Gastric dilatation and volvulus, (GDV) is a potentially life-threatening condition characterized by enlargement and obstruction of the stomach associated with its rotation. The stomach becomes enlarged as gas or fluid or both accumulate. The act of rotation results in impaired blood flow and loss of stomach tissue. Emergency surgery is typically required and success is variable.
Common name: Bloat
Scientific name: Gastric torsion, gastric dilatation and volvulus, GDV
GDV is most common in large and giant breed dogs. Dogs with a high thoracic depth-to-width ratio or ‚Äúdeep chest‚Äù are at a higher risk. Underweight, older, male dogs are at increased risk dogs are at a higher risk. GDV can occur in any breed of dog or cat.
The incidence in large and giant breed dogs is 6%.
There is no known geographic predilection for this disease.
Clinical signs (primary, most to least frequent, scientific term, synonyms)
Unproductive retching, distended abdomen, pale mucous membranes (gums), ‚ÄúPraying‚Äù posture, biting or looking at the abdomen.
Clinical signs (secondary, most to least frequent, scientific term, synonyms)
Anxiety, weakness or recumbency.
Genetic predisposition, breed predisposition, behaviors, (e.g., rapid and ‚Äúgulping‚Äù eating style, exercise before or after eating). Certain disease conditions, (e.g., nasal mites, inflammatory bowel disease, other gastrointestinal diseases), stress, (e.g., grooming, dog shows, boarding).
Organ system affected
Gastrointestinal, cardiovascular, respiratory, immune, renal, Central Nervous System.
Abdominal Radiographs, chemistry panel and electrolytes, complete blood count, coagulation profile, blood-gas analysis, differential Diagnosis, tumor, trauma.
Gastric Dilatation and Volvulus, (GDV) is a potentially life-threatening condition that is most common in large and giant breed dogs characterized by enlargement and obstruction of the stomach associated with its rotation or twisting on itself. Breeds most at risk include German shepherd, Great Dane, Saint Bernard, Rottweiler, Labrador retriever and Alaskan Malamute, although any breed can be affected. Rotation of the stomach results in loss of blood flow and entrapment of gases. Impaired blood flow leads to loss of viable stomach tissue. Shock and cardiovascular failure may result. Potential causes and associated risk factors include a hereditary and breed predisposition, chest conformation, ‚Äúdeep chest,‚Äù increasing age, feeding one large meal per day, dry food only diet, exercise shortly before or after eating or drinking, gastrointestinal disease and stress. The most common clinical signs include unproductive retching, restlessness, pain and abdominal distension. GDV is most commonly diagnosed via radiography.
There is no home care to manage GDV. This is an emergency situation requiring immediate veterinary intervention.
The goal of initial treatment is to stabilize the cardiovascular, respiratory and renal systems. This is mainly accomplished via intravenous fluid and medical therapy. When successful, gastric decompression to remove excess gas and fluid is accomplished by passage of a stomach tube. Twisting of the esophagus often makes passage of a stomach tube challenging. Decompression will improve blood flow and decrease the extent of stomach tissue damage. Emergency surgery, called a gastropexy, is performed to replace the stomach and prevent recurrence. Recurrence without gastropexy may reach 80% but reduces to 3-5% with gastropexy.
Providing food as several small meals a day rather than one large meal may reduce the chance of torsion. Avoid stress during feeding and restrict exercise before and after eating. Do not use an elevated food bowl. In addition, do not breed dogs with a first degree relative with a history of GDV. Seek veterinary care as soon as signs of bloat are noted. Some veterinarians may recommend prophylactic (preventive) gastropexy for high risk dogs.
With timely decompression and surgery prognosis for survival is fair. Survival rates are associated with the viability of stomach tissue at the time of surgery directly related to impaired blood flow from twisting. Recurrence rates are high if a surgical gastropexy is not performed.
Gastric dilatation and volvulus is a life-threatening condition. See your veterinarian immediately for proper diagnosis and treatment of suspected gastric dilatation and volvulus.
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Fossum, TW. Surgery of the Digestive System. Gastric Dilatation and Volvulus; In: Fossum, TW. Small Animal Surgery, 2nd edition. St. Louis: Mosby, 2002; 354-360.
Glickman LT, et al. Non-dietary risk factors of gastric dilatation-volvulus in large and giant breeds. JAVMA. 2000; 217: 1492-1499.
Glickman LT, et al. Incidence of and breed-related risk factors for gastric dilatation-volvulus in dogs. JAVMA. 2000; 216: 40-45.
Raghavan M, et al. Diet-related risk factors for gastric dilatation and volvulus in
dogs of high risk breeds. Jaaha. 2004; 40: 192-203.
Karen L. Cherrone, DVM
Steven Hansen, DVM, MS, MBA