Sunday, July 24, 2011

"Bloat" and Gastric Dilative Volvulus

"Bloat" isn't the condition we fear as large breed dog owners.  The term is used to describe a condition that is actually called Gastric Dilative Volvulus, or "GDV".  Bloat describes a different, less severe condition of gas buildup on the abdomen, think "I feel bloated today".  Your dog can have abdominal distension and perhaps pain, but it is not the condition where we think of their stomach "twisting".   Some believe that bloat may hold the potential to become GDV, but I don't have the impression there is research to back up that theory.

GDV is a serious, life-threatening condition where our dog's stomach can twist or dilate. Pressure in the stomach will increase, and blood supply may be cut off, and your dog will die without treatment.  There is no definitive theory as to what causes GDV.  In general, medicine tends to revere it as a condition to which deep-chested dogs are prone. There are no varying degrees of severity; GDV is serious, period. 

Your dog will show abdominal pain (and probably will react painfully to your touch in that area), stretching (to try to compensate for the pressure build up), and difficulty breathing.  Their abdomen will be distended and they may make attempts to regurgitate.  Their heart rate may  increase and they may show weakness or collapse.

Possible secondary complications include decreased cardiac output resulting in shock, arrhythmia, cell death and sloughing of the intestines due to lack of adequate blood supply, and perhaps bacteremia (bacteria in the blood stream) and sepsis (invasion of the body by toxins). 

If you believe your dog to be suffering, act immediately.  Time is of the essence, as this is a very treatable disease and the survival rate is very good if they get care quickly.  When transporting your dog to the vet, try to provide a board or something you can lay them on for transport, so as to not ask them to cuddle up their body in any way that will be painful.  Your animal will find the position it is most comfortable in, and don't try to manipulate that position, ie. "come on buddy, sit up".  When you get to the vet, they will do a radiograph to diagnose the condition; it's easily diagnosed and seen in an x-ray.  They will get him on fluids but if he is suffering from GDV, surgery needs to happen right away to fix the stomach. If treatment is sought within a few hours, the survival rate is 85%.  Aftercare consists of limited activity, fluids, and monitoring the diet. 

There are some theories regarding prevention, but because there is no true understanding of what causes this, none of these theories are proven.  Some suggest a gastropexy, and a dog who received surgery for GDV may get a gastropexy performed during the procedure.  This is a procedure where the stomach is sutured to the abdominal wall to prevent the volvulus.  Some vets may recommend this procedure during the spay/neuter of a deep chested dog, some may tell you they think it is an ineffective idea; I've heard vets have varying opinions on gastropexy.  Another theory, is that our dogs become at risk by eating large amounts of food too fast, and/or then going out to play right afterward.  If this theory is correct, then we need to install methods of slowing our ravenous eaters down, such as bowls they sell which have elevated portions to make eating more of a challenge.  Someone even suggested to me once that you put a very large rock (too large for them to ever swallow) in the center of their food bowl to produce the same "slow down" effect.  Dog dishes that are elevated can help the movement of food through the body and theoretically prevent GDV.  Elevated bowls are good anyway.. especially for animals who have to constantly bend over.  Arthritic or dogs with back problems benefit from not having to constantly stress those body parts.

Distinguishing between bloat and GDV isn't the job of the owner, and any thought that your dog may be suffering GDV is an extreme emergency and need immediate veterinary care.  If your dog is suffering from GDV, there is no cure except for surgery.  If you own a deep-chested dog, speak to your vet proactively about how you can prevent this condition.  There is a lot of information on the internet, and nothing ever trumps the advice of your veterinarian.

Recently I was speaking of this condition with a Colorado veterinarian who has been practicing for many decades.  When speaking of the Great Pyrenees breed, he mentioned to me that that was the only large chested, large breed dog he didn't try to convince the owners to perform a gastro pexy on.  He told me that in all of his years of practice, he's never known a Pyr's stomach to twist.  I thought this was great to hear, and knew I needed to share it with other Pyr owners.  He told me if I ever heard of one who did, to let him know.  This doesn't mean we should drop our guard with our big angels, but it's good to hear that feedback when considering the prevalent conditions of the breed.

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