Gastric Dilatation Volvulus Syndrome (GDV) or Bloat in Dogs
Dr Sanjeet Kumar,CEO-PET Kingdom veterinary hospital,New Delhi
Bloat in dogs is a life-threatening condition where the stomach twists and expands with gas. It is also known as gastric torsion, gastric dilatation volvulus, or canine GDV and it is one of the most serious pet emergencies. No one knows exactly what causes GDV in dogs but there are certain risk factors that make it more likely, particularly eating a large meal very soon before or after exercising. GDV stands for gastric dilatation and volvulus. It is more commonly known as bloat but is also regularly referred to as gastric torsion, canine GDV or simply gastric dilatation.
A GDV is when the stomach bloats and twists around itself. Once the stomach twists, it quickly starts to fill with gas, causing severe and life threatening bloat. The only cure for a GDV is an operation to reverse the twist but sadly, due to the seriousness of the condition, even with treatment, some GDVs are still fatal.
The distended stomach presses on the diaphragm and other internal organs, causing problems with the circulation and respiratory system. This makes it difficult for your dog to breathe and for their heart to get blood and oxygen around the body, as it should. Your dog will very rapidly go into shock. While the stomach is twisted, the blood supply to the stomach and also sometimes the spleen is affected meaning that the stomach wall and spleen can start to die.
Symptoms of GDV
Clinical signs can include restlessness or pacing along with nonproductive vomiting or retching. Ptyalism, abdominal distention, weakness, or collapse may be observed. Dogs can present anywhere on a spectrum of clinical signs, from alert and wagging their tail, with normal pulse quality and only mild abdominal distention, to collapsed, in decompensated shock, or even dead.
Bloat from GSV usually comes on very quickly. At first, your dog may show signs that their stomach hurts. They may:
- Act restless
- Drool
- Have a swollen stomach
- Look anxious
- Look at their stomach
- Pace
- Try to vomit, but nothing comes up
- Stretch with their front half down and rear end up
As the condition gets worse, they may:
- Collapse
- Have pale gums
- Have a rapid heartbeat
- Be short of breath
- Feel weak
If you think your pet has bloat, get them to a clinic right away. If dogs don’t get treatment in time, the condition can kill them.
Symptoms of a GDV tend to start very suddenly, and get worse quickly. Dogs are at more risk after they have eaten or drunk a lot, especially if they exercise straight afterwards.
Diagnosis
A primary method of diagnosing GDV is imaging techniques, such as x-rays of the abdomen. Other tests may include a urine analysis and testing concentrations of lactate substance in the plasma.
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Causes of GDV
No one really knows why GDVs develop, but there are some factors that are known to make it more likely:
- Breed – large, deep chested dogs such as Great Danes, German Shepherds and Greyhounds are most at risk of GDV.
- Exercise around meal times – vigorous exercise or travelling in a car after a meal can increase the risk of a GDV.
- Eating quickly – eating quickly and gulping air can increase the chance of a GDV. Feed several small meals through the day rather than one big one and feed a mixture of wet and dry food. If your dog gulps his/her food, consider using a slow feeding bowl or scatter feeding.
- Feeding from a height – feed from the floor, not from a raised bowl. Previous advice was to feed from a raised bowl, but this has now been shown to increase the risk of a GDV.
- Gulping water – drinking a lot of water in one go can increase the chance of a GDV, try to encourage your dog to drink little and often (but never withhold water).
- Excitable/nervous dogs – excitable and nervous dogs tend to be more prone to developing a GDV.
Large and deep-chested dog breeds are considered to be the most at risk for GDV, including the German shepherd, Great Dane, standard poodle, Saint Bernard, Doberman pinscher, Irish setter, and Weimaraner. Even medium- and small-breed dogs with a deep chest conformation, including shar-peis, basset hounds, and cocker spaniels, can develop GDV. Most patients are middle-aged to older, and incidence of GDV increases with increasing age. The most commonly reported potential risk factors for GDV are listed below-
- Large- or giant-breed dog
- Deep chest conformation (increased thoracic depth-to-width ratio)
- Increasing age
- Familial history, particularly having a first-degree relative with a history of GDV
- Previous episode of gastric dilatation
- Preexisting gastrointestinal disease or gastric foreign body
- History of previous splenectomy
- Large volume of food fed once daily
- Eating a meal quickly
- Dry dog food
- Eating from a raised food bowl
- Anxiety or stress
Treating dog bloat
In only a matter of hours without treatment, bloat can threaten a dog’s life. The vet will decide on a treatment method based on the severity of a dog’s gastric dilatation.
Treatment for gastric dilatation (GD)
In cases when a dog’s stomach has not yet twisted, the vet might use a tube to release gas. This relieves pressure to the veins and arteries. They may also use a needle to draw out excess fluids.
Treatment for gastric dilatation volvulus (GDV)
When the bloat has caused the dog’s stomach to turn, the vet will have to turn to an emergency surgery known as gastropexy. In this surgery, the vet will make an incision to enter the dog’s abdominal cavity in what is called a laparotomy. Then they will reverse the stomach torsion. If the stomach is necrosed, gastric resection is necessary. If your dog is experiencing shock, the vet will use fluids or an IV drip.
There are several important steps that must be taken quickly.
- Shock must be treated with the 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 anesthesia 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 devitalized 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.
Recommendations for preventing bloat are feeding several small meals a day, discouraging drinking large amounts of water at one time, allowing some time between eating and activity, and feeding on the floor.
