Bloat and GVD

 

By Melissa Devault, DVM

 

Bloat – no other five letter word will bring such a sense of panic as this one. For those of us loving this saintly breed, a knot forms in our stomach when we hear this word.  Many injuries can be considered life threatening emergencies, however bloat requires rapid treatment.

 

What is bloat and why is it life threatening?

The stomach sits in the upper abdomen. Its function is to receive food, begin the digestion process and move it through to the small intestine. In the case of bloat, food or gas can stretch the stomach to enormous size. In the case of GDV (gastric dilatation and volvulus), the stomach will actually twist on itself.This cuts off not only exit routes for food and gas, but it also interferes with blood supply.

Bloat_Illustration

 

What are the risk factors for developing bloat?

 

There are many conditions that may increase the risk of bloat:

  • Feeding once a day
  • Eating rapidly
  • Having a close relative such as a parent, sibling, offspring, that have bloated
  • Feeding from an elevated bowl (once recommended in the past)
  • Restricting water
  • Fearful or anxious temperament
  • Sex predilection: Males are more likely to bloat then females
  • Age: Older dogs tend to be affected
  • Diets with oil or fat as component of first 4 ingredients

 

This condition affects larger, deep-chested dogs such as Great Danes (likelihood of 42% over lifetime), Saint Bernards, Weimaraners, German Shepherd Dogs, Irish Wolfhounds, Rottweilers, Standard Poodles are examples of dogs that are affected, however any breed can develop bloat.

 

 

How to tell if your dog has bloated:

 

NON PRODUCTIVE VOMITING:

If your dog is attempting to vomit, but there is very small amount or nothing coming up…IMMEDIATELY seek veterinary care.

 

HYPERSALIVATION:

 Excessive drooling with any of these additional signs:

–       Restlessness

–       Abdominal distension

–       Abdominal pain

 

With any combination of these signs, seek veterinary care IMMEDIATELY!! Time is critical in catching this and increasing the odds of survival.

 

What has to be done?

 

Stomach decompression: Blood flow through the body is minimized because of the enlarged stomach. Parts of the stomach that are stretched will start to die off because it is not receiving blood.There are various ways to decompress the stomach.These will depend on the severity of the bloat, inserting a needle into the stomach, passing a stomach tube, or surgery.

 

IV Fluids: When the stomach is distended, pressure is placed on the body’s major blood vessels minimizing circulation to the body. Administering fluids will help to reestablish blood flow to the body.

 

Assessing Heart Rhythm:The pumping chambers of the heart (ventricles) can begin to function irregularly. This may be present at the time of bloat, or may develop after bloat has been addressed. EKG monitoring and treatment of this needs to be addressed.

 

Surgery: This is the ultimate step in treating this condition. Internal damage must be assessed.  If tissue is dying, it needs to be removed. The spleen must be visualized as well. It is not uncommon that if the stomach does twist, the spleen will follow and will require removal.  Without surgery, the risk of bloat occurring again is 75%. Surgical tacking of the stomach to the body wall will prevent twisting from occurring again.

 

Conservative management: Surgical management:
50% survival 67-87% survival

  • 86-98% w/o tissue necrosis (death)
  • 10-66% w/ tissue necrosis
47-85% recurrence rate 3-5% recurrence rate
  **Quick action in identifying that there is a problem can reduce the chance of tissue death and potentially increase the odds of survival

 

The more complicating factors involved with a GDV: prolonged time to seek veterinary care, splenectomy, removal of stomach tissue, lowered blood pressure, other organ damage, infection, presence of cardiac arrhythmias, increases the risk of complications and death.

 

Prevention of  Bloat: Gastropexy

Preventative tacking of the stomach to the body wall will prevent volvulus (twisting of the stomach).This can be performed either as an open abdominal procedure or as a laprascopic surgery.

 

Treatment of GDV: Preventative gastropexy:
$3,500-$8,000 $1,500-$1,800

 

Time is of the essence in this emergency. This is one of the big killers in our breed and thus the SBCA Health Panel is deeply committed to finding out how we can prevent this from happening.  A huge amount of money has been committed to research on this and we encourage you to continue to support our efforts to eradicate this killer. The Saint Bernard Club of America thanks you for your support.

 

I would like to thank Gretchen Kuchenmiester (Sicard), DVM, at the Northwest Veterinary Specialist Hospital in Clackamas, Oregon, who was gracious enough to help edit this material. She is a Veterinary Specialist, specializing in neurosurgery and all aspects of soft tissue surgery including reconstructive, oncologic, gastrointestinal, hepatobiliary, respitory, cardiovascular and urogenital surgery.   Dr. Kuchenmiester also gives bloat presentations to breed clubs.  For more information please visit  http://www.vcaspecialtyvets.com/northwest-veterinary-specialists/departments-doctors/departments/surgery