Gastric dilatation volvulus

It’s a scary situation when your dog looks like he has a bloated tummy, but he’s really experiencing a life-threatening medical emergency. Gastric dilatation volvulus or GDV is also called bloat, but it’s more than just a bit of air in the stomach. Its other name – gastric torsion – describes how, once inflated with air, the stomach can also twist around itself and cut off blood supply to other major organs. The body then goes into shock and the condition becomes life-threatening.

What causes GDV?

A dog does not suddenly develop gastric torsion or GDV – there are behavioural elements to this condition. It most commonly happens in dogs who eat one large meal a day or who eat or drink a large volume of food or water, gulping air as they consume it. The delayed emptying of the digestive system (potentially due to consuming oil-enriched foods) can also be a factor. Engaging in vigorous play or exercise after eating can trap air in the stomach and twist it. Add to this a dog who is prone to stress and the chances of them developing GDV increase.

After the stomach has already twisted and the contents of the stomach can’t be released, it can continue to distend, pushing up against the diaphragm and putting stress on the heart and lungs. All of this may be going on inside the dog, but what does it look like from the outside?

What are the symptoms of GDV?

A stomach filled with food and air may or may not present as a distended belly, although this is a common symptom. The following symptoms might also present, but again – not all symptoms will show in all dogs with GDV: 
•    Vomiting foam or retching without vomiting
•    Restlessness
•    Drooling
•    Look anxious
•    Pacing
•    Stretching with their front legs down and their hips up

If your dog shows any of these symptoms without an obvious cause, but you suspect gastric dilatation volvulus, get him to the vet immediately. If the condition worsens, his symptoms can progress to:
•    Shortness of breath
•    Rapid heartbeat
•    Pale gums
•    Weakness
•    Collapse and death

Which dogs are more likely to develop GDV?

Veterinarians and researchers have attempted to isolate the causes of GDV in order to reduce the risk of susceptible dogs from developing the condition, but not every dog with the risk factors will end up with this syndrome. GDV is most commonly seen in large breed dogs who are also deep chested. Think of Great Danes, German shepherd dogs, Dobermans, boxers, bassets, Gordon and Irish setters, St Bernards, Irish wolfhounds, Rhodesian ridgebacks and Weimaraners. Older dogs are more prone to developing GDV, however, it’s not impossible for any breed of dog at any age to experience this dangerous condition. Males are more commonly affected than females. 

Why is GDV a medical emergency?

The distension of the stomach is caused, in part, by its inability to empty its contents. Add torsion or twisting to this equation and suddenly there is increased pressure in the body, decreased blood supply to vital organs and damage to the cardiovascular system. Dehydration and systemic shock can ensue. There is no way for GDV to correct itself and it becomes life-threatening from a few minutes to a few hours. Some dogs go from having no visible symptoms to collapsing and dying, while others will show visible distress and need immediate veterinary attention.

How is GDV diagnosed and treated?

It’s important to tell the veterinarian that you suspect GDV, although in most cases, the dog’s distress will be evident. Looking at the breed, age and history of the dog can provide predetermining information that allows the vet to reach the GDV diagnosis. However, in this emergency situation, the vet’s first priority will be to relieve the pressure in the dog’s stomach to save the wall of the stomach (since there is always a risk of it bursting) and to remove pressure on other internal organs. They will attempt to insert a stomach tube, although this might be impossible due to the stomach torsion; in which case, the vet will insert a large needle through the skin to release the gas and relieve the pressure.

Treatment for shock can then begin (IV fluids and medicine to stabilise the dog’s vital signs) and as soon as the dog is stable, he can be placed under general anaesthesia so that surgical treatment can take place. The veterinarian may take X-rays to confirm the presence of gastric dilatation (distension) and volvulus (torsion) and to prepare for surgery. Some dogs will need a longer period of stabilisation before surgery, depending on how severe their condition was before treatment began.

The surgical intervention involves returning the stomach and spleen to their correct position in the body. If the spleen’s blood supply has been too compromised or if the spleen is the suspected culprit of the GDV, the whole organ may be removed. The vet may decide to perform a gastropexy to prevent GDV from happening again. This involves attaching the wall of the stomach to the wall of the dog’s body to position it permanently. 

If stomach torsion has cut off blood supply to the stomach wall to the extent that necrosis (tissue death) has begun to set in, it may be necessary for the vet to remove part of the dog’s stomach – a procedure called a gastrectomy.

What is the prognosis after treatment?

Gastric dilatation volvulus is a traumatic and life-threatening event, followed by surgery. The prognosis depends on the severity of the condition before medical treatment was administered, the cardiovascular stability of the dog before surgery, and the level of aftercare received. The survival rate of GDV is around 80%, although this may be reduced by certain factors such as pre-existing heart problems, the tissue damage incurred during the ordeal, and the necessity of removing the spleen. 

The dog must be hospitalised for a few days after surgery to keep a close eye on his progress and to catch any complications that may arise. There may be infections or sepsis, inflammation (peritonitis) or low blood pressure (hypotension) that could compromise his recovery and cause the dog to die.

Can GDV be prevented?

While no preventative steps can be 100% guaranteed, the following changes can be made to reduce the risk of your dog developing GDV:
•    Feed two or more smaller meals throughout the day, rather than one large meal
•    Give your dog time to rest after eating, before he engages in vigorous activity or exercise
•    Do not raise your dog’s food bowl off the ground unless instructed to do so by the vet
•    Ensure that your dog experiences a happy, relaxed environment – fearful, stressed dogs are more likely to develop GDV
•    Large dogs should eat large, high-quality kibble and not drink an excessive amount of water after eating

Address any concerns you may have over GDV with the vet and always have the emergency number for the vet on hand if your dog is susceptible to developing this condition.

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