Bloat

Bloat is the common term for Gastric Dilatation with Volvulus. This occurs when the stomach twists so that both the esophagus (intake) and pylorus (outflow) are blocked. This is a life-threatening disease that can kill up to 40% of affected dog.


Occurrence:
Most cases of bloat occur in deep-chested, large-breed dogs. Think German Shepards, Great Danes, St. Bernards, although, you can see this occur in almost any breed of dog. I’ve actually seen this in a Beagle and a Shitz Tzu. Most of the dogs that bloat are over 7 years old, and dogs that have bloated once tend to do so again.

Causes:
Many causes have been associated with this disease, although no one knows for sure. It is thought that there needs to be a loosening of the ligaments that hold the stomach in place. But, since there are so many ways for the stomach to flip in a deep and narrow chested dog, it’s unlikely that one factor will emerge as the sole cause. Some factors that may be associated with bloat include: drinking large amounts of water; eating a single, large meal daily; fearfulness, anxiety; exercising just after eating. I strongly recommend that people not exercise their large dogs for 1 hour after meals to help reduce the chances of bloat occurring. My last bloat was an 8 week old puppy that rolled over on his back to be petted just after eating.

Signs:
Most professors will tell veterinary students that bloat is the only disease you should be able to recognize while driving by a dog on the street. The tell-tale sign for veterinarians is an abdomen that is swollen on the left side. Most clients will bring that dog in because “he acts like he’s trying to vomit, but nothing comes up”. This sign is an emergency that requires you leave the house with the dog, before you call the emergency clinic. By the time the dog is doing this you have about 30 minutes before the dog will die, in most cases. Other signs that can occur are often vague and confusing to the owner: the dog will appear restless, the dog will hunch-up, some dogs will appear to try and defecate repeatedly. All large-breed dog owners should be concerned about bloat whenever the dog is not feeling well or refuses to eat. In many cases, the dog will swell and deflate several times before the stomach finally twists.

Treatment:
The best thing you can do for your dog is to be prepared. You should know where your closest emergency clinic is. And I also recommend all owners carry pet health insurance. Often the treatment for this disease will run more than $1000.
Once the dog is at the emergency clinic, they will take X-rays to confirm the diagnosis and begin to prepare the patient for surgery. This disease always requires surgical replacement of the stomach, with or without removal of the spleen. In my experience, about 50% of the dogs also have a spleen that has twisted, which requires removal of that organ as well.
Outcome:
The prognosis for dogs with GDV is generally fair to good. The highest mortality rates appear to be associated with:

Increased levels of lactate at time of presentation. Since lactate accumulates when tissues are deprived of oxygen, it’s safe to assume that high levels of lactate would be associated with tissue death.

Increased length of time between insult and presentation. The longer it takes for the veterinarian to decompress the stomach the more damage is done.

Financial Reasons. Many of these dogs that are savable are euthanized due to the cost of the surgery.

Inadequate veterinary care. I know I’m biased because I own an emergency clinic; however, it’s just not possible for one doctor to treat this disease, by himself late at night. For one thing, the surgery is very demanding. There is no way for someone to do this surgery and monitor the patient at the same time. Before surgery, these patients require a catheter, fluids, antibiotics, pain medication, tubing of the stomach to let the gas out, X-rays and continuous monitoring. You may very well save some money, but you be doing so at some risk to your dog.


Here are some references for you:

http://www.globalspan.net/bloat.htm
http://www.animalhealthchannel.com/gdv/symptoms.shtml
http://www.peteducation.com/article.cfm?cls=2&cat=1571&articleid=402