• Some type of obstruction at the outflow end of the stomach

Whatever the cause, the stomach first enlarges with gas, liquid, or both. This enlargement is known as "gastric dilatation." The stomach then swings like a pendulum, eventually swinging or twisting all the way over on itself, causing obstructions at both ends of the distended stomach. These obstructions prevent the dog from vomiting or expelling the gas and liquid into the intestine for eventual delivery to the outside. The twisting of the stomach is known as "volvulus." The stomach continues to enlarge, leading to rapid and severe compromise of blood flow and breathing.

What are signs of gastric dilatation and volvulus (GDV) syndrome?

The signs of gastric dilatation and volvulus (GDV) syndrome vary, depending on the extent of changes in the stomach. Some animals may be identified with gastric dilatation only. In these cases, the stomach has a large volume of gas, fluid, or both, but the stomach has not twisted on itself. Other animals will be presented soon after the stomach twists. Some animals will be presented in shock and with heart problems due to the effects of the abnormal stomach and the compromised blood flow and breathing.

• Rapid onset of condition
• Rapid worsening of condition
• Unsuccessful attempts to vomit, dog will retch but will not produce any vomited material
• Excessive salivation or drooling
• Bloat (abdominal distension), when tapped by fingers or hand, the bloated abdomen sounds like a drum
• Weakness and lethargy, leading to collapse
• Increased heart and breathing rates

Gastric dilatation and volvulus syndrome is a medical emergency. Pets require immediate medical treatment with special attention to establishing improved function of the heart and lungs. The gas and fluid must be removed from the stomach (that is, the stomach must be decompressed).

Gastric dilatation and volvulus (GDV) syndrome is diagnosed by a good medical history and a physical examination. Occasionally, radiographs (X-rays) of the abdomen are required. Other diagnostic tests such as blood work and electrocardiography (ECG or EKG, an electrical analysis of the heart) will help in the medical management of the pet.

Gastric dilatation and volvulus (GDV) syndrome is a life-threatening emergency, requiring immediate and intensive medical intervention. Fluids will be administered intravenously (through the vein) to improve the compromised blood flow and to treat shock. Steroids and antibiotics may be administered. Relief of dangerous bloat (stomach distension) usually follows the initiation of fluid therapy. Passage of a tube into the stomach generally is effective. Use of a large-bore needle to puncture the stomach through the abdominal wall is necessary in some cases. Surgical exploration of the abdomen, release of excess gas and liquid in the stomach, and return of the stomach to its normal position are the definitive treatments for GDV. Permanently anchoring the stomach to the body wall (gastropexy) is performed to prevent recurrence. Some patients require removal of the spleen or part of the stomach during the surgery.

Exercise is restricted and a special feeding plan is developed immediately after surgery. Prevention of GDV or its recurrence requires avoidance of over eating (over ingestion) of food or fluids, feeding multiple smaller meals spread throughout the day, and avoidance of exercise around feeding time.

The prognosis (outcome) for animals with gastric dilatation and volvulus (GDV) syndrome varies. The prognosis depends on findings at surgery. Damage to stomach tissue and injury to the spleen complicates GDV. Animals may develop complications, such as stomach ulcers. Patients recovering well through the seventh day after surgery generally recover completely. Without gastropexy, up to 80% of the cases will have recurrences.

Bloat: How can GDV be avoided?

Even though there are no sure-fire preventives for bloat, the following suggestion may increase the odds of avoiding it:

1. Feed your dog two or three small meals daily, rather than one large meal. To minimize the amount of air your dog ingests while eating, don't allow the dog to eat large quantities of food too rapidly.
2. Premix dry kibble with water so the food expands before it enters your dog's digestive system.
3. Feed dogs individually and in a quiet location and from an elevated dish.
4. Feed at times when someone can observe him 1-2 hours after he eats.
5. Avoid vigorous exercise, excitement and stress one hour before and two hours after feeding. Walking is okay because it helps stimulate normal gastrointestinal function.
6. Be especially watchful when your dog is under stress (for example, during kenneling, hospitalization, or showing).
7. Gradually introduce any dietary changes over a period of 3-5 days.
8. Avoid feeding your dog table scraps or "people food" treats.
9. Ensure water is always available but limit the amount immediately before and after feeding.
10. Watch for any actions or behavior that may signal abdominal discomfort. If a dog with GDV could talk, it would complain of abdominal pain, nausea, and weakness. But, alas, our canine friends can't verbalize this information, so owners have to look for outward signs. If your dog exhibits one or more of the following conditions or behaviors -- especially within a few hours of eating -- call your veterinarian without delay!
    • Abdominal swelling and tenderness (note: abdominal swelling is not always obvious with GDV)
    • Pacing
    • Excessive drooling
    • Whining
    • Restlessness or frequent change of position, often accompanied by whining
    • Panting or labored breathing
    • Stretching
    • Staring at the abdomen, sometimes with apparent confusion or distress
    • Anxiety
    • Unsuccessful attempts to vomit
11. Establish a good relationship with your veterinarian. Always have your veterinarian's phone number and that of the nearest emergency animal hospital handy. Discuss emergency procedures and preventive surgery such as circumcostal gastropexy (stomach tack) and medical management of your dog.

Veterinarians continue to study the gastric dilatation syndrome (GDV) and still have many unanswered questions. The above recommendations have been prepared by researchers to help prevent the problem from occurring. Please remember that this material is not meant to be a substitute for professional medical advice. You should discuss GDV (bloat) prevention and first aid procedures with your veterinarian and follow his/her advice.