One of the main goals of emergency gastrointestinal surgery is to have a rapid and repeatable means of assessing organ viability. Assessment of gastric viability in dogs with gastric dilatation and volvulus (GDV) is presently limited to subjective parameters, with a reported incidence of gastric necrosis in 35% of cases. This study evaluated the use of an imaging modality that uses photons in the near-infrared spectrum to penetrate tissue and react with an intravenously administered fluorescent dye, permitting visualization of the microvasculature and quantification of fluorescence, in dogs with GDV. The stomach of 20 dogs with GDV was assessed using near-infrared fluorescence (NIRF) and compared to the appearance and quantitative parameters in dogs without gastrointestinal disease. Quantitative NIRF parameters did not differ between controls and GDV dogs with subjectively viable stomachs, however, the fluorescence intensity of the cardia and fundus was significantly lower in GDV dogs with histopathologically confirmed gastric necrosis. Similarly, visual inspection of the microvascular fluorescence pattern in these dogs was scant. Thus, identification of viable gastric tissue in dogs with GDV and differentiation between those dogs with and without gastric necrosis is possible using NIRF. As such, intraoperative use of NIRF in dogs with GDV may aid in delineating borders of resection or determining the need for intraoperative euthanasia, potentially altering the morbidity and mortality traditionally associated with GDV. Ultimately, this is the first study to investigate a qualitative and quantitative method for interrogating gastric viability and microvascular health intraoperatively in dogs with GDV.
