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What is Gastric Dilation / Volvulus (GDV)

Gastric dilation or bloat, occurs when the stomach becomes enlarged or distended due to a build up of gas, fluid or food. After distending, the stomach will often rotate or twist so that the oesophagus and pylorus (the openings at either end) block off the stomach, preventing the escape of gases and making the problem much more serious. This twisting is called volvulus, or gastric torsion. Both gastric dilation and gastric dilation with volvulus (GDV) are medical emergencies, and unless treated quickly, these conditions can kill. The swelling and twisting of the stomach blocks off blood vessels, preventing the normal flow of blood to abdominal organs at first, and then to the heart. The resulting low blood pressure causes shock, the stomach or intestines may perforate, and the dog may soon die from multiple organ failure, unless the pressure and twisting is relieved very quickly.The condition mainly occurs in deep-chested, large breed dogs including Standard Poodles, Dobermanns, and German Shepherds. Occasionally a case may be seen in small breed dogs.

There are many theories about why some dogs suffer from GDV and others don't, such as a genetic predisposition (especially if it occurs in young dogs), a history of gastric upsets, or the habit of sucking lots of air and hyperventilating. However, most experts agree that contributing factors may be that they eat large meals of predominantly dry food, the diet has poor digestibility, or they are permitted to exercise or drink large amounts of water just before or after a meal.

What are the signs or symptoms?

Early signs of GDV may include a change in your dog's behaviour eg a reluctance to move around, or resting in an unusual position. This may be followed by restlessness, excessive salivation and unsuccessful attempts to vomit or defecate. Your dog may also show some signs of pain, especially if you gently touch its abdomen. The abdomen may also look swollen, feel tight to the touch or sound hollow if tapped very gently. As the condition worsens, symptoms of shock will set in, as the blood supply to vital organs gets interrupted. Your dog's gums may become pale and its breathing will become more rapid.

How is it diagnosed?

Apart from observing the above symptoms, your vet will want to know when your dog ate or drank last, how much they consumed, and whether it has been exercising, burping or passing wind. Treatment will vary depending on whether the stomach has twisted, so they may also decide to do a quick X-ray. As GDV is a medical emergency, it can save precious time if you are able to warn your vet that you are coming in, so they can prepare.

How is it treated?

The gas must be removed from the stomach as quickly as possible to relieve the pressure on blood vessels, and intravenous fluids will usually be required to treat for shock. If there is gastric dilation without volvulus, then a tube down the dog's throat and into the stomach may assist in decompressing the stomach. However, if this doesn't work, the vet may cut a slit in the wall of the stomach to release the gas directly. Unfortunately, if the stomach has twisted, then major surgery will be required to not only release the gas, but also to untwist it. Once a dog has suffered from GDV, there is a very strong chance that it will have repeat episodes. Your vet may therefore recommend a gastropexy once your dog is stable. This is an operation which permanently pins the stomach into place so it won't be able to twist again.

How can you avoid buying a dog with gastric dilation / volvulus?

You cannot avoid buying a dog with GDV - even smaller breeds will occasionally succumb to the condition. However, if you own a deep chested dog such as a Standard Poodle or Dobermann, where the chances of it occurring are higher, then you can help prevent an episode by following a few simple guidelines:

• Divide the daily feed into a couple of smaller meals - one large meal is more likely to distend the stomach.
• Do not exercise your dog for a couple of hours before or after a meal - this can increase the gas build up and air intake.
• Feed a high quality diet that is easily digested, and if you are making dietary changes, do it slowly over a couple of weeks.
• Don't feed large quantities of dry food, or let your dog drink large quantities of water before or after meals. Although many pet food companies now recommend feeding a diet that is primarily dry (kibble), it may cause GDV in breeds that are already predisposed to the condition. This is because they need to drink large quantities of water to help digest the kibble which can cause the stomach to bloat. Don't panic and avoid dry food altogether - it is an excellent source of nutrition and also helps with dental health. However do avoid feeding large quantities of dry food and consider soaking it before feeding to your dog.
• Don't give your dog foods that give it flatulence eg peas and beans.