Gastric dilatation-volvulus (GDV) – also called bloat or stomach torsion – is a life-threatening condition of dogs. It occurs most commonly in large, deep-chested breeds such as Great Danes, Dobermans, Weimaraners, German Shepherds, St Bernards and Irish setters.
Gastric dilatation-volvulus is a sudden dilation of the stomach with a simultaneous twisting of the stomach at one or both ends (the volvulus). Food and gas can’t escape and the severe distension of the stomach puts pressure on surrounding organs and blood supply. Blood supply to the stomach and spleen is blocked, and other major blood vessels are compressed, including the portal vein supplying the liver and the caudal vena cava (a large vein in the abdominal cavity), blocking the return of blood to the heart. Pressure on the diaphragm prevents the lungs from expanding properly and the pet has difficulty breathing. Shock sets in rapidly – this condition is a true emergency and immediate veterinary attention is required.
What causes GDV?
While there is no definite clinical or experimental evidence to support these hypotheses, the condition is often initiated by a single large meal in a deep-chested dog, usually middle aged or older. If the dog is a greedy eater, drinks a lot of water or exercises after eating, there can be a greater tendency for the stomach to dilate. Dogs that have survived GDV are more vulnerable to repeat episodes. Some foods have been implicated, but again, there is no evidence to suggest specific diets cause GDV.
Symptoms
Dogs suffering from GDV are almost always presented in shock and extremely ill. Early signs owners may see at home include standing and stretching, drooling, the pet may look anxiously at its stomach, or begin to dry retch, and the abdomen may be noticeably bloated.
As the condition progresses, the dog will start to pant and have trouble breathing, become weak and eventually collapse and be unable to stand. The condition is fatal without immediate veterinary intervention.
Diagnosis and treatment
An x-ray clearly shows a gas-filled, very distended stomach and confirms a diagnosis of GDV. The stomach is so dilated it almost fills the entire abdomen (gas shows up as black on radiographs).
Abdominal x-rays will confirm the diagnosis and show the extended, gas-filled stomach. A full blood count is recommended to provide information about damage to other organs such as the liver and kidneys.
Stablisation of the pet is critical before surgery. Balanced I/V fluid therapy is instituted to help combat circulatory collapse. Surgery is then begun as soon as possible to return the stomach to its normal position and remove the contents. At CVH we always perform gastropexy – the fixing of the stomach to the abdominal wall to prevent future rotation. During surgery, all other abdominal organs are evaluated. The pet requires intensive fluid therapy, pain relief and other intensive care during recovery. Early intervention is essential if the pet is to recover and survive.
Managing pets post GDV
Long term, dietary management is essential following correction of gastric dilatation-volvulus. This means feeding 2 to 3 small meals each day rather than a single large meal, avoiding exercising the dog after eating, and monitoring the pet for any signs of abdominal pain or discomfort.