Gastric Dilatation-Volvulus

What is it? GDV is when the dog’s stomach bloats and twists. This is a life threatening disorder. –Fatality rate ranges from 10% - 60%

The bloating could come from: –Accumulation of: Air Gas Food Liquid Any combination of these

When the stomach accumulates too much of one of these, it can start to distend. If severe enough, the stomach will flip over on itself. –This is called torsion

Bloat usually leads to torsion, although torsion can happen without a bloat.

Since the stomach is securely fixed only at one spot near the top, when the stomach is dilated, it can rotate on that one fixed axis.

The stomach generally rotates in a clockwise direction and can rotate up to a maximum of 360 degrees. A less common rotation is counter- clockwise direction and can rotate up to 90 degrees.

If the rotation is severe enough, it could mean the displacement of both the stomach and the spleen. –In other words, they will switch places.

After the stomach has twisted, it will cut off both the stomach contents and the blood supply. –Blood vessels that feed the stomach are kinked and stretched as the stomach twists.

Where the stomach has twisted, toxins start to build up in the dying stomach lining. The liver, pancreas, and upper small intestines may be damaged also.

Shock can occur from the low blood pressure and endotoxins rapidly develop. –Endotoxins- potentially toxic, natural compounds found inside pathogens such as bacteria.

Sometimes the stomach will rupture, leading to peritonitis. –Peritonitis- an inflammation of the membrane that lines the wall of the abdomen and covers the abdominal organs.

Causes of GDV The exact cause is unknown; however there are many theories. –Gulping food down When the dog eats too fast and swallows a lot of air at the same time.

–Eating large meals in one sitting –Drinking large amounts of water immediately after eating –Vigorous exercise/work after a full meal. Due to the extra stomach contents and the belly swinging while full.

–Eating food that swells excessively when soaked in water. –Certain food types such as: Peas Onions Beans Beet pulp

There are also some medical problems such as: –Gastric fermentation (digestive disorder) –The speed in which the stomach empties itself. –The pace of the stomach’s digestive contractions.

What are the symptoms? Abdominal distention Abdominal pain Restlessness Depression

Anxiousness Respiratory dysfunction Hypersalivation Belching

Retching Frequent attempts to vomit Vomit foamy mucous Mucousy foam around lips

Pale mucous membranes Lethargy Weakness Whining for no apparent reason

Thumping sound on abdomen Can’t get comfortable Excessive panting

Prolonged capillary refill time – >2 seconds Rapid heart rate –Greater than 120 bpm Rush dog to the vet, this is an EMERGENCY!!

What we do for it Decompress by placing a large bore needle or trocar catheter through the skin and muscle directly into the stomach. Attempt to pass a stomach tube.

Place one or two large catheters and pump them with fluids and steroids for shock. X-rays, ECG, and blood tests. –Treatment will probably start before all test results are in.

Ways to prevent it Feed multiple, small meals throughout the day. Add liquid to food before feeding. Restrict exercise an hour before and two hours after eating.

Consider a bloat kit. –Contains the essentials needed to deal with a bloat. Usually includes a rubber hose for each dog, tools needed for an emergency, and even a large bore needle to puncture your dog’s stomach, should help not be available in time.

Use lubrication on the tube, if none available use water. Pass the tube down slowly and gently. –Push it down an inch or so at a time, only after the dog has swallowed, without gagging, the section you have already pushed in.

NEVER FORCE TUBE DOWN!! –You can do severe damage to the internal organs.

If the tube passage is unsuccessful due to internal obstruction, then it means that the stomach has probably twisted

Improperly used may harm your dog even more. DON’T TAKE THIS LIGHTLY!!

Gastropexy –This is a surgical procedure, but should be done anytime a dog bloats or even preventively for breeds that are predisposed: The stomach is attached to the body wall to prevent twisting, or future episodes of volvulus. Recurrent volvulus can be pretty effectively managed with a gastropexy, but dilatation can still occur.

Just to know All the female working dogs leaving Lackland Air Force Base have had a gastropexy done. They do this during the spay surgery.

People used to say that elevating the food bowl would help prevent GDV. Raising the bowl may actually increase the chance.

Case Study Dec 2006: Joop B021 –Returned from deployment to Iraq one month earlier (survived numerous IEDs) –Presented on emergency late at night with severe bloat/GDV –Last check on dog was 4 hours prior to presentation, MWD was fine at that time –CAN HAPPEN QUICKLY!!!!

Any Questions?