Do you have a large or giant breed dog? Then you should know that bloat (aka, gastric dilatation-volvulus) is a surgical emergency worthy of any gut-wrenching Emergency Vets episode.
Great Danes, Wolfhounds, German shepherds, Dobermans, Labs and other deep-chested large breeds (including mixed breeds with similar proportions) are especially at risk due to loose gastric ligaments that allow a stomach to twist when filled with excess gas, thereby cutting off it’s formidable blood supply and progressing quickly to stomach tissue death and its hard-core, systemic consequences.
It’s a nasty business and an every-minute-counts kind of emergency. If you’re one of my big dog clients and you call me up with a case of non-productive retching and a big abdomen, you’ll hear the urgency in my voice (or the staff’s): “You’d better come in right now!”
I hate these cases. They’re both deadly and expensive to treat. So owners often hesitate when presented with a sliding scale of fair to poor odds, which depends on the dog’s age, presenting condition and level of care. Because they inevitably end in surgery, it’s rare to expect recovery for less than a grand or two at a general practice and two to four thousand at the specialty hospital (where odds of survival increase, generally in proportion to the greater expense).
Every big dog owner should know the protocol: At the first sign of distress (pacing, retching, lethargy and/or abdominal distension) get in the car with your dog and drive to the your vet or the closest emergency or specialty hospital. In most cases you’ll need to be rushed in, so call ahead to give a heads up to the staff. Here’s the protocol:
First up, lots of fluids—two large, bore catheters are best to dump fluids into the collapsing circulatory system. Next, an X-ray to see if the stomach is indeed the cause. A big plastic tube is then pushed through the mouth and, hopefully, past the clenched-tight spot where it’s twisted.
If we can’t get past the too-tight twist, we use a big needle called a trocar to punch a hole into the stomach through the skin. This gets the gas out, loosening the twist and restoring some blood flow to the area—but it has its dangers, too. Sometimes it’s better to go straight to surgery.
In my career, I’ve done this dozens of times. Still, nothing prepares vets and their staff for these scenarios—they all play out differently. An awed owner (amazed and confused by our efforts), a dying dog and aggressively ugly techniques attempted in record time. It’s no wonder I dread the famed bloat.
Worse yet, sometimes the twist is so awful that the nearby speen is squelched, too. Emergency surgery relieves the twists, but afterwards, rapid release of the body’s own toxins, sometimes initiating deadly cardiac rhythms that require their own special treatment.
We GP’s see these cases far less often than our emergency vet counterparts. Because bloat often results after big, nighttime dinners and a casual romp in the backyard, they tend to occur after hours. So e-vets are much more adept at handling these cases. Still, there’s no vet I know who hasn’t handled a horrorshow bloat during daylight hours.
Most owners, after the fact, want to know how they could have prevented it. Since giant breed dogs are so predisposed, I sometimes offer to “tack” the stomach to the body’s wall (so it can’t twist when gas-filled) during other routine abdominal procedures such as spays and, though less routine, bladder surgeries as well. Some vets forget to ask. Unfortunately, it’s up to many owners to worry about these things and request them.
Twice daily feedings for these big guys are another regular recommendation. Although we’re still not sure of all the factors involved, big meals and post-meal exercise are common to too many cases, so we advise against these practices.
A bloat, though relatively common to vets, isn’t so common to owners. Only knowledgeable breeders and well-educated, experienced pet owners seem to be in-the-know. Here’s a perfect example:
Yesterday, I saw a client who made an unusual appointment to discuss her large-breed dog’s sudden death. Although she carried in two bags of dog food, wondering whether they might have been the cause, the signs were obvious: She’d found her dog in the last throes of a bloat, dying on her patio when she came home from work. The abdominal distension and puddles of retched-up saliva surrounding him were unmistakable. She had no idea what a bloat was and it took some convincing for me to get her off the topic of the foods.
Still, I can’t say for sure it wasn’t a toxin, especially since he’d been acting abnormally for the preceding week. Though her foods weren’t on today’s updated list, I’ll send out samples of the food on Monday to confirm they weren’t the source.
Bloat happens suddenly and ferociously. I wish I could say there was any way to prevent it with 100% certainty, but all dogs are potentially at risk (though rarely the barrel-chested, smaller canines, such as beagles and Frenchies). Your best bet? Know your dog and watch him. Tack your giant breed. Feed any big dog twice daily. Beyond that, it’s the surgeon’s nightmare…and your own, should you ever find yourself in this unenviable position.
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Those of you with dogs prone to bloat should check out this link, and keep it handy in case of emergency. Who knows, it may save your dog's life. http://www.iwane.org/A_P.htm
Margaret April 22nd, 2007 10:56:00 AM
And what of the e-vet clinic that doesn't react with urgency when the client says, "I think my dog is bloating -- I'm on my way"? Upon arriving at said clinic, the staff seemed to move in slow motion until I lost my patience, forced the leash of my obviously distressed dog into someone's hand and slid my credit card across the counter. Minutes later, in agonizing slowness, a staffer came out to ask if it was OK to do x-rays. OK? Of course it's OK!
Lucky for us, our dog was in a pre-bloat stage, resolvable with IV fluids and a tube down the throat to relieve the pressure. But what if? If it's up to owners to recognize the signs and symptoms of bloat, it's up to vet clinic and e-clinic staff to take the owner seriously.
Deanna April 22nd, 2007 01:34:00 PM
Deanna- you could react as if they did not know bloat was an emergency, assume they have never treated a case of bloat before, etc... and educate them BEFORE you need them again, or FIND ANOTHER VET! I would not risk the lives of my four mastiffs taking them to a vet or clinic that does not respond accordingly in an emergency situation. I am glad your dog turned out ok- it COULD have been so much worse. That said, I wouldn't take the chance with them in the future, personally.
Margaret April 22nd, 2007 02:42:00 PM
Deanna: That's a horrible story. Sadly, it happens.
Dr. Patty Khuly April 22nd, 2007 05:17:00 PM
Owning a standard poodle, I read up on bloat, and it's possible causes and preventatives. I may not be 100% able to prevent it, but I think I will recognize it in a timely manner if it ever rears it's ugly head.
Pet owners, the same as parents, have an obligation to do the best they can for their charges. I know my standard poodle- he can look at me and I know if he's in distress. If I walked into a vet's office and they didn't have the knowledge to recognize the problem, I'd walk right back out and find the nearest on-call vet. Luckily, this hasn't happened with my dogs.
However, I did once take my grandbaby to a small hospital ER near here. She had fallen and her shoulder was tender to touch. The nurse asked about KTBug's history. I mentioned her hydrocephalus, and that she had a VP shunt(variable pressure). The nurse looked at me like I was from Mars, and asked first WHAT IS HYDROCEPHWHATEVER YOU SAID and HOW DO YOU SPELL IT?
We left. Drove 30 minutes to a level 2 trauma center. All was well and understood.
Never be afraid to look like a nut. Go with your gut feeling and take care of your family. I always remind people--we are consumers. We have a right to adequate services.
Agadore's momma April 23rd, 2007 12:33:00 AM
Dr. Patty, in these bloat cases, do you see any long-term behaviors that make a dog more likely to bloat. My standard poodle is a big guy and he vomits bile off and on. Usually his stomach is upset and this passes. I don't know how to explain it, but it seems like he gets an upset stomach easily. Maybe he has a tendency to gas?
Kimberly Hanson April 23rd, 2007 03:18:00 PM
my weimaraner had bloat when she was 12. i think it happened because she drank too much water after running. i remember hearing her drink, and wonder about it.
4 hours later, i heard a funny retch outside, ran outside, and found her with foam on her mouth, lying down. i instantly knew in my gut it was bloat, called the emergency hospital, took her in immediately. she had surgery, and was actaully the second dog that night with bloat.
she recovered completely and lived till she was 14 and 3 months.
greydog April 23rd, 2007 03:47:00 PM
Thanks for touching on this subject I asked you about. I am still curious though if you have an opinion on it possibly being genetic? I personally think it is more stress related, and maybe possibly genetic (meaning carried in certain lines) and not necessarily as food / exercise related as is commonly noted. Most of the dogs I've known that have bloated, did so on empty stomachs and were usually just home from a stressful event like being kenneled etc. Again, that's just my opinion though.
Luckily I live close to the ER and know the symptoms well. I worry more now though since one of my Danes has had so many close relatives that have bloated. Neither one of my Danes is tacked and I'm still contemplating it, but I would prefer not to put them through it since no other surgery is needed.
Thanks again!
Great Dane Addict April 23rd, 2007 09:27:00 PM
Just wanted to note that I still follow the 2 meals a day, no forced exercise after eating rules because that is good advice regardless.
Great Dane Addict April 24th, 2007 12:21:00 AM
I'm sure that some of the traits that lead to bloat are heritable--like loose ligaments in deep chested breeds and perhaps even an anatomic and/or physiologic tendency towards gas production. But we don't rightly know ALL the factors--otherwise we'd be a whole lot closer to having licked this disease by now.
Dr. Patty Khuly April 24th, 2007 10:02:00 AM
My 3 year old Weimaraner bloated without warning two weeks ago, the night we returned from vacation (we'd boarded him at a vet, because he'd cut his paw 6 days earlier, trying to get to a cat & wanted him to take it easy). Fortunately, I recognized the symptoms (with him it was mainly a sudden change from his usual frisky self to depressed, trying to vomit but only drooling saliva, & the silent belly). Got him to the emergency vet, he had emergency surgery with a gastroplexy. Fortunately, he bounced back amazingly well. The vet said the key was getting him there in a timely manner. It's amazing how many people have never heard of bloat. Our e-vet said most regular vets don't see it, since it usually happens in the evening, but she sees an average of one/week. I'm so happy we had access to excellent care.
M. Knight May 3rd, 2007 12:49:00 AM
A veterinary research paper says that oil in pet food such as sunflower oil and the fat in pet food help cause GDV in dogs. As with so many illnesses in pets, pet food is a prime cause of illness.
Fiona MacMillan September 3rd, 2007 11:48:00 AM
I have had much experience...usually negative..with bloat...even after taking...Thank God..I have my faith as strenght to help me if things go wrong. I am owned by my Newfoundlands! Nothing could enrich my life more than my mates! Unfortunately, with this breed, as you know...bloat is a potential problem...and i have seen it in a some ugly forms! I am a member of the NDCC..and work with dogs...water rescue, draft dogs and backpacking. I have been blessed with some very special two-way-communicating relationships with the dogs..and have been able to help many...on regular occasions...tubing them etc in the field as a life saving measure.
My Question to you is....and i believe i know the answer..just please refresh me...why can the drug "Simthicone" not be utilized for bloat in dogs. It is used in babies.
I do know that much research in the area of bloat is ongoing...i am very interested in this..can you suggest any sites that might aid me in keeping up to date on the progress being done to fight/research this condition??.....Thank you so much! Newfoundly yours!!!
Jill Wood December 30th, 2008 05:45:30 PM
Here's a pet-sitter's nightmare: a bull mastiff being fed (per owner instructions) once per day, who, after eating his daily ration and then doing his usual silly dog prancing, suddenly starts trying to vomit with nothing coming up, and starts holding himself as though he were in pain, with a tight, distended abdomen.
I'd never seen bloat before, but I'd read about it a lot, and I know not to exercise dogs after they eat. The dog started looking uncomfortable maybe 10 mins after he ate. Luckily, I was able to get hold of the owner, the owner's vet, and the emergency clinic they wanted the dog taken to. I had the dog in my car even before I had the ok to take him to the vet, because I knew if he'd gone down, I wouldn't have been able to lift him to get him to the car.
The emergency vet said the dog HAD bloated (x-rays confirmed.) But apparently A Miracle Happened, and the dog got better without surgery. The vet said he'd never seen it happen before. Good thing for the dog, because the owner would have had him euthanized instead of spending $5k for the surgery/recovery time. In the owner's defense, the dog was 9 or 10, and had some other health problems.
I had to pick the dog up from the emergency vet and take him home where he stayed outside only. I had to feed him when we got back (24 hrs since previous meal). He got fed by hand, a few pieces at the time. I worried about him all night, but he was still ok the next morning for my last visit with him. He got fed by hand a few pieces at a time again. I don't know what happened to him after that. I often wonder how he's doing.
I hope I never see that again.
Janice in GA April 10th, 2009 06:02:27 PM
my dog molly A Saint Bernard just died of Bloat she was four years what i dont under stand till that night she was fine she went out side came back in Breathing heaving she was 175 pounds,my baby dead in 7 hours
mary lee May 15th, 2009 08:45:30 AM
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