Pet Columns, Office of Public Engagement, College of Veterinary Medicine at the University of Illinois at Urbana-Champaign

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A Twisted Stomach is a Life-Threatening Problem

Pet Column for the week of May 15, 2006

Office of Public Engagement
2001 S. Lincoln Ave.
Urbana, Illinois 61802
Phone: 217/333-2907
Kim Marie Labak
Information Specialist

Behaviors or conditions that promote aerophagia, or swallowing of air, such as exercising a dog immediately after eating or drinking a large amount of food or water may increase its risk for a life threatening condition known as gastric dilatation and volvulus or GDV, sometimes referred to as a twisted stomach or bloat.

According to Dr. Kathleen Ham, veterinary surgery resident at the University of Illinois Veterinary Teaching Hospital in Urbana, large breed dogs with deep-chested bodies such as Great Danes, Rottweilers, and golden retrievers may have extra room in their abdomen for the stomach to move around. Sometimes the stomach may expand, or dilate, with gas or fluid and rotate in the abdomen. This may also happen, rarely, in small breed dogs.

There are many factors that may predispose an animal to GDV, one of which is genetics. "Family history of the condition is the most important factor to consider--dogs at risk to develop GDV often have a primary relative (a parent, sibling, or offspring) that's had GDV."

Any activity that promotes aerophagia may predispose an animal to GDV, and other risk factors include old age, an underweight condition, and stress.

Veterinarians are not sure which comes first: the rotation or the expansion of the stomach, but once the stomach is rotated, it will continue to expand. This expansion of the stomach can threaten an animal's life. Dr. Ham explains, "Rotation blocks the ability for anything to exit the stomach through the esophagus or into the intestinal tract. Because nothing can get out, the stomach continues to get larger and can compress very important things in the belly."

If the expanding stomach compresses the nearby major blood vessels, blood cannot return to the heart, leading to an immediately life threatening condition. "In addition, a big giant stomach can compress the chest making it difficult to breathe," notes Dr. Ham. GDV can be fatal within a few hours, especially if shock, or failure of blood and oxygen to flow to the body, sets in or if the stomach ruptures and bacteria leak into the abdomen or bloodstream.

Signs of GDV include retching, excessive drooling, lethargy, and an abnormally enlarged belly. If you suspect your pet may have GDV, you should immediately call a veterinarian.

The first thing a veterinarian will do for an animal with GDV is to stabilize it by treating it for shock and decompress the stomach. A needle passed trough the abdominal wall into the stomach and a plastic tube passed through the esophagus into the stomach can help allow built-up air and fluid to escape, relieving pressure on affected blood vessels.

The next step is surgery to untwist the stomach and remove any stomach tissue that may be damaged from the ordeal. During surgery a veterinarian will also check the nearby spleen and other organs for injuries as well look for an underlying cause.

The stomach is then sutured to the inside of the abdominal wall to prevent recurrence of twisting, or volvulus. The body will form scar tissue that will hold the stomach in place. This procedure, called gastropexy, won't prevent the dilation, or the expansion of the stomach, but is 95 percent effective in preventing volvulus. Fortunately, dilation without volvulus is a less threatening condition that can be treated with medication.

According to Dr. Ham, dogs that get GDV should be spayed or neutered so they cannot pass on the trait. Knowing the health history of you dog's relatives may give you a heads-up to be vigilant for signs of GDV.

If you get a female puppy and you know there is a history of GDV in her family, Dr. Ham says a veterinarian can perform a prophylactic gastropexy while doing a spay, since both procedures take place in the abdominal cavity. "For dogs that are predisposed, it makes sense to do this when we already have the animal under anesthesia and have the abdomen open. This only adds about twenty minutes to a spay procedure, doesn't add much expense and doesn't cause the animal any extra pain."

There is no way to prevent GDV, but knowledge of the disease and clinical signs allow early recognition. With prompt diagnosis and treatment the prognosis can be good.

For more information about gastric dilatation and volvulus or gastropexy procedures, consult your veterinarian.