Severe post-GDV gastroparesis managed with sleeve-type gastrectomy in a dog

A Belgian Malinois dog developed advanced gastroparesis with gastric atony and progressive dilatation following surgical correction of gastric dilatation-volvulus. Following gastric dilatation-volvulus, the dog developed recurrent gastric distension, vomiting of undigested food and progressive weight loss. Imaging and endoscopy demonstrated a markedly enlarged, static stomach with a patent pylorus, refractory to prokinetic therapy. Exploratory laparotomy revealed global gastric atony, and a radical sleeve-type gastrectomy was performed. Histopathology identified interstitial fibrosis and sparsely distributed nerve plexuses. Although delayed gastric emptying persisted postoperatively on barium contrast study, the dog regained weight, tolerated liquid meals and remained clinically stable without further vomiting or dilatation at 12 months follow-up. Severe gastroparesis with chronic gastric dilatation can occur as a delayed complication of gastric dilatation-volvulus, likely related to truncal vagal injury. Sleeve-type gastrectomy might represent a salvage option for dogs with end-stage, medically refractory gastric atony.