CANINE BLOAT (GDV)

What is meant by the term "Canine Bloat"?

This is a term that is synonymous with the more scientific term "Gastric Dilatation/Volvulus." It is often called GDV. That means that a dog's stomach twists on its long axis and distends with air to the point where the dog goes into shock and may die.

Dilatation means that the stomach is distended with air, but it is located in the abdomen in its correct place (has not twisted). Volvulus means that the distension is associated with a twisting of the stomach on its longitudinal axis.

How or why does this occur?

We really do not know the answer to either of those questions. Original theories suggested that it occurred when a dog ate a large meal of dry food and then drank a lot of water. The water caused the dry food to swell. At the same time, the dog was supposed to be engaged in strenuous exercise that included running and jumping. That resulted in the dog's stomach twisting on itself as the heavy organ was jostled about in the abdomen.

Although that is the most common explanation given, there is no scientific evidence to support this theory. In most dogs experiencing GDV, the stomach is not excessively full of dry food and the dog has not recently engaged in strenuous exercise. The most current theory is that the stomach's contractions lose their regular rhythm and trap air in the stomach; this can cause the twisting event. However, the sequence of events for most cases defies a good explanation.

How is it diagnosed?

The first step in diagnosis is to determine if the correct breed is involved. This condition almost always occurs in deep-chested dogs of large breeds. Some of the more commonly affected breeds include Great Danes, Irish Setters, German Shepherds, and Afghan Hounds.

The next step is to establish that the stomach is distended with air. An enlarged stomach will cause the body wall to protrude prominently, especially on the dog's left side. The swelling will be very firm and obvious enough to see across the room. Occasionally, this distension is very apparent. This occurs in dogs which have a large portion of the stomach up under the rib cage. In most cases, however, the owner is able to detect the distension. The dog will be in pain or very depressed. It may lie in what is commonly called a "praying position" with the front legs drawn fully forward. This should occur quickly, within two to three hours at the most.


The presence of a rapidly developing distended abdomen in a large breed dog is enough evidence to make a tentative diagnosis of GDV. A radiograph (x-ray) is used to confirm that the diagnosis is dilatation. It can also identify the presence of volvulus, in most cases.

Some dogs experience a chronic form of the disease in which the stomach is partially twisted. Distension with air does not occur because the partial twist permits air that accumulates to be expelled out the mouth or into the small intestines. Repeated vomiting is the most common sign. It is diagnosed with radiographs (x-rays) of the stomach which will show an abnormal shape to the stomach.

What happens when the stomach is distended with air?

The first major life-threatening event that occurs is shock. This occurs because the distended stomach puts pressure on the large veins in the abdomen that carry blood back to the heart. Without proper return of blood, the output of blood from the heart is diminished, and the tissues are deprived of blood and oxygen.

The reduced blood output from the heart and the high pressure within the cavity of the stomach cause the stomach wall to be deprived of adequate circulation. If the blood supply is not restored quickly, the wall of the stomach begins to die and the wall may rupture. If volvulus occurs, the spleen's blood supply will also be impaired. This organ is attached to the stomach wall and shares some large blood vessels. When the stomach twists, the spleen is also rotated to an abnormal position and its vessels are compressed.

When the stomach is distended, digestion stops. This results in the accumulation of toxins that are normally removed from the intestinal tract. These toxins activate several chemicals which cause inflammation, and the toxins are absorbed into circulation. This causes problems with the blood clotting factors so that inappropriate clotting occurs within blood vessels. This is called disseminated intravascular coagulation (DIC) and is usually fatal.

What is done to save the dog's life?

There are several important steps that must be taken quickly.

Shock must be treated with administration of large quantities of intravenous fluids. They must be given quickly; some dogs require more than one intravenous line.


Pressure must be removed from within the stomach. In some cases, this may be done with a tube that is passed from the mouth to the stomach. However, if the stomach is twisted, the tube cannot enter it. Another method is to insert a large bore needle through the skin into the stomach. A third method is to make an incision through the skin into the stomach and to temporarily suture the opened stomach to the skin. The last method is usually done when the dog's condition is so grave that anaesthesia and abdominal surgery is not possible.


The stomach must be returned to its proper position. This requires abdominal surgery, which can be risky because of the dog's condition.


The stomach wall must be inspected for areas that may have lost its blood supply. Although this is a very bad prognostic sign, the devitalised area(s) of the stomach should be surgically removed.


The stomach must be attached to the abdominal wall (gastropexy) to prevent recurrence of GDV. This procedure greatly reduces the likelihood of recurrence.


Abnormalities in the rhythm of the heart (arrhythmias) must be diagnosed and treated. Severe arrhythmias can become life-threatening at the time of surgery and for several days after surgery. An electrocardiogram (ECG) is the best method for monitoring the heart's rhythm.

What is the survival rate?

This will largely be determined by the severity of the distension, the degree of shock, how quickly treatment is begun, and the presence of other diseases, especially those involving the heart. Approximately 60 to 70% of the dogs will survive.

What can be done to prevent it from occurring again?

The most effective means of prevention is gastropexy, the surgical attachment of the stomach to the body wall. This will not prevent dilatation (bloat), but it will prevent volvulus in most cases.

Various dietary and exercise restrictions have been used, but none of these have proven successful for all dogs.

BLOAT IN DOGS


Bloat is a very serious health risk for many dogs, yet many dog owners know very little about it. According to the links below, it is the second leading killer of dogs, after cancer. It is frequently reported that deep-chested dogs, such as German Shepherds, Great Danes, and Dobermans are particularly at risk. This page provides links to information on bloat and summarizes some of the key points we found in the sites we researched. Although we have summarized information we found about possible symptoms, causes, methods of prevention, and breeds at risk, we cannot attest to the accuracy. Please consult with your veterinarian for medical information.

If you believe your dog is experiencing bloat, please get your dog to a veterinarian immediately! Bloat can kill in less than an hour, so time is of the essence. Notify your vet to alert them you're on your way with a suspected bloat case. Better to be safe than sorry!

The technical name for bloat is "Gastric Dilatation-Volvulus" ("GDV"). Bloating of the stomach is often related to swallowed air (although food and fluid can also be present). It usually happens when there's an abnormal accumulation of air, fluid, and/or foam in the stomach ("gastric dilatation"). Stress can be a significant contributing factor also. Bloat can occur with or without "volvulus" (twisting). As the stomach swells, it may rotate 90° to 360°, twisting between its fixed attachments at the esophagus (food tube) and at the duodenum (the upper intestine). The twisting stomach traps air, food, and water in the stomach. The bloated stomach obstructs veins in the abdomen, leading to low blood pressure, shock, and damage to internal organs. The combined effect can quickly kill a dog.

Be prepared! Know in advance what you would do if your dog bloated.

If your regular vet doesn't have 24-hour emergency service, know which nearby vet you would use. Keep the phone number handy.
Always keep a product with simethicone on hand (e.g., Mylanta Gas (not regular Mylanta), Gas-X, etc.) in case your dog has gas. If you can reduce or slow the gas, you've probably bought yourself a little more time to get to a vet if your dog is bloating.
This information is not intended to replace advice or guidance from veterinarians or other pet care professionals. It is simply being shared as an aid to assist you with your own research on this very serious problem.

Symptoms

Typical symptoms often include some (but not necessarily all) of the following, according to the links below. Unfortunately, from the onset of the first symptoms you have very little time (sometimes minutes, sometimes hours) to get immediate medical attention for your dog. Know your dog and know when it's not acting right.

Attempts to vomit (usually unsuccessful); may occur every 5-20 minutes
This seems to be one of the most common symptoms & has been referred to as the "hallmark symptom"
Doesn't act like usual self
Perhaps the earliest warning sign & may be the only sign that almost always occurs
Significant anxiety and restlessness
One of the earliest warning signs and seems fairly typical
"Hunched up" or "roached up" appearance
This seems to occur fairly frequently
Bloated abdomen that may feel tight (like a drum)
Despite the term "bloat," many times this symptom never occurs or is not apparent
Pale or off-color gums
Dark red in early stages, white or blue in later stages
Lack of normal gurgling and digestive sounds in the tummy
Many dog owners report this after putting their ear to their dog's tummy
Coughing
Unproductive gagging
Heavy salivating or drooling
Foamy mucous around the lips, or vomiting foamy mucous
Unproductive attempts to defecate
Whining
Pacing
Licking the air
Seeking a hiding place
Looking at their side or other evidence of abdominal pain or discomfort
May refuse to lie down or even sit down
May stand spread-legged
May attempt to eat small stones and twigs
Drinking excessively
Heavy or rapid panting
Shallow breathing
Cold mouth membranes
Apparent weakness; unable to stand or has a spread-legged stance
Especially in advanced stage
Accelerated heartbeat
Heart rate increases as bloating progresses
Weak pulse
Collapse
Causes

According to the links below, it is thought that the following may be the primary contributors to bloat. To calculate a dog's lifetime risk of bloat according to Purdue University's School of Veterinary Medicine, click here.

Stress

Dog shows, mating, whelping, boarding, change in routine, new dog in household, etc.
Although purely anecdotal, we've heard of too many cases where a dog bloated after a 3rd dog was brought into the household (perhaps due to stress regarding pack order).
Activities that result in gulping air
Eating habits, especially...

Elevated food bowls
Rapid eating
Eating dry foods that contain citric acid as a preservative (the risk is even worse if the owner moistens the food)
Eating dry foods that contain fat among the first four ingredients
Insufficient Trypsin (a pancreatic enzyme present in meat)
Dilution of gastric juices necessary for complete digestion by drinking too much water before or after eating
Eating gas-producing foods (especially soybean products, brewer's yeast, and alfalfa)
Exercise before and especially after eating
Heredity (especially having a first-degree relative who has bloated)
Build & Physical Characteristics

Having a deep and narrow chest compared to other dogs of the same breed
Older dogs
Males
Being underweight
Disposition

Fearful or anxious temperament
Prone to stress
History of aggression toward other dogs or people
Prevention

Some of the advice in the links below for reducing the chances of bloat are:

Avoid highly stressful situations. If you can't avoid them, try to minimize the stress as much as possible. Be extra watchful.
Can be brought on by dog shows, mating, whelping, boarding, new dog in household, change in routine, etc.
Do not use an elevated food bowl
Do not exercise for several hours (e.g., 2 or 3) before and especially after eating
Particularly don't permit your dog to roll over, which could cause the stomach to twist
Do not permit rapid eating
Feed 2 or 3 meals daily, instead of just one
Do not give water one hour before or after a meal
It dilutes the gastric juices necessary for proper digestion, which leads to gas production.
Always keep a product with simethicone (e.g., Mylanta Gas (not regular Mylanta), Phazyme, Gas-X, etc.) on hand to treat gas symptoms.
Some recommend giving your dog simethicone immediately if your dog burps more than once or shows other signs of gas.
Some report relief of gas symptoms with ½ teaspoon of nutmeg or the homeopathic remedy Nux moschata 30
Allow access to fresh water at all times, except before and after meals
Make meals a peaceful, stress-free time
When switching dog food, do so gradually (allow several weeks)
Do not feed dry food exclusively
Feed a high-protein (>30%) diet, particularly of raw meat
If feeding dry food, avoid foods that contain fat as one of the first four ingredients
If feeding dry foods, avoid foods that contain citric acid
If you must use a dry food containing citric acid, do not pre-moisten the food
If feeding dry food, select one that includes rendered meat meal with bone product among the first four ingredients
Reduce carbohydrates as much as possible (e.g., typical in many commercial dog biscuits)
Feed a high-quality diet
Whole, unprocessed foods are especially beneficial
Feed adequate amount of fiber (for commercial dog food, at least 3.00% crude fiber)
Add an enzyme product to food (e.g., Prozyme)
Include herbs specially mixed for pets that reduce gas (e.g., N.R. Special Blend)
Avoid brewer's yeast, alfalfa, and soybean products
Promote an acidic environment in the intestine
Some recommend 1-2 Tablespoons of Aloe Vera Gel or 1 Tablespoon of apple cider vinegar given right after each meal
Promote "friendly" bacteria in the intestine, e.g. from yogurt or supplemental acidophilus
Avoids fermentation of carbohydrates, which can cause gas quickly. This is especially a concern when antibiotics are given since they tend to reduce levels of "friendly" bacteria.
And perhaps most importantly, know your dog well so you'll know when your dog just isn't acting normally.

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