Summary of Signs and Symptoms of Gastric Dilation and Torsion Complex
- Excessive salivation and drooling
- Attempts to vomit or pass stool
- Extreme restlessness
- Evidence of abdominal pain
- Distended abdomen
- Seeking a hiding place
- Rigid [hard] abdomen
- Looking at their side
- Abdomen painful when touched
- Vomiting foamy or liquid material
- Arched back
- Unproductive vomiting or retching
- Praying position [down in front, rear standing]
- Aerophagia [frequent swallowing]
- Laying down on belly - crouched position
- Hypersalivation [drooling heavily]
- Curling up in a ball
- Drinking excessively
- Laying or sitting in an unusual location
Lethargy, weakness
- Lack of appetite
- Panting, breathing rapidly or heavily
- Quiet, any abnormal behavior
- Red or white gums [not normal pink]
Treatment
At home give GAS X immediately, call the closest Vet and take your dog there immediately.
- There are several steps to saving a bloated dogs life. Part of the problem is that all steps should be done at the same time and as quickly as possible.
- The huge stomach is by now pressing on the major blood vessels carrying blood back to the heart. This stops normal circulation and sends the dog into shock. Making matters worse, the stomach tissue is dying because it is stretched too tightly to allow blood circulation through it. There can be no recovery until the stomach is untwisted and the gas released. A stomach tube and stomach pump are generally used for this but sometime surgery is needed to achieve stomach decompression.
ALSO FIRST: RAPID IV FLUIDS MUST BE GIVEN TO REVERSE THE SHOCK
- Intravenous catheters are placed and life-giving fluid solutions are rushed in to replace the blood that cannot get past the bloated stomach to return to the heart. The intense pain associated with this disease causes the heart rate to race at such a high rate that heart failure will result. medication to resolve the pain is needed if the patient’s heart rate is to slow down. Medication for shock, antibiotics and electrolytes are all vital in stabilizing the patient.
ALSO FIRST: THE HEART RHYTHM IS ASSESSED AND STABILIZED
- There is a special very dangerous rhythm problem, called a "premature ventricular contraction" or "pvc," associated with bloat and it must be ruled out. If it is present, intravenous medications are needed to stabilize the rhythm. Since this rhythm problem may not be evident until even the next day continual EKG monitoring may be necessary. Disturbed heart rhythm already present at the beginning of treatment is associated with a 38% mortality rate.
- Getting the bloated dog's stomach decompressed and reversing the shock is an adventure in itself but the work is not yet half finished.
SURGERY
- All bloated dogs, once stable, should have surgery. Without surgery, the damage done inside cannot be assessed or repaired plus bloat may recur at any point, even within the next few hours and the above adventure must be repeated. Surgery, called gastropexy, allows the stomach to be tacked into normal position so that it may never again twist. Without gastropexy, the recurrence rate of bloat may be as high as 75%!
- Assessment of the internal damage is also very important to recovery. If there is a section of dying tissue on the stomach wall, this must be discovered and removed or the dog will die despite the heroics described above. Also, the spleen, which is located adjacent to the stomach may twist with the stomach. The spleen may require removal, too.
- If the tissue damage is so bad that part of the stomach must be removed, the mortality rate jumps to 28 - 38%.
- If the tissue damage is so bad that the spleen must be removed, the mortality rate is 32 - 38%.
- After the expense and effort of the stomach decompression, it is tempting to forgo the further expense of surgery. However, consider that the next time your dog bloats, you may not be there to catch it in time and, according the study described below, without surgery there is a 24% mortality rate and a 76% chance of re-bloating at some point. The best choice is to finish the treatment that has been started and have the abdomen explored. If the stomach can be surgically tacked into place, recurrence rate drops to 6%.
RESULTS OF A STATISTICAL STUDY
In 1993, a statistical study involving 134 dogs with gastric dilatation and volvulus was conducted by the School of Veterinary Medicine in Hanover, Germany.
Out of 134 dogs that came into the hospital with this condition:
10% died or were euthanized prior to surgery (factors involved included expense of treatment, severity/advancement of disease etc.)
33 dogs were treated with decompression and no surgery. Of these dogs, 8 (24%) died or were euthanized within the next 48 hours due to poor response to treatment. (Six of these 8 had actually re-bloated).
Of the dogs that did not have surgical treatment but did survive to go home, 76% had another episode of gastric dilatation and volvulus eventually.
88 dogs were treated with both decompression and surgery. Of these dogs, 10% (9 dogs) died in surgery, 18% (16 dogs) died in the week after surgery, 71.5% (63 dogs) went home in good condition. Of the dogs that went home in good condition, 6% (4 dogs) had a second episode of bloat later in life.
In this study 66.4% of the bloated dogs were male and 33.6% were female. Most dogs were between ages 7 and 12 years old. The German Shepherd dog and the Boxer appeared to have a greater risk for bloating than did other breeds.
Excellent blog article on bloat here.
