A typical scenario starts with a large, deep-chested dog, usually fed once daily. Typical breeds affected are Akita, Great Dane, German Shepherd, St. Bernard, Irish Wolfhound, and Irish Setter. Sight hounds, Doberman Pinschers, Weimaraners, Bloodhounds, other similar breeds, and large, deep-chested mixed breeds are also affected.
Factor in the habit of bolting food, gulping air, or drinking large amounts of water immediately after eating to this feeding schedule and body type. Then add vigorous exercise after a full meal, and you have the recipe for bloat.
Of course, the fact that not all bloats happen in just the same way and the thought that some bloodlines are more at risk than others further complicates the issue.
Simple gastric distention can occur in any breed or age of dog and is common in young puppies who overeat. This is sometimes referred to as pre-bloat by laymen. Belching of gas or vomiting food usually relieves the problem.
If this condition occurs more than once in a predisposed
breed, the veterinarian might discuss methods to prevent bloat, such as feeding
smaller meals or giving Reglan (metoclopramide) to encourage stomach emptying.
Some veterinarians recommend, and some owners request, prophylactic surgery to
anchor the stomach in place before the torsion occurs in dogs who have
experienced one or more bouts of distention or in dogs whose close relatives
have had GDV.
Now a complex chain of physiologic events begins. The blood return to the heart decreases, cardiac output decreases, and cardiac arrythmias may follow. Toxins build up in the dying stomach lining. The liver, pancreas, and upper small bowel may also be compromised. Shock from low blood pressure and endotoxins rapidly develops. Sometimes the stomach ruptures, leading to peritonitis.
Abdominal distention, salivating, and retching are the
hallmark signs of GDV. Other signs may include restlessness, depression,
lethargy, anorexia, weakness, or a rapid heart rate.
Do take the time to call ahead.; while you are transporting the dog, the hospital staff can prepare for your arrival. Do not insist on accompanying your dog to the treatment area. Well-meaning owners are an impediment to efficient care. Someone will be out to answer your questions as soon as possible, but for now, have faith in you veterinarian and wait.
Initial diagnosis may include x-rays, an ECG, and blood tests, but treatment will probably be started before the test results are in.
The first step is to treat shock with IV fluids and steroids. Antibiotics and anti-arrythmics may also be started now. Then the veterinarian will attempt to decompress the stomach by passing a stomach tube. If this is successful, a gastric levage may be instituted to wash out accumulated food, gastric juices, or other stomach contents. In some cases, decompression is accomplished by placing large-bore needles or a trochar through the skin and muscle and directly into the stomach.
In some cases, this medical therapy is sufficient. However, in many cases, surgery is required to save the dog. Once the dog's condition is stabilized, surgery to correct the stomach twist, remove any unhealthy tissue, and anchor the stomach in place is performed. The gastroplexy, or anchoring surgery, is an important procedure to prevent recurrence, and many variations exist. Your veterinarian will do the procedure he feels comfortable with and which has the best success rate
Recovery is prolonged, sometimes requiring hospital stays of a
week or more. Post-operative care depends on the severity of the disease and the
treatment methods employed and may include a special diet, drugs to promote
gastric emptying, and routine wound management. Costs may run $500-1000 or more
in complicated cases.
While the genetics of GDV are not completely worked out, most
breeders and veterinarians feel there is some degree of heritability. Therefore,
while prophylactic gastroplexy will probably help an individual dog, it makes
sense not to breed dogs who are affected or who are close relatives of those
suffering from GDV.