Gastric Dilatation-Volvulus (Bloat)

Gastric dilatation-volvulus is otherwise known as “bloat,”
“stomach torsion,” or “twisted stomach.” The cause of the
condition is unknown. It can have tragic consequences and result
in death in as short a time as 2 to 3 hours. The stomach bloats
as a result of rapid accumulation of gas. Eventually, the
distended stomach rotates around its supporting ligaments,
trapping the gas and choking off its own blood supply. The
distended stomach presses on the chest, making it difficult for
the dog to breathe, and compresses large veins in the abdomen,
preventing blood from returning to the heart. The difficulty in
breathing and the poor blood flow eventually result in collapse
and death unless treatment is prompt.

Treatment of gastric dilatation-volvulus is successful in up to
70 per cent of cases if the owners recognize the signs of the
disease promptly. The most important sign is distention of the
abdomen. If the abdomen becomes drum tight, the diagnosis is
almost certain. Other signs include loss of appetite, frequent
retching, abdominal pain, distress, and eventually collapse.
Treatment begins with rapid intravenous fluid therapy (to
replenish lost fluid and improve blood flow) and decompression
of the bloated stomach. Decompression of the gas-filled stomach
is usually performed by placing a needle directly into the
stomach through the abdominal wall or by passing a tube into the
stomach via the mouth. Drugs may be required, including
antibiotics, drugs to help prevent shock, and drugs to reduce
damage to the stomach lining.

When the dog is in as fit a state for surgery as possible, it is
anesthetized and operated on to return the stomach to the normal
position. In addition, the surgeon will attempt to suture the
stomach to the abdominal wall in the correct position in the
hope of preventing a further bout of bloat. This is called a
“gastropexy.” Without this procedure the likelihood of
recurrence of the bloat is as high as 80 per cent. If the
surgery reveals extensive areas of dead stomach, the likelihood
of the dog surviving the postoperative period is very low.
Sadly, in this situation, a veterinarian may advise euthanasia
of the dog on the operating table in order to avoid further
suffering.

The postoperative period is full of risk for dogs with bloat.
Abnormal beats of the heart are common postoperatively, as are
life-threatening problems such as severe ulcers or holes
(perforations) in the stomach and bowel, pancreas or liver
damage, infections, and excessive blood clotting. For this
reason, dogs usually remain at the veterinary clinic under close
observation for several days after the surgery.

Prevention of gastric dilatation-volvulus is difficult because
the underlying cause or causes of the disease are unknown.
However, some risk factors that predispose a dog to develop
bloat have been recognized. Avoidance of these risk factors
(where possible) minimizes the likelihood of the disease
occurring. Knowledge of these factors is important if you own a
large, deep-chested dog because dogs with this type of
conformation are predisposed to the disease (e.g., Great Danes,
Saint Bernards, Weimaraners, Irish setters, Dobermans, German
shepherds).

Risk factors that have been identified in some (but not all)
studies include eating only one meal per day (this leads to a
larger stomach size than eating two or more meals), eating
faster, and a nervous temperament. It is also prudent to avoid
exercising dogs when their stomach is full. Many predisposed
dogs have the disease precipitated by a stressful event, so
owners should be particularly vigilant for the disease at such
times.

The above is general veterinary information. Do not begin
any course of treatment without consulting your regular
veterinarian. All animals should be examined at least once every
12 months.