Canine Bloat

 

 


Bloat is a very serious health risk for many dogs, yet many dog owners know very little about it.  It is frequently reported that deep-chested dogs, such as German Shepherds, Great Danes, and Dobermans are particularly at risk. 

The technical name for bloat is "Gastric Dilatation-Volvulus" ("GDV").  Bloating of the stomach is often related to swallowed air (although food and fluid can also be present).  It usually happens when there's an abnormal accumulation of air, fluid, and/or foam in the stomach ("gastric dilatation").    Stress can be a significant contributing factor also.  Bloat can occur with or without "volvulus" (twisting).  As the stomach swells, it may rotate 90 to 360, twisting between its fixed attachments at the esophagus (food tube) and at the duodenum (the upper intestine).  The twisting stomach traps air, food, and water in the stomach.  The pressure on the diaphragm makes it difficult for the dog to breathe. The air-filled stomach also compresses large veins in the abdomen, thus preventing blood from returning to the heart. Filled with air, the stomach can easily rotate on itself, thus pinching off its blood supply. Once this rotation (volvulus) occurs and the blood supply is cut off, the stomach begins to die and the entire blood supply is disrupted and the animal's condition begins to deteriorate very rapidly and the combined effects can quickly kill a dog.

Simple gastric distention can occur in any breed or age of dog and is common in young puppies who overeat. This is sometimes referred to as pre-bloat by laymen. Belching of gas or vomiting food usually relieves the problem.

If this condition occurs more than once in a predisposed breed, the veterinarian might discuss methods to prevent bloat, such as feeding smaller meals or giving Reglan (metoclopramide) to encourage stomach emptying. Some veterinarians recommend, and some owners request, prophylactic surgery to anchor the stomach in place before the torsion occurs in dogs who have experienced one or more bouts of distention or in dogs whose close relatives have had GDV.

The exact cause of GDV has never been resolved but theories abound. One theory claims some dogs are born with their stomachs slightly out of position allowing it to twist more easily. Another theory speculates affected dogs are born with impairment of either the esophagus or pylorus, effectively preventing food from leaving the stomach. Dogs that gulp food and then exercise heavily may also be at increased risk. Some dogs under extreme anxiety suffer "stress-related bloat" by gulping large amounts of air when nervous. Tumors of the spleen, stomach, kidney or other internal organs, may cause twisting and subsequently result in bloat. Eating indigestible materials like clothing or garbage may also cause bloating.

Studies have been ongoing at many veterinary schools for decades but the exact cause(s) remains a mystery. The frequency of bloat has been estimated at 2.9 to 6.8 cases per 1,000 dogs. Dogs seven years and older appear to be twice as likely to bloat as dogs among 2 and 4 years old. Purebred dogs are 3 times more likely to bloat then mixed breeds.

 

The earliest clinical signs of a dog suffering bloat include:

...Restlessness. The dog will act anxious, agitated, uncomfortable, and unable to rest.

...Loss of appetite. It may not be interested in food or water, though some dogs dry to drink.

...It may vomit once or twice followed by nonproductive retching and gagging. It may
    attempt to defecate.

...Whining, crying, heavy panting, and salivation accompany the physical distress.

 

If your dog exhibits any of the above mentioned symptoms, transport the animal to your vet or to an Emergency Clinic without delay. Treatment is aimed at stabilizing shock, and relieving gas pressure. Surgery should be performed to turn the stomach back to its normal position, remove necrotic tissue and finally, to tack the stomach (gastropexy) to prevent a recurrence of torsion. Once a dog bloats, it will bloat again and torsion or twisting will recur if surgery is not performed following the first GDV episode.

Twenty-nine to thirty-three percent of all dogs with GDV die. Survival depends on how quickly the owners get the dog in for emergency care, how experienced your veterinarian is in treating the disease and luck. Shock, heart arrhythmias, a build-up of metabolic poisons and post-operative infection are the primary causes of death with GDV. These dangerous post-bloat effects can occur for at least 7 days following the GDV episode and surgery.
 

 

Despite adopting all of the recommendations listed below, a dog may still develop GDV.

  • Owners of susceptible breeds should be aware of the early signs of bloat and contact their veterinarian as soon as possible if GDV is suspected.
  • Owners of susceptible breeds should develop a good working relationship with a local veterinarian in case emergency care is needed.
  • Large dogs should be fed two or three times daily, rather than once a day.
  • Water should be available at all times, but should be limited immediately after feeding.
  • Vigorous exercise, excitement, and stress should be avoided one hour before and two hours after meals.
  • Diet changes should be made gradually over a period of three to five days.
  • Susceptible dogs should be fed individually and, if possible in a quiet location.
  • Some studies suggest that dogs who are susceptible to bloat should not be fed with elevated feeders; other studies have not found this to be true. It is recommended, however, that dogs at increased risk be fed at floor level.
  • Some studies have associated food particle size, fat content, moistening of foods containing citric acid, and other factors with bloat. At this time, no cause-and-result relationships between these factors and bloat have been verified.
  • Dogs that have survived bloat are at an increased risk for future episodes; therefore prevention in the form of preventive surgery or medical management should be discussed with the veterinarian.

 

References and Further Reading

Beck, JJ; Staatz, AJ; Pelsue, DH; Kudnig, ST; MacPhail, CM; Seim HB; and Monnet, E. Risk factors associated with short-term outcome and development of perioperative complications in dogs undergoing surgery because of gastric dilatation-volvulus: 166 cases (1992-2003). Journal of the American Veterinary Medical Association, 2006;229(12):1934-1939.

Ellison, GW. Gastric dilatation volvulus: An update. Presented at the Western Veterinary Conference, Las Vegas NV, 2004.

Glickman, LT; Glickman, NW; Shellenburg, DB; et al. Multiple risk factors for the GDV syndrome in dogs: A paractitioner/owner case control study. Journal of the American Animal Hospital Association, 1997, 33: 197-204.

Monnett, E. Gastric dilatation volvulus. Presented at the Western Veterinary Conference, Las Vegas NV, 2002.

Simpson, KW. Diseases of the stomach. In Ettinger, SJ; Feldman, EC. Textbook of Veterinary Internal Medicine. W.B. Saunders Co. Philadelphia, PA; 2005: 1319-1321.

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  Canine Bloat
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