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The Dangers of Gastric Dilatation - Volvulus (GDV)

All About Bloat and Torsion in Dogs (GDV)

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Radiographic Image of Bloat or Gastric Dilatation and Volvulus (GDV)

Ventral-dorsal radiograph of dog with GDV: The stomach is distended with food and the intestines are dilated with gas - note the white outline of the large, round stomach.

Image courtesy of Georgia Veterinary Specialists

What Is GDV?

Gastric Dilatation-Volvulus (GDV), commonly called bloat, is an emergency medical condition that is seen most commonly in large and giant breed dogs. This is a life-threatening situation that occurs when the stomach fills with gas and/or food, expands, and then rotates, trapping gas inside the stomach and cutting off blood supply to the stomach and spleen. As pressure in the stomach builds up and cannot be released, the stomach tissue becomes necrotic (dies) and the stomach can even rupture. The expansion of the stomach also has a serious effect on the heart and lungs, causing difficulty breathing and abnormal heart rhythm. Most dogs will go into shock soon after the signs of GDV are seen. Death can occur within a matter of hours (or less). The most common signs of GDV include the following:
  • Distended (bloated) abdomen
  • Unproductive retching / heaving
  • Extreme lethargy
  • Excess salivation
  • Heavy panting
  • Restlessness / pacing
  • Pale gums
If you notice any of these symptoms, you should go to a veterinarian immediately – especially if you have a large dog. Some dogs will experience gastric dilation (bloating) without the volvulus (torsion / twisting) – these dogs still need immediate veterinary attention. Either way, catching this condition early enough will increase your dog’s chances of survival.

How is GDV Handled?

If your veterinarian suspects GDV, one of the first steps is to stabilize the dog. Veterinary staff will swiftly place intravenous catheters and rapidly administer fluids for shock therapy. Oxygen therapy is sometimes required for dogs with difficulty breathing. Once the treatment for shock is underway, the standard next step is to attempt decompression by passing a stomach tube. If the tube can be passed, the gas is released and the stomach may be pumped to remove food. An electrocardiogram (EKG) may be performed to check for cardiac arrhythmia. If necessary, medications may be given to stabilize the heart. Blood will need to be drawn to run a number of tests – these typically include a complete blood count (CBC), chemistry panel (to assess organs and other body functions), and sometimes electrolytes and blood gas analysis. When the dog is stable enough to be moved, abdominal radiographs may be taken to check for gastric torsion. Veterinarians, technicians and assistants work as a team to perform these tests and treatments simultaneously and as quickly as possible. The above procedures will all take place in the first 10 to 20 minutes.

Once the dog is stabilized, surgery must be performed – even if decompression has been successful. Without surgery, the dog is at an extremely high risk for recurrence of GDV. During surgery, the stomach and surrounding tissues will be inspected for damage. In some cases, the spleen and/or part of the stomach will need to be removed due to tissue necrosis - this lowers the odds of recovery. Unfortunately, some dogs will have such a high degree of tissue damage that they cannot be saved. That is why acting on GDV as soon as possible is so important. If the damage can be repaired, the stomach is then surgically tacked to the body wall (a procedure called gastropexy). This will help prevent GDV from occurring in the future.

The hours to days following surgery are crucial, as many post-operative complications can occur. Dogs are hospitalized on intravenous fluids and medical treatments until deemed stable. They are not released from the hospital until they are well on their way to recovery.

What Causes GDV?

Many studies have been done to determine the causes of GDV, but researchers are still not completely certain why the condition occurs. However, most experts agree that the following circumstances may increase a dog’s risk for GDV:
  • Breed (large or giant)
  • Large, deep chest
  • Gulping food / eating too quickly
  • High activity following large meals
  • Feeding only one meal a day
  • Stress / anxiety
  • Thin body condition
  • Genetic predisposition
It is without question that certain dog breeds are predisposed to GDV. According to most studies, the most common dog breeds at risk for GDV are large, deep-chested dogs including (but NOT limited to) Great Danes, Weimaraners, Standard Poodles and Saint Bernards.

Can GDV Be Prevented?

There are many theories about GDV prevention, though studies have contradicted these methods throughout the years. One of the most surefire ways to prevent GDV is prophylactic gastropexy, an elective surgery that involves tacking the stomach to the body wall. This can often be performed during the routine spay or neuter of a young dog. Prophylactic gastropexy is highly effective at preventing GDV, but it can also be quite expensive. Some surgeons also offer laparoscopic gastropexy – this procedure involves the insertion of rigid cameras through tiny incisions. It is less risky than traditional surgery, but may be more expensive. Prophylactic gastropexy is usually only recommended in dogs that are considered at risk for GDV. Talk to your veterinarian about the available options for your dog.

Other preventative measures are up for debate. Not all experts agree on the efficacy of the following methods, so please discuss them with your veterinarian:

  • Eating two or more meals per day
  • Eating more slowly (some dog bowls are designed to slow down eating, but do not always work)
  • Avoiding vigorous exercise after meals
  • Adding canned food to the regular diet
  • Elevating the food and water bowls (some research shows that this may actually increase the risk for GDV)
Beyond prophylactic gastropexy, the most important thing you can do is to observe you dog closely. Watch for any changes or signs of illness and report them to your veterinarian. Once again, it cannot be stressed enough how important it is to discuss prevention with your veterinarian.
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