SERVICES » SURGERY » Gastric Dilatation Volvulus GDV / Bloat / Preventative Surgery
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GDV, also known as Bloat, and gastric torsion is an acute life threatening problem affecting the stomach of larger breed dogs, particularly those with a deep chest.
The stomach twists in the abdomen (Fig 1), the dogs feel nauseous and retch and swallow air. The air seems to make it into the stomach, but the twisting means they cannot burp it up. The stomach swells in the abdomen like a basketball and the pressure is so great that the blood flow back to the heart from the hindquarters and abdomen is blocked, causing shock and death.
The actual cause is unknown, although it is recognized that some breeds are certainly more likely to be affected with about 45% of Great Danes affected and about 10% of Standard Poodles.
Extensive surveys in the US over the last few years have helped to determine some of the factors that seem to predispose to the syndrome.
• Dogs with a deep chest ie the distance from the sternum to the top of the back is greater compared with the width of the chest are at greater risk.
• Dogs fed one large meal a day are twice as likely as ones fed two smaller meals daily.
• Eating slowly also helps decrease the incidence, and bowls have been designed to slow down the rate the dogs can eat.
• Elevated feeding may increase incidence and is really only indicated for mega-oesophagus.
• Temperament and environment are important. Those animals characterized as unhappy or fearful were two and a half times more likely to be affected. Dogs who experience stress going to shows etc are also 2-3 times more likely to develop GDV.
• Most affected dogs are over 7 years of age.
Although a recent American survey found the rate among Standard Poodles to be about 10%, certain families may have higher or lower incidents. At North Shore Veterinary Specialist Centre we have seen 8 Standard Poodles in the last 2 years. It would be interesting to keep a log of the incidents in the breed in Australia.
When dogs are affected urgent veterinary care is needed. The rate of onset of the severe signs seems to vary, but most dogs will die in 2 to 6 hours without treatment. The earlier treatment is started the better the odds, but the mortality rate within the first few days is still about 30%.
When presented, the patients need decompression of the stomach, pain management, shock therapy and rapid surgery to de-rotate the stomach and perform a "gastropexy" to fix the stomach to the right side of the inside of the abdomen to prevent recurrence. Some dogs have damage to the blood supply of the wall of the stomach and the necrotic (avascular or dead) area must be resected.
There are several serious complications that can develop in these patients in the 2-3 days after surgery and I never feel they are "out of the woods" for 4 days or so. The survival rate has been improved with the intensive care and rapid surgery available at specialty centres with 24 hour service, but this type of management can be very expensive.
There has been an increasing trend to perform a prophylactic gastropexy to prevent the problem in susceptible breeds and especially in dogs in affected families or otherwise deemed to be at risk. In the past this has required a major surgery with a large incision into the abdomen. At North Shore Veterinary Specialist Centre we now perform this using minimally invasive surgery or laparoscopically (using scopes etc) which means there is only a small incision (about 5cms) and little discomfort for the dog.
Prophylactic gastropexy is recommended for all high risk breeds such as Great Danes, Mastiffs, Rottweilers and Standard Poodles. If you'd like to discuss if it may be appropriate for your dog please telephone and speak to John Culvenor (Ph: 02 9436 4884).
© North Shore Veterinary Specialist Centre
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