News You Can Use- Bloat!

What is gastric dilation volvulus?

If you have seen the heart wrenching movie “Marley and Me”, you may be more familiar with the disease than you think. In the story, Marley was diagnosed with a condition referred to in the movie as a “stomach twist” which is medically known as gastric dilation volvulus. The movie gave us the notion that it is a very serious disease, but doesn’t really give us much beyond that. Today, we will dive into what happens behind the scenes in the case of GDV.

What is GDV?

Gastric dilation volvulus (GDV) is a life-threatening condition in which the stomach twists on itself and causes distension of the stomach. The stomach can twist anywhere between 90° and 360°. The torsion causes the outflow tract of the stomach (pylorus) and the esophagus (if the twist is greater than 180°) to close, kind of like twisting two ends of a Tootsie Roll. This means gas, solids, and liquids cannot enter or leave the stomach. This causes the stomach to bloat. The gas distended stomach occludes the blood vessels that lead to the heart which prevents proper blood flow and causes the pet to go into shock. If left untreated, GDV can lead to organ failure from lack of oxygen rich blood, heart arrhythmias, stomach rupture, sepsis, and death. Because there are blood vessels that connect the spleen to the stomach, the spleen is sometimes involved in the torsion.

What Causes GDVs

GDV most commonly occurs in large breed, deep chested dogs, such as the Great Dane and the Doberman. It tends to occur when dogs consume large amounts of food or water followed by exercise.

Signs to Watch For

It is assumed a dog experiencing GDV will look bloated. Though many dogs will be visibly bloated, some dogs’ stomachs are tucked up within the rib cage which would hide the bloat. Therefore, it is important to consider GDV if your pet fits the following characteristics and is showing the following signs.

●     Distended abdomen

●     Retching without vomiting 

●     Pain

●     Restlessness

●     Recently consumed a lot of food or water followed by exercise

●     Large breed and deep chested dog 

Diagnosis and Treatment

A confirmatory diagnosis is based on a right lateral (right side of patient on table) abdominal radiograph (x-ray). The radiographs will show a gas distended stomach that takes the shape of a smurf hat or Popeye’s arm.

Treatment

Decompressing the stomach and IV fluid therapy are the most important steps in treating GDV. Passing a stomach tube may be attempted, but if the esophagus is twisted, then passing a tube will not work. In those cases, puncturing the stomach with a needle (trocarization) can relieve the pressure until the surgery can be performed. Once the patient is stabilized, the dog is put under anesthesia for surgery. The stomach is first untwisted so that a stomach tube may be passed to clear the contents of the stomach. Then a procedure, called gastropexy, is performed in which the stomach is tacked to the left side of the body wall to decrease the risk of torsion in the future. 

Prevention

The gastropexy procedure mentioned above can also be performed prophylactically to decrease the risk of stomach torsion in large breed, deep chested dogs. It is actually a common procedure performed in military and police dogs. A gastropexy can be requested to be done at anytime if your pet is an at risk breed. It is often a procedure performed in conjunction with a spay or neuter.

Sometimes, It’s Not GDV

It is possible for dogs to experience bloat without torsion of the stomach in a condition called gastric dilation or simple bloat. This usually occurs in gluttonous dogs who have the tendency to eat too much, too fast. This condition, unlike GDV, is usually not life threatening. However, the pet should be immediately evaluated by a veterinarian because the symptoms are indistinguishable from GDV. As stated previously, radiographs of the abdomen can be taken for a confirmatory diagnosis.

Dr. Jalika Joyner

https://vcahospitals.com/hollywood/primary

Canine bloat- GDV!!!

I remember the night like it was yesterday. I was finally relaxing at home after a long day of clinics when Captain, my four year old German shepherd starting acting, well, strange. Twenty minutes later, radiographs at the emergency room confirmed my suspicion. Captain had gastric dilatation and volvulus or GDV.

GDV is commonly known as canine bloat. Many of you may remember this as the heart-wrenching disease from Marley and Me. This is a potentially life-threatening condition where the dog’s stomach rotates completely around itself causing the entrance and exit of the stomach to become obstructed. This obstruction leads to air getting trapped in the stomach (bloat) and decreased blood supply to the affected areas. Emergency surgery is required to correct this situation.

While the exact cause of this condition is still unknown, several risk factors have been identified. These risk factors include large or giant breed dogs (Great Danes, German Shepherds, Irish Wolfhounds, Labradors), older age, rapid food intake, naturally anxious or stressed dogs or dogs with a parent that had GDV.

Signs you may notice at home that may indicate your dog has GDV include but are not limited to the following: pacing, circling, restlessness, whining, increased breathing rate or effort, looking at their side, attempting to vomit a foamy substance or nothing at all produced, distended abdomen, pale gums, drooling, weakness or in severe stages collapse. GDVs have a better outcome the sooner they are addressed. So if you notice these clinical signs a veterinarian should immediately see your dog.

Treatment of GDV is based on the needs of your individual dog when they arrive to the hospital but initially consists of fluids and pain medications. Once GDV is confirmed with radiographs, the stomach is decompressed. Meaning the air trapped in the stomach is released prior to surgery to relieve some discomfort to the dog and lessen the stretch of the stomach. Then surgery is performed to de-rotate the stomach. The stomach and surrounding intestines and organs are examined to make sure they are still healthy. In some cases, the compromised organs die due to the lack of blood supply they experienced. In these cases the dead portions are removed and the remaining healthy gut is reattached. A gastropexy, a fancy word for suturing the stomach to the side of the body, is then performed to prevent the stomach from rotating again in the future. Following surgery, your dog will likely be hospitalized for a couple of days for close monitoring and supportive care.

While we cannot tell for sure which dogs will develop GDV in the future, it can be prevented in at risk dogs. A prophylactic, or preventative, gastropexy can be performed. It is highly recommended at the time of spay or neuter since the dog will already be under general anesthesia.

Luckily in my case, Captain’s surgery went smoothly and he recovered perfectly. I hope that you never have to experience the fear of what I went through with Captain. But if it does occur, now that you know what to look for, hopefully your dog too will be back to doing what they love in no time


Abigail Kreines

Canine Bloat

Gastric Dilation Volvulus (AKA:Bloat, gastric torsion, GDV). Large, deep-chested dogs are predisposed to this condition where the stomach rotates around itself. Risk factors associated with this condition include stress, once a day feeding, dogs that eat too fast and/or exercise after eating.

The signs of bloat include abdominal distention, abdominal pain, salivation, retching and/or vomiting. If your dog shows these clinical signs, immediate veterinary intervention is necessary and surgery to return the stomach to a normal position.



Dr. Leo Londono D.V.M.- HAH
University of Florida