The Meowing Vet is joined by contributing guest writer I Love Veterinary to discuss Gastric Dilatation-Volvulus (GDV). Also commonly called “bloat”, GDV is an emergency life-threatening twisting of the stomach that can occur in dogs, particularly large, deep-chested breeds such as Great Danes.
Read I Love Veterinary‘s full article below…
The Meowing Vet is grateful to our respected friends at I Love Veterinary (www.iloveveterinary.com) for the work they do and for being guests on our blog with this article about GDV. If you’d like to know more about the work they do, visit their website and store, as well as their social media profiles. (Click links below…)
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Gastric Dilatation-Volvulus (GDV) is a condition that is rapidly progressive and very much life-threatening to dogs. This condition is most commonly linked with very large meals that cause the stomach to bloat, with a mixture of food and gasses that cannot exit. As the stomach expands and dilates, the pressure inside increases. This combined, the increased pressure and the size of the bloated stomach may lead to very severe consequences, including:
difficulty with adequate blood flow and blood return from the abdomen to the heart- ischemia of the lining of the stomach
- a sudden rupture of the stomach wall
- pressure on the diaphragm that can lead to the lungs not being able to expand fully and thus decrease the ability for normal breathing
Additionally to dilatation, the stomach can extend enough to rotate itself in the abdomen; this condition is called volvulus. This condition can lead to a blockade of the blood supply to the stomach and the spleen. Most pets are in a state of shock when this happens.
This condition is treated by primarily stabilizing the patient, decompressing the stomach, and via surgery. The surgical procedure is called gastropexy and is performed to return the stomach to the normal position permanently. During surgery, other abdominal organs must be evaluated for possible related injuries and treated appropriately. The entire body may suffer from the poor oxygenation, and cell death may occur in many tissues.
Risk factors for this condition may include:
- dog breeds that have a deep chest (see photo caption below)
- dogs that are fed one large meal a day
- geriatric dogs
- relatives of dogs that suffer the same condition
Mortality rates associated with this condition have been reported to be as high as 15%.
Dog breeds predisposed to GDV include Great Danes, St. Bernards, Weimeraners, Irish Setters, Standard Poodles, Basset Hounds, Dobermans, Old English Sheepdogs, German Shorthaired Pointers, Newfoundlands, and German Shepherds.
SYMPTOMS
- anxiously pointing its head to the abdomen
- standing and stretching more than normal
- drooling extensively
- distended abdomen
- retching without producing anything
As the condition will progress, the dog may start to pant, and physical examination will show signs of elevated heart rate and respiration, will have poor pulse quality and poor capillary refill time (CRT). Surgery is indicated and recommended even without the volvulus. If this condition is not treated on time, it may lead to:
- hypoxia due to the diminished respiration and cardiac output. This will lead to cell death in all the vital organs.
- cardiac arrhythmias
- the lining of the whole gastrointestinal tract (GIT) is at risk of cell death
As the conditions progress, it may lead to bacteremia due to all the bacteria from the abdomen circulating through the bloodstream. It may also come to a local increase of toxins from the bloated stomach which may lead to acute kidney and liver failure.
DIAGNOSIS
To determine the diagnosis, it is recommended the following:
- bloodwork that includes CBC (complete blood count), blood electrolytes, serum chemistry and urine analysis. This allows the veterinarian to rule out other diseases that can mimic the signs of GDV.
- abdominal x-ray. It is used to visually confirm the diagnosis.
- ECG (electrocardiogram). It is used to evaluate the heart condition and the presence of arrhythmias.
TREATMENT
First, the most important thing to do is to stabilize the dog. This often begins with the administration of IV fluids and oxygen therapy. After that, often a gastric decompression is performed. This is done by passing a gastric tube down into the stomach to let the air out. A gastric lavage is often followed to remove remaining food particles.
After the dog is stable, it is time for surgery. The surgery involves full exploration of the abdominal cavity and de-rotation of the stomach to its original position. Additionally, the vital organs around the stomach must be evaluated for their viability. If necessary, partial gastrectomy (removal of a part of the stomach) or splenectomy (part of the spleen) may be performed. Once the stomach is put in its normal position, it is permanently fixed to the abdominal wall. This is called gastropexy. The purpose of the gastropexy is to prevent this condition from ever happening again.
POST-OPERATIVE CARE AND OUTCOME
Most dogs will remain hospitalized for several days and will be given IV fluids. While recovering, they will be evaluated for arrhythmias and other possible post-op complications.
When the dog will be released, home post-op care will include exercise restrictions for several weeks (for the incision site to heal) and dietary management that will include multiple small meals during the day instead of one big meal for the rest of its life.
– The ‘I Love Veterinary’ Team
The Meowing Vet thanks our friends at I Love Veterinary for this guest feature! If you suspect that your dog may have GDV, consult with your local veterinarian immediately. If you have an at-risk breed, ask your vet how to help prevent this disorder from occurring, such as changes in your dog’s feeding routine as well as prophylactic gastropexy.
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