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Dog Bloat – Gastric Dilatation-Volvulus (GDV) In Dogs
Gastric dilatation-volvulus (GDV) or canine bloat or gastric torsion is a serious, life-threatening disease in dogs. Gastric dilatation-volvulus is a condition in which the stomach twists on itself, causing the esophagus to twist where it enters the stomach and the pylorus where the stomach normally empties into the intestines, reducing the ability for things to enter or exit the stomach. Once twisted, the stomach begins to expand with gas that turns into a large balloon inside the abdomen, which leads to disruption of blood flow in the body and death of the stomach wall due to overstretching. If left untreated, almost all dogs with GDV will die.
Canine bloat mainly affects large breed dogs with deep chests. Common breeds are Great Dane, Doberman Pinscher, Weimaraner, St. Bernard, German Shepherd and Irish Setter. It is not known why dogs get bloated. There are some predisposing factors that have been identified such as exercise after a large meal, increased feeding, fearful temperament and a parent or close relative who has had GDV.
Classic signs of bloating include nonproductive vomiting, hypersalivation, restlessness, and progressive abdominal distension and tension. The diagnosis of GDV is made by radiography. Radiographs taken with the dog lying on its right side show the classic “inverted C” or “double bubble” sign, which is a malpositioned pyloric region of the stomach overlying the fundal region of the stomach.
Initial treatment of dogs with GDV includes fluid resuscitation to improve blood flow to the heart and some form of gastric decompression, either by orogastric tube or gastric trocharization. An orogastric tube passes through a tube from the mouth to the stomach. This can be difficult in an awake dog with a very distended stomach. Trocharization involves passing a large sterile needle or catheter through the abdominal wall into the stomach to release gas in the stomach. Both are temporary ways to relieve pressure build-up in 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 pex or permanently attach the stomach to the abdominal wall so that it cannot twist again. If pexy is not done, the probability that the dog will re-inflate is as high as 80%. After pexing the stomach against the abdominal wall, the chances of re-bloating 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, those parts should be removed. When gastric resection is required, the mortality rate associated with the operation increases to about 60%.
Postoperative dogs should be closely monitored for arrhythmias that may occur within the first 24 hours after surgery. In addition to gastric resection, other conditions such as disseminated intravascular coagulation (DIC) are common and potentially life-threatening. Most dogs recover without problems and can go home once they start eating, usually within 48 hours of surgery. Owners are advised to give smaller, multiple meals instead of one large meal. Exercise is restricted for two weeks until the abdominal incision heals, and then the dog can return to normal activities.
Prophylactic gastropexies are usually recommended for high-risk breeds. These are sometimes performed during spaying or neutering as puppies, and can be done using a laparoscope to aid in the procedure so that abdominal incisions are kept to a minimum. Or if abdominal surgery is needed for another reason, such as removing a foreign body from the bowel, prophylactic gastropexy can be performed during the same surgery.
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