Does the Funnel sign in GDV help differentiating between GD and GDV?

This episode of the Vet Surgery Podcast hosted by Dr. Jolle Kirpensteijn is featuring Dr. Elizabeth Maxwell (Assistant Professor of Surgical Oncology, University of Florida) and Dr. Federico Vilaplana Grosso (Associate Professor in Diagnostic Imaging, University of Florida), who co-authored a recent JAVMA article.

Topic: Differentiating 360° GDV from Simple Gastric Dilatation The discussion centered on the caudal esophageal "twist sign" — a funnel-shaped appearance in the lower esophagus that helps identify 360-degree gastric dilatation-volvulus (GDV), which is notoriously difficult to distinguish from regular gastric dilatation on radiographs.

Key findings from the study: The research compared 29 dogs with 360° GDV to 38 dogs with simple gastric dilatation. The twist sign was present in all dogs with esophageal dilation, except when the esophagus had been decompressed by tube placement. Unlike typical 180° GDV cases (which show classic signs like abnormal pylorus positioning), 360° twists return the stomach to its normal anatomic position, making radiographic diagnosis much harder.

Clinical perspectives: Dr. Maxwell noted that unsuccessful oral gastric tubing and endoscopy attempts were more common in 360° cases. Dr Vilaplana Grosso shared that the funnel sign was not part of his standard diagnostic approach before collaborating with Dr. Maxwell. The group discussed differing institutional practices on whether to image first or decompress first in emergency GDV situations.