Gastric dilatation-volvulus is the condition where the stomach rotates on itself causing a twisting of the esophagus where it enters the stomach and the pylorus where the stomach normally empties into the intestines, thus reducing the ability for things to get in or out of the stomach.
Once twisted, the stomach starts to distend with gas turning into a large balloon within the abdomen, leading to impairment of blood flow in the body and to the stomach wall dying because of overdistention.
Left untreated, almost all dogs with GDV will die.
Dog bloat affects mainly large breed dogs with deep chests.
Common breeds include the Great Dane, Doberman Pinscher, Weimaraner, Saint Bernard, German Shepherd dog, and Irish Setters.
Why canine bloat occurs is not known.
There are some predisposing factors that have been identified such as exercising after eating a large meal, elevated feeding, having a fearful temperament, and having a parent or close relative that had a GDV.
The classic signs of bloat include nonproductive retching, hypersalivation, restlessness, and a progressively distending and tight abdomen.
Diagnosis of GDV is made with radiographs.
Radiographs taken with the dog laying on the right side show a classic "reverse-C" or "double bubble" sign which is the malpositioned pyloric region of the stomach sitting above the fundic region of the stomach.
Initial treatment for dogs with GDV involves fluid resuscitation to improve blood flow to the heart, and some form of decompression of the stomach, either by an orogastric tube or by trocharization of the stomach.
An orogastric tube is passing a tube from the mouth into the stomach.
This can be difficult in an awake dog and with the stomach severely dilated.
Trocharization involves passing a large sterile needle or catheter through the abdominal wall into the stomach to relieve the gas within the stomach.
Both of these are temporary ways of relieving the pressure build-up within the stomach to make the dog more stable.
Surgery is always recommended for dogs with gastric torsion.
Surgery is necessary to reposition the stomach and to pexy or permanently attach the stomach to the abdominal wall so that it cannot twist again.
If a pexy is not performed, the chance that the dog will bloat again is as high as 80%.
After pexying the stomach to the abdominal wall, the chances of bloating again are less than 10%.
In some cases, the stomach wall shows areas of necrosis or death.
If areas of the stomach wall are not viable, then these portions need to be removed.
When a gastric resection needs to be performed, the mortality rate associated with surgery increases to around 60%.
Post-op dogs need to be monitored closely for arrhythmias which can occur within the first 24 hours after surgery.
With gastric resection, other conditions like disseminated intravascular coagulation (DIC) are common and potentially life-threatening.
A majority of dogs recover with no problems and once they are eating, can go home, usually within 48 hours of surgery.
Owners are instructed to feed smaller, multiple feedings rather than one large meal.
Exercise is restricted for two weeks while the abdominal incision heals then the dog can return to normal activity.
Prophylactic gastropexies are commonly recommended for high risk breeds.
These are sometimes performed during spaying or neutering as puppies and can be done using a laparoscope to assist the procedure so the incisions in the abdomen are kept to a minimum.
Or if surgery into the abdomen is required for another reason such as to remove an intestinal foreign body, a prophylactic gastropexy can be performed during the same surgery.