. The Heineke-Mikulicz pyloroplasty increased the immediate postoperative complication rate after surgical fixation of the stomach for the treatment of GDV. It did not appear to influence the long-term outcome of the surgical treatment of this disease. The Heineke-Mikulicz pyloroplasty is not recommended in the treatment of GDV unless pyloric outflow obstruction can be demonstrated.     

Benefits of prophylactic gastropexy for dogs at risk of gastric dilatation-volvulus

The lifetime probability of death from gastric dilation–volvulus (GDV) for five dog breeds was estimated based on published breed-specific longevity and GDV incidence. These breeds were Great Dane, Irish Setter, Rottweiler, Standard Poodle and Weimaraner. Lifetime risk (95% CI) of GDV in these breeds ranged from 3.9% (0–11.2%) for Rottweiler to 36.7% (25.2–44.6%) for Great Dane.

A decision-tree analysis for prophylactic gastropexy—using lifetime probability of death from GDV and expected cost savings for veterinary services as outcome measures—was undertaken to determine the preferred course of action in several dog breeds. Prophylactic gastropexy was the preferred choice of action for all breeds examined, with the reduction in mortality (versus no gastropexy) ranging from 2.2-fold (Rottweiler) to 29.6-fold (Great Dane). Assuming a prophylactic gastropexy costs US$ 400, the procedure was cost-effective when the lifetime risk of GDV was ≥34%. The maximum and minimum estimated breakeven costs for the gastopexy procedure ranged from US$ 20 (Rottweiler) to US$ 435 (Great Dane). The cost-effectiveness of prophylactic gastropexy was most sensitive to the cost of treating GDV (US$ 1500). Prophylactic gastropexy raises ethical issues that need to be considered by veterinarians and dog breeders.     

Diet-related risk factors for gastric dilatation-volvulus in dogs of high-risk breeds

A nested case-control study was conducted among 1634 dogs with complete diet information in a 5-year prospective study to determine diet-related risk factors for gastric dilatation-volvulus (GDV). Cases included 106 dogs that developed GDV; controls included 212 dogs without GDV that were frequency matched to cases by year of GDV onset. Proportionate energy consumed from major food types and from carbohydrates was determined. Dogs were categorized as consuming either a low volume or high volume of food based on the median number of cups of food fed per kg of body weight per meal. Dogs fed a larger volume of food per meal were at a significantly (P<0.05) increased risk of GDV, regardless of the number of meals fed daily. For both large- and giant-breed dogs, the risk of GDV was highest for dogs fed a larger volume of food once daily.     

Evaluation of laser Doppler flowmetry for measurement of capillary blood flow in the stomach wall of dogs during gastric dilatation-volvulus

OBJECTIVES: To validate laser doppler flowmetry (LDF) for measurement of blood flow in the stomach wall of dogs with gastric dilatation-volvulus (GDV). ANIMALS: Six purpose-bred dogs and 24 dogs with naturally occurring GDV. STUDY DESIGN: Experimental and clinical. METHODS: Capillary blood flow in the body of the stomach and pyloric antrum was measured with LDF (tissue perfusion unit (TPU) before and after induction of portal hypertension (PH) and after PH plus gastric ischemia (GI; PH + GI) and compared with flow measured by colored microsphere technique. Capillary flow was measured by LDF in the stomach wall of dogs with GDV. RESULTS: PH and PH+GI induced a significant reduction in blood flow in the body of the stomach (P = .019). A significant positive correlation was present between percent changes in capillary blood flow measured by LDF and colored microspheres after induction of PH + GI in the body of the stomach (r = 0.94, P = .014) and in the pyloric antrum (r = 0.95, P = .049). Capillary blood flow measured in the body of the stomach of 6 dogs that required partial gastrectomy (5.00+/-3.30 TPU) was significantly lower than in dogs that did not (28.00+/-14.40 TPU, P = .013). CONCLUSIONS: LDF can detect variations in blood flow in the stomach wall of dogs. CLINICAL RELEVANCE: LDF may have application for evaluation of stomach wall viability during surgery in dogs with GDV.     

Canine urolithiasis in Sweden and Norway: Retrospective survey of prevalence and epidemiology

It was estimated that 23 to 24 dogs per 10,000 in Sweden were operated on for urolithiasis between 1956 and 1982. During this period urinary calculi were confirmed in 2898 dogs of 95 breeds, chiefly in chondrodystrophic and well proportioned (not short legged) miniature breeds. The distribution between the sexes in the period 1956 to 1970 was estimated at 57 per cent male and 43 per cent female in the chondrodystrophic breeds, 74 per cent male and 26 per cent female in the well proportioned miniatures, and 83 per cent and 17 per cent female in the large breeds; in the dalmatian (1956 to 1982) 94 per cent were male and 6 per cent female. Urinary calculi were found at a younger age in the chondrodystrophic breeds (1956 to 1970) than in the well proportioned miniature dogs and in large dogs (P<0–001). It was estimated that five dogs per 10,000 in Norway were operated on for urolithiasis between 1956 and 1970. During this period urinary calculi were diagnosed in 71 dogs of 28 breeds. Seventy-nine per cent were male and 21 per cent were female. Urolithiasis in dogs appears to be chiefly constitutionally dependent. Chondrodystrophic breeds and small breeds are particularly susceptible.     

RADIOLOGICAL ASSESSMENT OF THE RELATIONSHIP BETWEEN THORACIC CONFORMATION AND THE RISK OF GASTRIC DILATATION-VOLVULUS IN DOGS

To test the hypothesis that breeds of dogs with a deeper and narrower thorax have an increased risk of gastric dilatation-volvulus (GDV), thoracie depth, width, and length were measured for 437 dogs of 17 different breeds using radiographs on file at the Veterinary Teaching Hospital of the Purdue University School of Veterinary Medicine for the period of 1977 to 1993. These data were applied to risk estimates of GDV that were generated from a separate case control study using the Veterinary Medical Data Base. Multiple linear regression analysis was used to relate the mean thoracie measurements and the ideal, adult body size of the breeds to the risk of each breed developing GDV. When the risk of GDV was evaluated as a function of the mean thoracie depth/width ratio alone, or as a function of the thoracie depth/width ratio plus ideal adult breed weight, 37% (p = 0.022), respectively, of the variability in GDV risk was explained. These findings support the hypothesis tested and suggest that selective breeding can be used to decrease a breed's risk of GDV over time.     

Evaluation of initial plasma lactate values as a predictor of gastric necrosis and initial and subsequent plasma lactate values as a predictor of survival in dogs with gastric dilatation‐volvulus: 84 dogs (2003–2007)

Objective – To test whether an initial plasma lactate≥6.0 mmol/L is associated with the presence of macroscopic gastric wall necrosis and overall survival in dogs presenting with gastric dilatation‐volvulus (GDV). Additionally, if no association was identified we sought to identify a different predictive initial plasma lactate concentration and to examine whether serial plasma lactate concentrations provide better prediction of survival. Design – Retrospective study over a 5‐year period (2003–2007). Setting – Urban private referral small animal teaching hospital. Animals – Eighty‐four client‐owned dogs with a diagnosis of GDV and plasma lactate measurements. Interventions – None. Measurements and Main Results – There was no statistically significant relationship found between survival and the presence of macroscopic gastric wall necrosis with the initial plasma lactate≥6 mmol/L. There was a significant relationship between the initial plasma lactate >2.9 mmol/L for predicting necrosis and <4.1 mmol/L for predicting survival to discharge. Forty dogs that had an increased initial plasma lactate (>2.5 mmol/L) also had a subsequent plasma lactate measured within 12 hours of presentation, with 37/40 dogs surviving and 70% of these surviving dogs having the subsequent lactate decrease by≥50% within 12 hours. The 3/40 that died failed to decrease their plasma lactate by≥50% from the initial blood lactate. Conclusion – The results of this study indicate that an initial presenting plasma lactate concentration≥6.0 mmol/L is not predictive of macroscopic gastric wall necrosis or survival in dogs presenting with GDV. A decrease in plasma lactate concentrations≥50% within 12 hours may be a good indicator for survival. Limitations to the study include its retrospective nature, the small number of patients, and the number of dogs that were euthanized rather than allowed to progress to a natural outcome.     

Non-dietary risk factors for gastric dilatation-volvulus in large and giant breed dogs

OBJECTIVE: To identify non-dietary risk factors for gastric dilatation-volvulus (GDV) in large breed and giant breed dogs. DESIGN: Prospective cohort study. ANIMALS: 1,637 dogs > or = 6 months old of the following breeds: Akita, Bloodhound, Collie, Great Dane, Irish Setter, Irish Wolfhound, Newfoundland, Rottweiler, Saint Bernard, Standard Poodle, and Weimaraner. PROCEDURE: Owners of dogs that did not have a history of GDV were recruited at dog shows, and the dog's length and height and the depth and width of its thorax and abdomen were measured. Information concerning the dog's medical history, genetic background, personality, and diet was obtained from the owners, and owners were contacted by mail and telephone at approximately 1-year intervals to determine whether dogs had developed GDV or died. Incidence of GDV, calculated on the basis of dog-years at risk for dogs that were or were not exposed to potential risk factors, was used to calculate the relative risk of GDV. RESULTS AND CLINICAL RELEVANCE: Cumulative incidence of GDV during the study was 6% for large breed and giant breed dogs. Factors significantly associated with an increased risk of GDV were increasing age, having a first-degree relative with a history of GDV, having a faster speed of eating, and having a raised feeding bowl. Approximately 20 and 52% of cases of GDV among the large breed and giant breed dogs, respectively, were attributed to having a raised feed bowl.     

Measurement of urinary 11-dehydro-thromboxane B2 excretion in dogs with gastric dilatation-volvulus

OBJECTIVE: To measure 11-dehydro-thromboxane B2 (11-dTXB2) in urine of healthy control dogs, dogs undergoing ovariohysterectomy, and dogs with gastric dilatation-volvulus (GDV) and assess the relationship between urinary 11-dTXB2 concentrations in dogs with GDV and postoperative outcomes. SAMPLE POPULATION: Urine samples from 15 nonsurgical control dogs, 12 surgical control dogs, and 32 dogs with GVD. PROCEDURE: Urine samples were obtained from healthy pet dogs (ie, nonsurgical control dogs), dogs undergoing ovariohysterectomy at anesthetic induction and 1 hour following surgery (ie, surgical control dogs), and dogs with GDV at hospital admission and 1 hour following surgical derotation of the stomach (ie, GDV dogs). Urinary 11-dTXB2 concentrations were determined with an ELISA and normalized to urinary creatinine (Cr) concentrations by calculation of the 11-dTXB2 -to-Cr ratio. Differences in median 11-dTXB2 -to-Cr ratios among dogs and before and after surgery were analyzed. RESULTS: Urinary 11-dTXB2-to-Cr ratios did not differ between nonsurgical control dogs and surgical control dogs before or after surgery. Urinary 11-dTXB2-to-Cr ratios were significantly higher in GDV dogs at the time of hospital admission and 1 hour after surgery, compared with those of nonsurgical control dogs. Postoperative urine samples from GDV dogs had significantly higher 11-dTXB2-to-Cr ratios than postoperative urine samples from surgical control dogs. Median urinary 11-dTXB2-to-Cr ratios increased significantly in GDV dogs that developed postoperative complications. CONCLUSIONS AND CLINICAL RELEVANCE: Urinary 11-dTXB2 concentration is increased in GDV dogs at the time of hospital admission and after surgical derotation of the stomach, compared with that of healthy dogs. An increased urinary 11-dTXB2-to-Cr ratio following surgery is associated with an increased incidence of postoperative complications in dogs with GDV.