Gastric Dilation Volvulus - BLOAT
Updated: Apr 14, 2019
This information is not intended to replace advice or guidance from veterinarians or other pet care professionals. It is simply being shared as an aid to assist you with your own research on this very serious problem.
Tim and I live in the country where our travel time to the first vet clinic is 17 minutes. If that clinic is not open, our first emergency clinic is 1.25 hours away and that will include speeding. I do not feel confident in administering a bloat emergency kit but should this occur, I may have to. Having said that, at our next vet appointment I will be booking “extra time” to discuss with our vet.
Bloat is a very serious health risk for many dogs, yet many dog owners know very little about it. From what ‘ve researched on the web, the mortality rate for GDV is nearly 50 percent. Even with emergency treatment, as many a one-third of afflicted dogs die. It is frequently reported that deep-chested dogs, such as German Shepherds, Great Danes, and Dobermans are particularly at risk. This blog provides information on bloat and summarizes some of the key points I found in the sites I researched.
- UPDATE 04/14/2019 : Since posting this blog, I've had people with a very wide variety of breeds contacting me to say they've lost their dogs to Bloat. Some of these breeds consist of Golden Retrievers, Weimeraners, Vizslas, and also Border Collies. Please, anyone of any breed please beware!
Although I have summarized information I found about possible symptoms, causes, methods of prevention, and breeds at risk, I cannot attest to the accuracy. Please consult with your veterinarian for medical information.
If you believe your dog is experiencing bloat, please get your dog to a veterinarian immediately! Bloat can kill in less than an hour, so time is of the essence. Notify your vet to alert them you're on your way with a suspected bloat case. Better to be safe than sorry!
The technical name for bloat is "Gastric Dilatation-Volvulus" ("GDV"). Bloating of the stomach is often related to swallowed air (although food and fluid can also be present). It usually happens when there's an abnormal accumulation of air, fluid, and/or foam in the stomach ("gastric dilatation"). Bloat can occur with or without "volvulus" (twisting). As the stomach swells, it may rotate 90° to 360°, twisting between its fixed attachments at the esophagus (food tube) and at the duodenum (the upper intestine). The twisting stomach traps air, food, and water in the stomach. The bloated stomach obstructs veins in the abdomen, leading to low blood pressure, shock, and damage to internal organs. The combined effect can quickly kill a dog.
Be prepared! Know in advance what you would do if your dog bloated.
· If your regular vet doesn't have 24-hour emergency service, know which nearby vet you would use. Keep the phone number handy.
· Always keep a product with simethicone on hand (e.g., Mylanta Gas (not regular Mylanta), Gas-X, etc.) in case your dog has gas. If you can reduce or slow the gas, you've probably bought yourself a little more time to get to a vet if your dog is bloating.
· Consider keeping a “Bloat Kit” (listed below) and ensure by direction of your vet, you know how to use appropriately.
Unfortunately, from the onset of the first symptoms you have very little time (sometimes minutes, sometimes hours) to get immediate medical attention for your dog. Know your dog and know when it's not acting right.
Symptoms include but are not limited to:
- Attempts to vomit (usually unsuccessful); may occur every 5-30 minutes. This seems to be one of the most common symptoms and has been referred to as the "classic symptom". "Unsuccessful vomiting" means either nothing comes up or possibly just foam and/or mucous comes up.
- Doesn't act like usual self : Perhaps the earliest warning sign and may be the only sign that almost always occurs. There have been several reports that dogs who bloated asked to go outside in the middle of the night. If this is combined with frequent attempts to vomit, and if your dog doesn't typically ask to go outside in the middle of the night, bloat is a very real possibility.
- Significant anxiety and restlessness : One of the earliest warning signs and seems fairly typical.
- "Hunched up" or "roached up" appearance.
- Lack of normal gurgling and digestive sounds in the tummy : Many dog owners report this after putting their ear to their dog's tummy.
- Bloated abdomen that may feel tight (like a drum) : Despite the term "bloat," many times this symptom never occurs or is not apparent.
- Pale or off-color gums, dark red in early stages, white or blue in later stages.
- Heavy salivating or drooling.
- Foamy mucous around the lips, or vomiting foamy mucous.
- Unproductive attempts to defecate.
- Licking the air.
- Seeking a hiding place.
- Looking at their side or other evidence of abdominal pain or discomfort.
- May refuse to lie down or even sit down.
- May stand spread-legged.
- May curl up in a ball or go into a praying or crouched position.
- May attempt to eat small stones and twigs.
- Drinking excessively.
- Heavy or rapid panting.
- Shallow breathing.
- Cold mouth membranes.
- Apparent weakness; unable to stand or has a spread-legged stance, especially in advanced stage.
- Accelerated heartbeat. Heart rate increases as bloating progresses.
- Weak pulse.
- UPDATE : 04/14/2019 - Beware that a blog reader reported to loosing their dog to bloat immediately following a spay surgery.
Potential Causes :
- Stress : Dog shows, mating, whelping, boarding, change in routine, new dog in household, etc. Many cases have been reported where a dog bloated after another dog (particularly a 3rd dog) was brought into the household, perhaps due to stress regarding pack order.
- Activities that result in gulping air.
- Eating habits, especially level height of the food bowls. Sadly, I found that some sites recommended elevated bowls yet some also recommend leaving the bowls at floor level.
- Rapid eating (bowls specifically designed to slow down eating are available online).
- Eating dry foods that contain citric acid as a preservative (the risk is even worse if the owner moistens the food).
- Eating dry foods that contain fat among the first four ingredients.
- Insufficient pancreatic enzymes, such as Trypsin (a pancreatic enzyme present in meat).
- Dogs with untreated Exocrine Pancreatic Insufficiency (EPI) and/or Small Intestinal Bacterial Overgrowth (SIBO) generally produce more gas and thus are at greater risk.
- Dilution of gastric juices necessary for complete digestion by drinking too much water before or after eating.
- Eating gas-producing foods (especially soybean products, brewer's yeast, and alfalfa).
- Drinking too much water too quickly (can cause gulping of air).
- Exercise before and especially after eating.
- Heredity, especially having a first-degree relative who has bloated.
- Build & Physical Characteristics : Having a deep and narrow chest compared to other dogs of the same breed, older dogs, large dogs, males, being underweight.
- Disposition : Fearful or anxious temperament, prone to stress, history of aggression toward other dogs or people.
Prevention : Avoid highly stressful situations. If you can't avoid them, try to minimize the stress as much as possible. Be extra watchful.
- Do not exercise for at least an hour (longer if possible) before and especially after eating, particularly avoid vigorous exercise and don't permit your dog to roll over, which could cause the stomach to twist.
- Do not permit rapid eating.
- Feed 2 or 3 meals daily, instead of just one.
- Do not give water one hour before or after a meal as it dilutes the gastric juices necessary for proper digestion, which leads to gas production.
- Allow access to fresh water at all times, except before and after meals.
- Make meals a peaceful, stress-free time.
- When switching dog food, do so gradually (allow several weeks).
- Do not feed dry food exclusively.
- Feed a high-protein (>30%) diet, particularly of raw meat.
- If feeding dry food, avoid foods that contain fat as one of the first four ingredients.
- If feeding dry foods, avoid foods that contain citric acid.
- If you must use a dry food containing citric acid, do not pre-moisten the food.
- If feeding dry food, select one that includes rendered meat meal with bone product among the first four ingredients.
- Reduce carbohydrates as much as possible (e.g., typical in many commercial dog biscuits).
- Feed a high-quality diet.
- Whole, unprocessed foods are especially beneficial.
- Feed adequate amount of fiber (for commercial dog food, at least 3.00% crude fiber).
- Add an enzyme product to food (e.g., Prozyme).
- Include herbs specially mixed for pets that reduce gas (e.g., N.R. Special Blend).
- Avoid brewer's yeast, alfalfa, and soybean products.
- Promote an acidic environment in the intestine.
- Promote "friendly" bacteria in the intestine.
- Avoids fermentation of carbohydrates, which can cause gas quickly. This is especially a concern when antibiotics are given since they tend to reduce levels of "friendly" bacteria.
- Don't permit excessive, rapid drinking, especially a consideration on hot days.
Most importantly, know your dog well so you'll know when your dog just isn't acting normally.
EMERGENCY FIRST AID : BE ADVISED – THIS IS A DANGEROUS PROCEDURE AND SHOULD IDEALLY ONLY BE PERFORMED BY PROFESSIONAL VETERINARY CARE GIVERS! KNOW YOUR LIMITS! YOUR FIRST PRIORITY SHOULD BE TO REACH MEDICAL CARE ASAP!
- Always stay calm.
- Call the hospital and tell them you’re coming with a bloat case and ensure to give approximate arrival time.
- Take 1/2 inch tube that has been PRE-MEASURED and marked (below) and ensure it’s ready for use. The point of having it pre-measured is to save time and having it marked will give you an idea as to whether the tube has successfully been passed into the stomach when you're actually doing it.
- Pry open dog's mouth and position wood block behind the canines and between the upper and lower jaws, so that the 3/4 inch hole is facing you when you're standing in front of the dog's face. The dog will struggle, but you must keep the block in position.
- Use the nylon cord to tie the block to the dog's lower jaw. Be sure the block is tied firmly in place.
- Lightly lubricate about 3 inches of the outside of the vinyl tube (the end that you'll be passing).
- Turn the tube so any natural curl in the hose is downward.
- Slide the lubricated tube through the wood block towards the dog's throat, in a slightly downward direction.
- Once the tube gets to the throat, push gently but firmly, about an inch at a time. Let the dog swallow what you've passed before pushing more in. The first resistance point you'll feel is the esophagus. If the dog coughs persistently, it means that you've gone into the lungs instead of the stomach. Pull the tube out, and try again, angling slightly downwards towards the back of the throat--the air way is above of the food canal.
- Once the tube passes the esophagus, passage should be somewhat easier until you approach the stomach. You will encounter the second resistance point at the entrance into the stomach. Continue to push gently but firmly - NEVER FORCE the tube down!
- Once you think you've entered the stomach (which you can guess by looking at the marking on your tube, and by having passed through 2 resistance points), you should be able to feel air come out by putting your cheek close to the outside end of the tube.
- Be sure to keep the tube in place and not allow it to slide back out. Lower the outside end of the tube (preferably to a lower level than the dog's stomach) to allow gravity to suction the air and stomach contents out through the tube.
- If air and other stomach contents do not appear to be coming out at this point, then something is blocking the flow. You will need to clear the tube by blowing a small puff of air into the stomach through the tube, and then quickly lowering the outside end of the tube. Air and other contents should flow then, and the stomach should begin to decompress.
- Food particles occasionally get in the way and block the flow. In that case, you'll have to repeat the above step.
- In the event that you're unable to pass the 1/2 inch tube down to the stomach, try using the 1/4 inch tube. If the stomach has partially torsioned (i.e. 90° or less), the entrance to the stomach may be too constricted to allow the 1/2 inch tube to pass, but the smaller tube may squeeze by.
- If tube passage is unsuccessful, then the stomach must have torsioned, and hopefully, your driver is pulling into your veterinarian's hospital.
Making your own Bloat Kit (Please note that these can also be purchased online) : If you have multiple dogs of different sizes, you may wish to pre-measure and label multiple tubes specifying which tube is for which dog.
- 1/2 inch ( inside diameter ) x 6 feet, clear, non-toxic, vinyl tube ( outside diameter = 5/8 inch ).
- 1/4 inch (inside diameter) x 6 feet, clear, non-toxic, vinyl tube (outside diameter = 3/8 inch).
- 2x2 wood block, 8 inches long with 3/4 inch diameter hole in center (make sure your tubing can slide through this opening).
- Water soluble lubricating jelly, such as K-Y jelly.
- Two feet of soft nylon cord, or an old soft nylon leash.
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