In this final episode of the stomach series, we dismantle one of the most dangerous illusions in soft-tissue surgery:

👉 A perfect gastric surgery does not guarantee a living patient.
👉 The stomach lies — beautifully. It can look pink, perfused, and “saved”… while the physiology collapses quietly over the next 72 hours.

This Deep Dive reframes gastric surgery as a systems reboot, not a mechanical repair.
You’ll learn why the stomach’s redundant blood supply fools surgeons, why “successful repair, dead dog” is a predictable pattern, and the five lethal endpoints that occur after a perfect closure.

We walk through:

• Why the stomach’s vascular redundancy masks ischemia
• How reperfusion injury poisons patients even as the stomach looks better
• Why gastric emptying — not the suture line — determines survival
• How silent reflux and aspiration pneumonia kill dogs days after surgery
• Why lactate kinetics (not a single number) are your prognostic lifeline
• The role of MDF (myocardial depressant factor) in post-op arrhythmias
• The gastric failure cascade: the real cause of death after a “successful” surgery
• Why owners elect euthanasia in “technically successful” cases — and how to prevent that spiral

If you judge success by the photo you took in the OR, you will keep losing patients after surgery.
 Success is measured 48–72 hours later, when the dog can eat, empty, and breathe.

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