Gastric Dilatation Volvulus

Introduction

Bloat, sometimes referred to as gastric dilation-volvulus (GDV), is a serious condition affecting the stomach of some larger breeds of dogs such as Great Danes, Dobermans, Old English Sheep Dogs, Blood Hounds, Irish Wolfhounds and German Shepherds. A variety of factors trigger the distension of the stomach with gas, fluid, food and foam and the subsequent risk of stomach rotation (volvulus) and the catastrophic effect this can have on the other intestinal organs, making this a true veterinary emergency.

Trigger factors

Not surprisingly there are a number of different trigger factors which underlie the condition apart from breed susceptibility. These are broadly:

Owner related factors

  • Allowing the dog to eat too quickly
  • Feeding large meals or feeding just once daily
  • Feeding foods likely to produce gas, especially soya based products and vegetables such as cabbage and related plants
  • Feeding certain supplements/additives, specifically citric acid (used as a preservative in some foods) and brewer’s yeast (used to supply B vitamins)
  • Using manufactured foods containing significant levels of fats
  • Exercising the dog before and after feeding
  • Using food bowls, which are elevated off the ground (this was once thought to help, but proved to increase the risk)
  • Allowing the dog to drink large amounts of water or allowing the dog to drink too quickl

Dog related factors

  • Drinking large amounts of water after feeding, as this dilutes the digestive enzymes
  • Swallowing too much air during eating or drinking
  • Becoming stressed during kennelling, change of owner, change of diet or when new dogs are introduced into the household

There is an increased risk in dogs which

  • Are anxious, fearful or aggressive
  • Have a deep narrow-chest, especially if they are older or in poor condition
  • Have a weak digestive system or which have underlying illness such as Pancreatic Insufficiency or Small Intestinal Bacterial Overgrowth (SIBO)
  • Have close relatives with the same problem
  • Are male, as they have a slightly greater risk than females
  • Are older, probably due to the laxity in the ligaments which support the digestive tract

Some of these factors are more important than others and for a few, the links with the development of GDV have not been clearly established.

Symptoms

It is very important to be able to identify the symptoms as they develop in order to seek veterinary help as soon as you can. The main symptoms are, roughly in order of appearance:

  • Repeated attempts to vomit, usually every 10-15 minutes. Often only a little foamy liquid/mucus is produced each time
  • Appearing to cough or gag repeatedly
  • Drooling of saliva from the mouth
  • General appearance of malaise
  • Restlessness or agitation
  • Other changes in behaviour such as hiding away
  • Distension of the stomach with gas. The abdomen can look increasingly enlarged and may appear as taught as a drum due to the pressure of the gas in the stomach
  • Hunched up stance
  • Abdominal discomfort/colic symptoms
  • Absence of any normal gut sounds
  • Rapid breathing
  • Increased heart rate
  • Pale or blue tinged mucous membranes
  • Collapse
  • Cold to the touch in later stages

Treatment

GDV constitutes a real veterinary emergency, so, if you suspect a problem, contact your veterinary surgeon as soon as possible. The sooner the problem is identified, then the more likely it is that veterinary intervention will be successful.

Treatment will aim to relieve the gas build up in the stomach. Under general anaesthetic the vet will initially try to pass a stomach tube to let the gas out of the stomach. In the early stages of GDV this can be quite easy to do. However, in more advanced cases, this technique may not work due to the degree of rotation of the stomach. An alternative approach is to deflate the stomach using a hypodermic needle inserted through the side of the abdomen. Having released the pressure, the stomach will usually be drained of its contents using a stomach tube. Surgery is then carried out examine the health of the stomach and spleen and to rotate the stomach back to its correct position. Once back in its normal position, an operation called as gastropexy may be carried out to fix the stomach to the abdominal wall to prevent future rotation. Damaged areas of the stomach and the spleen may need to be removed surgically. Around 80% of dogs with GDV survive if the problem is identified early on and veterinary involvement is prompt.

Prevention

  • Feeding

It is best to divide the food into 3 or 4 separate meals rather than feeding just once or twice daily. It is generally a good idea to avoid feeding using elevated bowls, as this may increase the risk of GDV occurring. Dogs prone to bloat or at risk breeds should be allowed to feed in a quiet, calm situation away from any potential stressful situations. In addition, they should be allowed to eat slowly, so that they do not rush their food and swallow air. If necessary they should be fed alone, away from other dogs, to avoid causing the dog to rush its food because of competition.

Changes in diet should be made slowly over a few days. Although water should be available at all times, many vets consider it wise to limit water intake after eating in at risk breeds, especially in dogs prone to drink large quantities after eating.

Dry pet foods that contain high levels of fat should also be avoided, as should any foods containing soya products and brewers yeast. High protein foods with a protein content of more than 30%, or feeding a significant amount of raw meat in the diet, are generally acknowledged as being helpful in preventing the condition. There also needs to be a significant amount of fibre in the diet; a minimum crude fibre content of 3% or more is ideal. Reducing the level of carbohydrate in the diet can also help in some cases. Some vets advocate the addition of enzyme supplements to the food, so that it is digested more thoroughly.

  • Exercise

Avoid vigorous exercise about 1 hour either side of feeding, bearing in mind that gentle exercise before feeding can stimulate the digestion and help the digestive system to function properly.

  • Dietary Supplements

Denes has a number of supplements that are known to help in preventing the condition.

Denes Digestion+ Powder

Herbs which soothe, calm and protect the digestive system can significantly reduce the chances of bloat occurring in at risk dogs by reducing gas formation. Herbs included in Digestion+ Powder such as Peppermint, Slippery elm and Marshmallow root are all known to be useful.

Denes Probiotic+ Powder

Probiotics help by stabilising the levels of friendly bacteria in the bowel and reduce the risk of gas formation by the fermentation of dietary carbohydrates in the gut. Adding probiotics on a daily basis is recommended for dogs at significant risk of developing GDV.

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