by Betsy Sigmon DVM
Owner of Creature Comforts Animal Hospital in Cary, NC.
Dr. Betsy Sigmon, pictured above with Dr. Mackie, founded Creature Comforts in 1998. Her specialty is in zoonotic diseases and geriatric care. She is one of 17 Diplomates for the American Board of Vet. Practitioners in North Carolina. She can be reached at (919)387-3435.
Bloat, a veterinary emergency in dogs, is a condition in which the stomach is distended with air, more scientifically called Gastric dilation. When the dilated stomach rotates 90 to 360 degrees it called gastric dilation and volvulus (GDV).
It is more common in large breeds of dogs over 7 years of age. The most commonly affected breeds are the Great Dane, Weimaraner, Saint Bernard, Gordon setter, Irish setter, Doberman pinscher, Old English sheepdog, and standard poodle. The Bassett hound is at greatest risk among smaller breeds.
The underlying causes for GDV are poorly understood although there are several recognized risk factors which are described below. The signs noted by owners are often that of acute distress: distended abdomen, pain, drooling, retching, increased heart rate, and difficulty breathing. Due to compromise of the circulatory system from compression of vessels by the dilated stomach, acute collapse, shock, and even death may come quickly. The severe shock comes quickly and is accompanied by death of the stomach lining, enlarged spleen, and even stomach rupturing releasing toxins into the abdomen and general circulation.
Death may happen in as little as 4 to 6 hours and it the second leading cause of death in large breeds of dogs, second only to cancer. Radiographs demonstrate a severely enlarged, gas-filled stomach that if twisted has several compartments called a "double bubble" that may ping when thumped. In many cases, the patient is so compromised that emergency treatment to tap off the gas from the stomach, placing catheters in 2 to 3 veins to administer lifesaving IV fluids for shock, and emergency surgery supersede the ability to take time for diagnostics.
Definitive treatment involves surgery to correct the position of the stomach, remove devitalized, non-viable tissue (spleen and portions of stomach if necessary), and perform a gastropexy (stomach tack) to lower the risk of reoccurrence. Intensive 24-hour post-surgical care is critical to decreasing mortality.
Treatment for infection, electrolyte abnormalities, shock, pain, and heart arrhythmias can be emotionally and financially draining. The prognosis is up to a 15% mortality rate for patients with GDV treated surgically with a viable stomach lining. However, if circulation to the stomach wall has been compromised with delays of 5 or more hours, there is an increased risk of death.
Other factors associated with a guarded prognosis include low body temperature and low blood pressure at presentation. Prevention is an evolving target with no solid definitive answers. It is strongly recommended to perform a Prophylactic gastropexy (stomach tacking) in breeds at high risk for GDV to lower risk of stomach twisting. Some surgeons perform the procedure via laparoscopy.
Several recommendations have been made to prevent gastric bloat after discharge or to prevent GDV in dogs that have not had a gastropexy:
- Divide feedings into several small meals a day.
- Do not feed dry foods that contain an oil or fat ingredient listed as one of the first four ingredients or a small kibble size (<30mm).
- Avoid stress during feeding.
- Do not elevate feeding bowl during eating and discourage rapid consumption.
- Restrict exercise before and after meals.
This article was originally written for Pet Life Magazine by Betsy Sigmon DVM, owner of Creature Comforts Animal Hospital in Cary, NC. Used with permission.
