Immediate emergency treatment involves giving rapid intravenous fluids for circulation support and pain relief. This is often started before or at the time of abdominal x-rays. Once the diagnosis is confirmed, we then consider surgical options. The stomach must be relieved of the gas pressure, either by passing a tube through the mouth to the stomach, or by using a needle through the abdominal wall into the stomach. Once the initial pressure is relieved then the animal is prepared for an anaesthetic and surgery. Often blood tests are performed to determine their electrolyte balance as well as overall organ health. Surgery involves untwisting the stomach, assessing the health of the stomach wall, resecting any portions that are not able to be saved, and then performing a gastropexy to prevent the stomach from twisting again.
Anaesthesia and surgery in these patients carries a high level of risks and can be very costly.
Some patients do not survive their procedure, often due to poor circulation, electrolyte changes, heart arrhythmias, and toxins released into their blood stream. There is still a high risk period for up to 2 weeks after surgery. During this period, they can suffer from kidney damage, ongoing electrolyte imbalances, heart arrhythmias, and the stomach wall can break down further. Intensive care and monitoring is recommended 24 hours a day during the first few days of recovery.
Some owners elect not to proceed with surgery based on the risks or costs involved, at which point euthanasia is the only other recommended option.