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Dobberstein et al: Primary repair of nonsteroidal anti‐inflammatory drug‐associated full thickness gastrointestinal ulcers in 11 dogs
Veterinary Surgery 7, 2022

🔍 Key Findings

  • Primary repair of NSAID-associated full-thickness gastroduodenal ulcers was successful in 73% (8/11) of cases.
  • NSAID overdose, concurrent corticosteroid use, or extended duration were identified in 9/11 dogs and were major contributors to ulceration.
  • All perforations were in the pylorus or proximal duodenum, locations suitable for primary closure.
  • No significant association between ulcer size or location and postoperative survival.
  • Preoperative hyperlactatemia trended toward increased mortality (P = .0544; OR 2.045).
  • Postoperative vasopressor use was linked with a 9-fold increased risk of mortality (P = .0545).
  • Dehiscence was rare, suspected in only 1 of 11 cases, indicating that primary repair is structurally sound in selected cases.
  • Median follow-up of 444 days showed long-term survival was achievable post-primary repair.

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← Articles

Dobberstein et al: Primary repair of nonsteroidal anti‐inflammatory drug‐associated full thickness gastrointestinal ulcers in 11 dogs
Veterinary Surgery 7, 2022

🔍 Key Findings

  • Primary repair of NSAID-associated full-thickness gastroduodenal ulcers was successful in 73% (8/11) of cases.
  • NSAID overdose, concurrent corticosteroid use, or extended duration were identified in 9/11 dogs and were major contributors to ulceration.
  • All perforations were in the pylorus or proximal duodenum, locations suitable for primary closure.
  • No significant association between ulcer size or location and postoperative survival.
  • Preoperative hyperlactatemia trended toward increased mortality (P = .0544; OR 2.045).
  • Postoperative vasopressor use was linked with a 9-fold increased risk of mortality (P = .0545).
  • Dehiscence was rare, suspected in only 1 of 11 cases, indicating that primary repair is structurally sound in selected cases.
  • Median follow-up of 444 days showed long-term survival was achievable post-primary repair.

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Multiple Choice Questions on this study

In Dobberstein 2022 et al., on NSAID ulcer repair, what was the most commonly used surgical closure technique for ulcer repair?

A. Two-layer continuous closure
B. Stapled closure with omentalization
C. One-layer full-thickness simple interrupted closure
D. Y-U pyloroplasty
E. Gastrojejunostomy

Answer: One-layer full-thickness simple interrupted closure

Explanation: The majority of cases used a one-layer full-thickness closure with simple interrupted sutures.
In Dobberstein 2022 et al., on NSAID ulcer repair, which of the following was a significant predictor or trend for postoperative mortality?

A. Postoperative vomiting
B. Postoperative use of vasopressors
C. Length of surgery
D. Ulcer location (duodenal vs gastric)
E. Presence of adhesions

Answer: Postoperative use of vasopressors

Explanation: Vasopressor use showed a strong trend toward increased mortality (P = .0545; OR = 9.033).
In Dobberstein 2022 et al., on NSAID ulcer repair, what clinical parameter was associated with a trend toward increased risk of death?

A. Low serum albumin
B. Anemia
C. Hyperlactatemia
D. Hypertension at presentation
E. Hypochloremia

Answer: Hyperlactatemia

Explanation: Each 1 mmol/L increase in serum lactate doubled the risk of postoperative mortality.
In Dobberstein 2022 et al., on NSAID ulcer repair, what percentage of dogs survived to discharge following primary closure of full-thickness gastroduodenal perforations?

A. 55%
B. 64%
C. 73%
D. 82%
E. 91%

Answer: 73%

Explanation: 8 of 11 dogs (73%) survived to discharge after primary surgical repair.
In Dobberstein 2022 et al., on NSAID ulcer repair, what was a common factor among most dogs that developed gastrointestinal perforations?

A. Low-protein diet
B. Concurrent foreign body ingestion
C. Concurrent corticosteroid or NSAID overdose
D. Post-vaccine immunosuppression
E. Post-chemotherapy mucosal injury

Answer: Concurrent corticosteroid or NSAID overdose

Explanation: 9 of 11 dogs had NSAID misuse, such as overdose, prolonged use, or concurrent steroid administration.

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