Arrhythmias
Arrhythmias are commonly seen in the GDV patient. They can be caused by hypotension (cardiac ischaemia), endotoxins, hypoxia, and splenic involvement. Pain can also be a factor in creating arrhythmias.
Ventricular arrhythmias are the most commonly seen arrhythmia, either runs of ventricular premature contractions or ventricular tachycardia. They should be treated if they are causing a negative effect on cardiac output.
An ECG is the best way to diagnose the presence of an arrhythmia, but it is important to also assess blood pressure and pulse quality to identify its effect on cardiac output.
Lidocaine
3mg/kg IV (can be repeated)
CRI – 50mcg/kg/min
If an arrhythmia is detected, the patient should first be provided with oxygen and analgesia. Electrolyte abnormalities should be identified and treated e.g. hypokalemia. If the patient does not respond to these therapies or the patient is deteriorating then anti-arrhythmic drugs should be administered. The most common drug used is Lidocaine, this can be given as a bolus followed by a CRI.
Be aware those large breed dogs that are susceptible to GDV are also known to have cardiac problems such as dilated cardiomyopathy. Listen to the heart - is there a history of heart problems?
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