GDV (Bloat) a Twist of Fate
Activities or conditions promoting aerophagia (swallowing of air) are not good for deep chested dogs. Exercising a dog immediately after eating a large amount, fatty food or drinking large gulps of water may increase the risk for a life threatening condition known as gastric dilatation and volvulus or GDV. This is referred to as twisted stomach or bloat.Large breed dogs with deep chested bodies such as Great Danes, Rottweilers, and Retrievers may have extra room in their abdomen for the stomach to move around. The stomach may expand, or dilate, with gas or fluid and rotate in the abdomen. This can happen, rarely, in small breed dogs. I have done surgical corrections in Dachshunds and West Highland White Terriers.Of the predisposing factors to GDV, the most important factor is genetics and a family history of the condition. Dogs at risk to develop GDV often have a close relative (a parent, sibling, or offspring) that's had GDV. Not all lines of a breed will develop GDV. Dr Brieght, ACVS, (Board Certified Veterinary Surgeon) at Colorado State University, will recommend preventable surgery if there are known close relatives that have bloated.
Activity that promotes aerophagia (air swallowing) such as gulping food in fast, consumption of gas forming liquids or foods high in fat or very fermentable food stuffs may predispose an animal to GDV. Other risk factors include old age loosening attachments, the other internal organs stretch or change shape with time. What used to maintain position now allows more play with movement. Underweight conditions and stress also play a big part in developing GDV.It is the chicken or egg quandary, veterinarians are not sure which comes first: the rotation or the expansion of the stomach. Once the stomach is rotated, it will continue to expand. Expansion of the stomach threatens an animal's life. Stomach rotation blocks the ability for anything to exit the stomach via the esophagus or entrance into the intestinal tract. In the words of Shrek there is no attic or basement movement. By blocking both openings of the stomach enlargement continues and will compress very important things in the abdomen. If the stomach compresses nearby major blood vessels, blood cannot return to the heart. When twisted the stomach blocks its own blood supply leading to death of sections of the stomach wall (gangrene). This is a major life threatening cardiovascular condition (physiological volume depletion, hypovolemic shock). A huge giant stomach compresses the diaphragm making it difficult to move muscles of respiration. This makes it difficult to breathe. Compression of blood vessels allows intestines to loose their protective lining and bacteria normally kept at bay now are releasing endotoxins (poisons) into the blood stream. This leads to shock, failure of blood and oxygen to flow to the body, or if the stomach ruptures and bacteria leak into the abdomen (peritonitis) or bloodstream (septicemia). GDV can be fatal within a few hours.Signs of GDV include retching, excessive drooling, lethargy, and an abnormally enlarged belly. If you suspect your pet is having GDV, you should immediately call a veterinarian or a 24 hour Animal Emergency Clinic. GDV is a dark disease, by that I mean most cases are seen after dark. Approximately 98 percent of cases develop during night hours. Yes you are right; they can be dead by morning.
X-rays show a trapped gas picture that is like a "fingerprint" for GDV. Treatment involves some quick "prepping" prior to surgery. This should be done as efficiently as possible. GDV surgery is like a box of chocolates you really do not know what to expect until you get into the abdomen. You do know you wish to have the best chance of a positive outcome and you wish to get started sooner than later. Once under general anesthesia you need to first stabilize a GDV case by treating it for shock and decompress the stomach. A trocar (14 gage IV catheter needle) is passed trough the abdominal wall into the stomach to evacuate smelly gas. Next pass a plastic tube through the esophagus into the stomach to allow built-up air, food and fluid to escape. This relieves pressure on affected blood vessels, allows recirculation and oxygen to get to tissues.GDV surgery goal is to untwist the stomach and remove stomach tissue damaged from the disorder. During surgery you also check the nearby spleen and other organs for injuries. It is prudent to look for any other abdominal abnormalities while you are there. Some GDV surgeries are heartbreakers and low percentage positive outcomes. Some are so toxic that reperfusion allows tissue toxins loose that cause an animal to develop cardiac issues and even death. This can be an extremely risky surgery. It is a very expensive procedure and more so if complications arise either on the table or in recovery period.
Gastropexy is a preventative procedure done during a GDV surgery to prevent volvulus or twisting of stomach. This intentionally causes scar tissue to form that is 95% effective in preventing twisting. An incisional gastropexy show the best long term effectiveness. This will not stop a dilatation (expansion) of stomach but is easier to treat and much less of a life threatening condition. GDV dogs need to be taken out of the gene pool. They need to be spayed or neutered to prevent genetic transfer of predisposed lines.
A preventative gastropexy should be preformed in female puppies from lines known to have had GDV. This can be done during her ovariohysterectomy (spay) it will add modest time and some to the surgical fee. There is no extra pain as the dog is already under general anesthesia and will be covered with postoperative pain medications when sent home.
To date there is no silver bullet to prevent GDV, but understanding the disorder and early recognition of clinical signs allows a prompt diagnosis. Early intervention and treatment give a much better prognosis that allows the love story to continue.
For more information about gastric dilatation and volvulus or gastropexy procedures, consult your veterinarian.
Dr Mike Sweet
734-439-1112