Gastric Dilation - Volvulus (GDV) syndrome, most commonly called "bloat," can be an agonizingly deadly condition. The cause of GDV is still unknown. Certain large breed, deep cheated dogs are more commonly affected: Great Dane, German Shepherd, Irish Setter, Saint Bernard, Doberman Pinscher and Irish Wolfhound; however small breed dogs have been affected, rarely. Reported initiating factors include ingestion of a large amount of food or water, general anesthesia, trauma, stress, exercise after eating, intestinal obstruction, etc.
Initially the stomach distends due to gas or fluid build up. As the stomach dilates, the dog may be seen burping, vomiting, pacing, panting, etc. due to the pain of the distension. Some dogs may be able to relieve the bloat by themselves. It is also possible that the distension may continue and eventually the stomach may rotate on its own axis effectively sealing off either end of the stomach's in and out flow tracts. Attached along the side of the stomach is the spleen. As the stomach "twists" the spleen is choked off from its blood supply as well. This results in the possible death of both organs as they loose their oxygen source. Over time toxins build up, the animals blood supply becomes affected, the organs become further distended and painful, and the pet may go into shock. The heart may be starved of oxygen and possibly poisoned; as a result the heart ceases to beat regularly. Without intervention, the dog will die.
It is important that people with "at risk" dogs be able to recognize bloat. The earlier a veterinarian can intercede, the better the animal's chance for survival. Commonly seen signs include:
lethargy or pacing
pet glancing at abdomen
inability to stand
shock (pale gums, poor pulse quality)
The diagnosis of GDV is based on history, physical exam and clinical signs. Radiographs or exploratory abdominal surgery may be required to be sure. There are other diseases that may partially mimic bloat. They include:
simple distension of the stomach
small intestinal volvulus (rotation of the small intestine on itself)
splenic torsion - rotation of the spleen with loss of its blood supply
peritonitis - inflammation of the lining of the abdominal cavity
diaphragmatic hernia - a tear of the diaphragm that allows abdominal contents to enter the chest cavity
pleural effusion - fluid in the chest cavity
The priority of treating the dog becomes immediate stabilization. If needed, the veterinarian must support the dog with oxygen, intravenous fluids, anti-shock medications, and emptying the stomach (gastric decompression). If a stomach tube cannot be passed into the stomach to relieve the pressure, the animal must be taken to surgery as soon as the dog is deemed fit to survive anesthesia. Once in surgery, the rotation/obstruction can be relieved, and the stomach permanently "fixed" (adhered) to the abdominal wall to prevent a reoccurrence.
Unfortunately, even if the dog survives surgery it may die due to secondary complications (95% that die do so within 4 days). Complicating factors include fatal arrhythmias, endotoxic shock (shock caused by toxic bacterial by-products) and additional organ damage, recurrent distention, further death of an organ (stomach or spleen), and peritonitis (inflammation of the lining of the abdominal cavity).
Detection, stabilization, definitive correction and post-op hospitalization can be cost prohibitive for some owners. In the extreme case, the bill could run $1500 to $5000. Some owners may elect, and some veterinarians may advise, euthanasia depending on the severity of the case. Death is agonizing for these dogs and rather than let them suffer, they may be humanely relieved of suffering.
© 2006 Margot B. Schwag, VMD. All rights reserved. For permission to reprint contact author at Landisville Animal Hospital, 3035 Harrisburg Pike, Landisville, PA 17538.
BEWARE OF BLOAT
by Margot Schwag, VMD
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