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Расширение желудка



Расширение желудка представляет собой его массивное вздутие (пучение). Эта проблема характерна как для кошек, так и для любой породы и размера собак. Но чаще всего она наблюдается у собак, относящихся к крупным породам, реже – у собак мелких пород (такс).

Низко посаженная грудная клетка увеличивает вероятность заворота или расширения желудка у собак. Наиболее часто она проявляется у особей в возрасте от 7 до 10 лет. Причина расширения желудка пока полностью не ясна. Ему способствуют замедленное опорожнение желудка, закупорка привратника, аэрофагия (заглатывание воздуха) особенно во время приема корма и гиперемия, нередко приводящие впоследствии к завороту желудка.

Физические нагрузки после плотного приема пищи могут также способствовать расширению желудка. Угнетение двигательной функции желудка фармакологическими средствами, тупая травма живота, повреждение спинного мозга, длительные хирургические процедуры или продолжительное нахождение в лежачем положении – дополнительные факторы, провоцирующие вздутие. Существует мнение, что причиной также могут быть корма на основе злаковых. Однако данное мнение не подтверждается в ходе исследований.

Нередко расширение желудка у собак с глубокой грудной сопровождается заворотом. Заворот - это смещение желудка, повернутое вокруг своей оси. Следствием этого является образование замкнутой полости, в которой продолжаются ферментативные процессы, образуются газы, расширяющие и вздувающие желудок. Его размер при этом под действием газов увеличивается в размере в несколько раз по сравнению с нормальным состоянием.

Выделяют локальное и системное следствие расширения-заворота желудка. Вследствие ишемии желудка гастрит может прогрессировать до некроза с вероятностью прободения и перитонита. Кроме этого острое расширение желудка газом способствует сдавливанию полой вены и части аорты. Под этими воздействиями кровообращение нарушается, возникает гипоксия и сердечно-сосудистая недостаточность. На этом фоне развивается болевой шок, приводящий животное к летальному исходу.

Симптомы

Начальные симптомы вздутия: живот более или менее напряженный, животное чувствует себя явно неблагополучно, ведет себя беспокойно и стонет, отмечается в различной степени вздутие краниальной части живота. При прогрессировании расширения у животного развивается гиперсаливация (усиленное слюнотечение), позывы к рвоте, выраженная одышка, учащение пульса, бледность слизистых оболочек, слабость и смерть.

Диагностика

Диагноз "расширение", "расширение-заворот желудка" часто является очевидным и при наличии клинических признаков. Однако для подтверждения диагноза делают рентгенограмму живота животного, находящегося в лежачем положении на правом боку. На рентгеновском изображении виден желудок, похожий на большой пузырь, наполненный воздухом. При завороте желудка привратник напоминает газовый пузырь, расположенный дорсальнее и краниальнее дна желудка. Между привратником и дном желудка нередко видна разделительная линия. Наличие свободного воздуха в брюшной полости – одно из свидетельств возможного разрыва желудка.

Рентгенограмма брюшной полости собаки, на которой виден расширенный газом желудок.

Лечение

Хорошие результаты лечения возможны, если действовать сразу же и целенаправленно. Каждая потерянная минута может стать решающей в борьбе за жизнь питомца.

Основные этап терапии расширения/расширения-заворота желудка:

  1. Частичная декомпрессия посредством пункции желудка. Самое первое и неотложное мероприятие заключается в пункции желудка с левого бока и отсасывание накопившегося газа.
  2. Преодоление шока, в качестве второго по срочности мероприятия. В переднюю конечность устанавливается венозные катетер и быстро вводятся плазмозаменители, антибиотики, кортикостероиды.
  3. Декомпрессия с помощью желудочного зонда. На стоящей собаке без применения седативных средств осуществляется кратковременная попытка ввести желудочный зонд. В отдельных случаях это удается, если нет собственно заворота. Эта мера не имеет значительного эффекта, поскольку опорожнение желудка с помощью зонда не всегда возможно, и через небольшой промежуток времени вновь стоит ожидать расширения/заворота желудка.
  4. Оперативная декомпрессия и возвращение желудка в физиологическое положение. Необходимо всегда стремиться к оперативному лечению заворота, дающему длительный эффект. Только путем коррекции положения желудка и гастропексии (подшивание желудка к брюшной стенке) можно достичь полного выздоровления.

При консервативных методах лечения и частичных операциях частота рецидивов доходит до 80%.

Возможные профилактические меры:

  • Отсутствие физических нагрузок после обильного приема пищи.
  • Дневную порцию корма необходимо делить на 2-3 приема. Сам корм должен обладать свойствами высокой калорийности, легкоусвояемости и быстрого переваривания.
  • Ограничить количество приема воды после еды.

Особенности кормления

Нередко провокатором расширения или заворота является объемная жидкая пища, в то время как с физиологической точки зрения корм для собаки должен быть густым и концентрированным. Плохо замоченные и недостаточно сваренные крупы при попадании в желудок разбухают, увеличивают его в объеме, растягивая. Оптимальный корм с минимальным риском негативного воздействия на желудок – каши, мясо, овощи и высококачественные консервы и сухие корма.


Дата публикации: 2012-27-02 09:02:58


© Галенко Евгения Валерьевна, Ветеринарный врач, cпециалист визуальной диагностики
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