Over the weekend I was called in for an emergency surgery to help a dog suffering from Gastric Dilatation-Volvulus (GDV) or more commonly called dog bloat. She was a 12-year-old Boxer presented with a sudden onset of non-productive retching with a distended and painful abdomen. This is a surgical disease that occurs primarily in large breed, deep-chested dogs such as Great Danes, Standard Poodles, Doberman Pinschers, Boxers, Labrador Retrievers, Golden Retrievers and German Shepherds.
For an unknown reason the stomach fills with air and rotates, restricting blood flow to and from the abdomen. This lack of blood flow can quickly lead to shock resulting in tissue death of not only abdominal organs but the heart as well. When blood flow is restricted to the heart it cannot pump as effectively and the heart muscle begins to die resulting in cardiac arrhythmias. We quickly took abdominal x-rays which confirmed the presence of GDV and started her on intravenous fluids to help prepare for surgery.
She needed to be taken to surgery immediately before the restriction of blood flow caused any permanent damage to the abdominal organs. Often the stomach tissue will start to die which may require resection of the affected tissue. In addition, the spleen is closely attached to the stomach and will also rotate often necessitating removal.
When I opened her abdomen the stomach was severely distended and torsed but luckily the stomach tissue appeared healthy. I quickly reached in and flipped the stomach back into is appropriate position. While the spleen was enlarged and an angry purple color within a few minutes of repositioning the stomach, it returned to a normal size and color. The remainder of her abdominal organs were healthy in appearance.
After correcting the positing of the stomach and emptying it of all the trapped gas and fluid I performed a gastropexy. This procedure attaches the stomach to the body wall within the abdomen. This physically prevents the stomach from torsing so that she will not develop another GDV. After surgery she was started on a constant rate infusion of pain medication and was hooked up to an ECG so we could monitor her for any arrhythmias. She is doing well and set to be discharged from the hospital tomorrow.
The gastropexy procedure is often done prophylactically at the time of spay or neuter in at-risk breeds to prevent dog bloat from ever occurring. She was very lucky that her owners acted so quickly, as the disease can progress rapidly and is often fatal. Anyone with a large breed dog should be aware of this condition and the clinical signs to watch out for which include non-productive retching and abdominal distension. These signs can also be accompanied by hyper-salivation, restlessness, inability to stand and lethargy.
GDV or dog bloat is one of the few true surgical emergencies and getting treatment for your dog as quickly as possible is essential. I strongly recommend the prophylactic gastropexy at time of spay or neuter in any breed that is at risk. Dogs greater than sixty pounds have a 23% lifetime risk of GDV. That is a staggering statistic but luckily we have a way to prevent this potentially devastating disease.
Ashley Gallagher, DVM