A couple of weeks ago a “Tales from the Pet Clinic” reader asked about bloat. As promised, here is an update on the topic.
Bloat is a life threatening disorder of the stomach typically occurring in large breed, deep chested dogs. The correct medical term for bloat is gastric dilatation. If the stomach twists around itself, the word volvulus is added and in abbreviated doctor-speak, becomes GDV.
The diagnosis of GDV is made with a combination of physical examination findings (a dog with abdominal distension and unproductive vomiting) and an x-ray. Below, you see the x-ray of a dog with GDV. You are looking at the dog from side to side with the backbone at the top. The oval, less white area in the center is the stomach, distended by food and gas. The distended stomach has pushed the intestines into the pelvis or hip area. Treatment requires an abdominal surgery to empty the stomach and suture it back into its normal position.
Photo: The Animal Medical Center archives
Research has shown the Great Dane, Gordon Setter, Irish Setter, Weimaraner and St. Bernard are the most commonly affected breeds, but any breed can be effected. Successful treatment of GDV is possible, but carries a high mortality rate and a high cost, therefore, development of an effective prevention strategy for this syndrome is desirable.
Multiple interventions have been suggested to prevent GDV. They include dietary changes and using special food bowls designed to slow the rate at which dogs consume their food. One study of Rotweillers and Great Danes has shown prophylactic gastropexy decreases the risk of GDV.
The concept behind special food bowls is to slow the dog’s rate of food consumption. “Fingers” extending from the bottom of the special bowl keep dogs from bolting down their food in a single gulp
The data supporting dietary changes and special food bowls is not strongly convincing. These interventions are not likely to hurt your dog, but do check with your dog’s regular veterinarian before instituting any dietary change. There may be a protective effect of feeding dogs larger kibble and multiple meals per day. Some dogs may benefit from a low fat diet, which increases the rate at which the stomach empties.
Prophylactic gastropexy, the preemptive suturing of the stomach into place to prevent twisting is indicated in breeds at risk for GDV or in dogs who have a close relative with GDV. At the Animal Medical Center, we chose potential candidates from those with recurrent episodes of gastric dilatation (bloat) without volvulus, offspring or siblings of dogs that have had GDV, and from dogs of predisposed breeds whose owners are concerned about GDV. We consider performing this procedure at the same time as ovariohysterectomy or neutering in young dogs at risk for GDV.
Gastropexy can be performed using 2 different surgical techniques. The traditional technique is to surgically tack the stomach into position so it cannot twist. The newer procedure is to use laparoscopy to tack the stomach into position. Laparoscopic gastropexy is a minimally invasive technique that has been shown to result in a strong, permanent adhesion and therefore greatly reduces the risk of the gastric torsion that characterizes GDV. Laparoscopic gastropexy is minimally invasive, quick, method to prevent GDV. It has been reported to have few complications. Additionally, laparoscopic procedures have been shown to be associated with reduced postoperative pain and faster recovery than open procedures. In female dogs, this procedure can also be combined with a laparoscopic spay.