Gastric dilatation and volvulus syndrome (GDV), also known as bloat, occurs in dogs when the stomach dilates and twists into an abnormal position, causing nonproductive retching, a bloated abdomen, and other symptoms. GDV is a serious, life-threatening condition that requires emergency treatment. Without prompt medical attention, dogs with bloat can die very quickly. Even with prompt intervention, some dogs can still die from this condition. The cause of GDV is not completely understood; however, it is sometimes seen in dogs that eat a large amount of food or drink a large volume of water very quickly and then exercise soon after. The accumulation of fluids, food, and gas causes the stomach to twist, blocking the openings leading into and out of the stomach so that food, water, and gas cannot escape. GDV has been associated with increasing age and having a family history of GDV.
When the stomach dilates and maintains its normal position, the condition is known as gastric dilatation. Gastric dilatation can occur in any dog and is quite common among young puppies that overeat. Dogs are usually able to relieve the built-up pressure in their stomachs by vomiting or by belching. When belching and vomiting don’t provide relief, emergency treatment similar to that for GDV may be necessary. It may be difficult to determine whether a dog is experiencing simple dilatation, or dilatation and volvulus until radiographs are taken of the stomach.
Dogs with GDV will often have a distended abdomen and will retch nonproductively. Many will be depressed, salivate excessively, and act restless. The diagnosis is based on clinical symptoms and the dog’s medical history. It is not possible to differentiate between simple dilatation and volvulus until a radiograph of the dog’s abdomen determines if the stomach is displaced or not. GDV is a medical emergency, and treatment should begin as soon as possible. The sooner the dog is treated, the greater its chance of survival. Treatment is often initiated even before the test results (e.g. radiographs, an ECG, blood tests) are available. Initial treatment focuses on treating for shock, along with decompression of the stomach.
In cases of simple dilatation, the dog is sedated and a tube is passed through its mouth and into its stomach to remove built-up gas and fluid. This procedure is known as medical decompression. After the buildup is removed, a warm-water stomach lavage is performed to wash out accumulated food and gastric juices. If the stomach is twisted, it may be impossible to pass a tube through the mouth and into the stomach, and surgery will be required. Whether dogs with GDV require emergency surgery or not, prophylactic surgery is recommended to avoid recurrence. Surgery involves the following:
- Decompressing the stomach by inserting a large needle or trocar (a surgical instrument used for removing fluids from cavities) into the stomach cavity
- Moving the stomach back to its normal location
- Suturing the stomach to the body wall so it can’t twist again (gastropexy)
- Removing parts of the stomach that have been destroyed due to the lack of blood flow
- Removing the spleen if it has been compromised (splenectomy)
GDV surgery is not always successful, although early diagnosis and treatment greatly enhances the chances for success. Potential complications can include irregular heart beat, peritonitis, and death. Recurrence of the problem is a significant concern in patients decompressed medically.
Prognosis and prevention:
Without prompt medical attention, bloat can cause death. The patient’s prognosis depends primarily on its condition prior to and during surgery. The more time that passes from the onset of symptoms to the initiation of treatment, the worse the prognosis. Dogs that require removal of part of the stomach (partial gastrectomy) have a decreased chance of survival.
Feeding smaller, more frequent meals and waiting at least an hour after eating before exercising can reduce the risk of bloat.