Bloat

Gastric dilatation-volvulus (GDV), commonly called “bloat” is a potentially fatal condition in which a dog’s stomach distends (dilatation) with gas, food, and fluid and rotates or twists (volvulus). The twisting action block both the entrance to the stomach via the esophagus, and the exit from the stomach, the pylorus. This causes the contents in the stomach, tense abdomen, sometimes salivating, and may be attempting to vomit. If the problem has progressed, they may be collapsed, pale, and seriously endangered. It may not take long for death to occur if they are not treated quickly.

What causes it?
The causes of bloat are still being studied, but several factors are known to increase the risk of bloat. The mid– and large-breed dogs have the greatest chance of bloating, while it is much more rare in smaller breeds. It usually occurs within a few hours after a dog eats a meal. It is theorized that since dogs with a deep, narrow chest have longer ligaments that support the stomach, they can more easily stretch, especially when the stomach is full. When a dog is active after a meal, the stomach may simply get flipped over. Stress may also incite it, such as the dog being kenneled or hospitalized.

Why is Bloat so serious?
Distention and twisting can occur independently of one another. But when both occur, the stomach can swell tremendously, and it generally results in shock and organ damage. As GDV progresses, the twisting motion collapses and sometimes tears the blood vessels supplying the stomach and other organs, casing damage and eventual tissue death. To make matters worse, the reduction in blood flow returning to the heart diminishes overall cardiac output,, causing shock and possible heart and respiratory problems. The “cascading” effect GDV causes can quickly lead to death if not treated quickly and appropriately.

How is it treated?
The veterinarian will consult with you about what is happening and what needs to be done. You will be given a written estimate of the costs as soon as possible. However, since time is often very critical, with verbal permission, treatment is generally started immediately. First, radiographs (X-rays) are taken to confirm the diagnosis. On a radiograph, the stomach of a bloated dog will appear very large and full of gas. Standard treatment for GDV consists of sedating the dog to pass a special stomach tube down the esophagus, and decompress and empty the stomach. If the twist is bad enough to block access to the stomach, the veterinarian may trocharize the dog, which is to insert a needle though the skin and into the stomach to help release the gas buildup. Usually IV fluids are started, and if shock is suspected, anti-shock medications are given. Since circulatory stagnation also increases the probability that infection (sepsis) will occur, antibiotics are usually given as well.

What about surgery?
Even with trocharization, the veterinarian may still be unable to pass the stomach tube. In this case, immediate surgery is necessary to save the dog’s life. The doctor must open up the abdomen and manually re-align the stomach. Then the tube should be able to enter and decompress it. At this time the doctor will assess tissue damage. If things look repairable the doctor will then remove any necrotic tissue or organs (such as a damaged spleen, for instance) and performs one of several types of stomach attachments (gastropexies) to reduce the risk of future volvulus. In that procedure, the stomach is surgically attached to the wall of the abdomen, to help stop it from twisting again. Unfortunately, sometimes the GDV has so irreversibly damaged the stomach or other abdominal organs that the dog could never lead a normal life. The veterinarian may recommend euthanasia at this point to prevent further pain and suffering.

And recovery?
After surgery, a GDV patient still requires hospitalization with close monitoring to ensure a good recovery. Several things that are watched for are: possible re-bloat, any abnormal heart rhythms that sometimes occur with GDV, and many other problems related both to bloat and any abdominal surgery, such as infection. A special bland diet must be carefully administered for 2 or 3 weeks after surgery.

What else can I do at home?
If your dog bloats, time is critical. It is not always obvious that GDV is occurring. Look for these signs:

    * Abdominal swelling and tenderness (not always apparent).
    * Unsuccessful attempts to vomit (retching), and/or excessive drooling.
    * Restlessness or frequent change of position, often accompanied by whining.
    * Panting or labored breathing. Staring at the abdomen, sometimes with apparent confusion or distress.

There is no sure-fire way to prevent bloat. However, the following suggestions may help you avoid it:

    * Feed your dog 2 or 3 small meals a day rather than 1 large meal.
    * Premix dry kibble with water so the food expands before it enters your dog’s stomach.
    * Avoid feeding your dog table scraps or “people food” treat.
    * Do not vigorously exercise your dog for 1 hour before and 2 hours after meals.
    * Don’t allow your dog to drink large amounts of water before and after meals.
    * Secure any food bins or bags to ensure your dog can’t engorge while you’re away.
    * Gradually introduce any dietary change over a period of several days.