Deflating Bloat Prevention, recognition and treatment of gastric dilatation volvulus (GDV) in your dog

There are certain emergencies you come to anticipate when working in the ER; however none of them get a veterinary staff to jump to attention more quickly than when the word “bloat” is mentioned. Every member of the triage team understands that when it comes to bloat or the more scientific name – Gastric Dilatation Volvulus (GDV) - time is of the essence and cutting a half an hour off of initial treatment of that patient may be the difference of life or death.

“Bloat” is a bit of a misnomer. If you eat too much Thanksgiving dinner, too much Shawafel or too much Taylor Gourmet, you feel bloated (happy, but bloated). If your dog eats too much, they can get this “food bloat” as well. In and of itself, a large stomach full of food is not a dangerous condition. It is only if the stomach twists that the true emergency develops.

What is GDV? Technically it is the abnormal “twisting” of the stomach. A dog’s stomach is a bit “free swinging” in the abdomen and is connected on one end via the esophagus (food tube between the mouth and the stomach) and is anchored on the other via the duodenum (first part of intestine). Envision that “free hanging stomach” twisting around on itself (like grabbing two ends of a bean bag and flipping). The stomach then has no way to release the gas trapped inside of it and expands causing a dangerous, progressive distention which can impair blood flow to itself and other vital organs.

What are the signs of GDV? Aside from the classic distended abdomen, many dogs are restless, pacing, panting and choosing not to lie down. They will often act like they have to vomit and may repeatedly try to do so, but produce nothing or just a small amount of fluid. Dogs with advanced signs will be extremely weak, have a very fast heart rate and pale gums, and may collapse.

What can be done to treat GDV? Only through surgical intervention can this condition be reliably reversed. Yes, sometimes it can spontaneously resolve, but this is extremely rare. This is a life threatening emergency and if your dog is exhibiting the signs above, your veterinarian should be contacted immediately or your dog should be transported to the ER as soon as possible.

  •  The good: If signs are picked up on early, this is a very treatable disease and prognosis is fair to good.
  • The bad: Surgical intervention and overnight hospitalization and monitoring are not cheap. You should expect a $4000-6000K billdepending on where you have surgery and severity of signs on presentation. Also if the GDV is not treated quickly, a portion of the stomach may be deprived of blood supply and may need to be removed at surgery. This may affect long term prognosis.

How can you prevent GDV? Unfortunately, the causes of what makes a dog’s stomach twist are not well understood. It is usually a problem for large breed dogs that have deep chests but we have seen medium and small breed dogs affected as well. These dogs also tend to be older (five years oldand up) and may have a pre-existing condition (diabetes, pancreatitis, undiagnosed cancer, etc.)

Some good rules of thumb to follow for prevention are:

  • Feed your dog 2-3 small meals throughout the day, rather than one large meal to avoid it eating too much or too quickly.
  • Avoid strenuous exercise before and after meal time.
  • Limit intake of large amounts of water at one time. Instead, allow your dog a limited amount of water on a hot day or after exercise, and then give them a short break before re-offering.
  • Consider preventative surgery. Gastropexy is an elective surgical procedure performed to “tack” the stomach to the abdominal wall and will greatly reduce the possibility of GDV. If your large breed dog needs any abdominal surgery at a young age (spay, intestinal foreign body removal) then this procedure should be discussed with your veterinarian.

Educated awareness is the key to identifying and treating GDV. As usual, if you have questions or concerns about your pet, you should contact your veterinarian.

Have a great Thanksgiving and see you ‘round the Hill!

This is the third in a series on Veterinary Emergencies Deconstructed. Dr. Antkowiak and Dr. Miller are the owners of AtlasVet (the Atlas District Veterinary Hospital) at 1326 H St. NE and they reside in Capitol Hill. Twitter: @atlasvetdc, Website: www.atlasvetdc.com, Facebook: www.facebook.com/atlasvetdc


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