Bloat (gastric dilation)

Gastric dilation, or ‘bloat’ as it is often known, is a very serious condition mainly affecting large breed dogs with a deep chest. Dogs with bloat are restless and unable to settle, they may drool saliva and vomit frothy foam. If you suspect that your dog has bloat you should call your vet or emergency service at once. Time is of the essence (bloat can kill in less than an hour). Your vet will want to see your dog immediately but try not to turn up at the practice unannounced – if you call ahead they will be ready for you when you arrive.

Bloat is an accumulation of gas in the stomach. The gas can be produced from fermentation of food material in the stomach or from swallowing of air. In normal dogs, burping quickly relieves the pressure in the stomach but in some dogs there is a problem that prevents normal emptying of the stomach. Gas continues to build up causing the stomach to inflate like a balloon. As the stomach swells it may flop over to one side. This can block off the exit for gases – making the problem progress more rapidly. The stomach can also twist on itself. If this occurs the condition is termed gastric dilatation and volvulus (GDV) and this is quickly life-threatening.

Large breed dogs, particularly the German Shepherd Dog, Irish Setter and Great Dane, are most at risk from this condition. Bloat most commonly affects middle-aged or older animals.

Dogs that are highly stressed appear to be more likely to develop bloat and there is in an increased risk in any dog with a close relative that has also had bloat.

Generally the first signs noticed in a dog affected by bloat are restlessness coupled with retching and drooling of saliva. The dog may show attempts to vomit but only a little frothy foam may be produced. The abdomen may become swollen and firm to the touch (although this isnt always obvious). Affected dogs may look at their sides or show other signs of abdominal pain. Some dogs may cough and others want to drink a lot of water.

As the condition progresses the dog may have difficulty breathing and eventually will collapse and be unable to get up. If untreated, dogs that develop a twist in the stomach will die.

If you suspect that your dog has bloat, you should call your vet or emergency service at once. Time is of the essence because bloat can kill in less than an hour. Your vet will want to see your dog immediately but try not to turn up at the practice unannounced. If you call ahead they will be ready for you when you arrive and will therefore be better prepared to deal with the emergency.

Unfortunately you cannot change many of the risk factors for bloat. However some practical measures can help to reduce the risk.

Feeding several small meals daily (instead of one large one) can help reduce the risk in susceptible breeds and individuals. Since swallowing of air is increased when dogs eat quickly, it can be helpful to separate dogs when eating so that there is no competition for food and eating is not rushed. Special barrier bowls are available that are designed to slow down a dogs eating. Exercise and excessive drinking should be restricted for an hour before and after eating.

Contrary to common belief, feeding a dog from a raised food stand actually increases the risk of bloat,so avoid doing this and feed from the floor as usual.

Stress is another factor thought to influence the development of bloat. In highly strung dogs, an upset in normal routine, eg boarding kennels, dog shows and the introduction of a new dog to the household can bring on an episode, so owners should be especially vigilant at these times if they have a susceptible dog.

The diagnosis is based on the dogs history (i.e. what you notice and tell the vet) and a physical examination. Your vet will be looking to detect a distended gas filled stomach and other signs indicating the condition. Your vet will also take into account whether your dog is of a type likely to have a gastric dilation.

Diagnosis may be confirmed with an X-ray. This can also allow your vet to see whether the stomach is twisted or not a twisted stomach is much more dangerous. If there is no twist to the stomach, your vet may be able to pass a tube into your dogs stomach to allow the trapped gas to escape. The stomach contents can also be washed out through this tube which may help to improve the dogs condition.

Your vet will also want to take blood samples and perhaps an ECG (as dogs with bloat may develop abnormal heart rhythms). In severe cases, treatment may be started before all test results are obtained as early treatment may be essential to save the dogs life.

Animals with bloat may be suffering from shock. To treat this your vet will give intravenous fluids (a drip) and other drugs. To treat the bloat itself a tube is passed into the stomach to let some gas escape and reduce pressure on the internal organs. However, this is not possible in every case sometimes the tube cannot enter the stomach due to the way the stomach has twisted. In these cases it may be necessary to operate to empty the stomach.

Unfortunately the condition is serious no matter how it is managed. About 3 dogs in 20 will not survive even with surgery. Some dogs will have widespread organ damage at the time of surgery. This may not be known until surgery has actually started and the vet is able to examine the internal organs directly. Sometimes organs, or parts of organs, may have to be removed to save your pet’s life.

In nearly all cases a procedure to fix the stomach in place will be carried out. This procedure is called gastropexy. If this is not done about 8 out of 10 dogs will get a further episode of bloat.

Once the stomach has been deflated a tube may be fitted between the stomach and the body wall (a gastrostomy tube) to allow any further gas to escape safely.

A gastrostomy tube is a rubber pipe that is placed at the time of stomach surgery. One end of the tube is attached to the inside of the stomach. The other end passes through the stomach wall and then through the body wall and fixed to the outside of the body. This tube serves 2 purposes; any gas produced in the stomach can be safely vented through the tube without risk of stomach dilation; and the stomach becomes fixed to the body wall at the point where the tube leaves. This prevents stomach twisting ever happening again.

The gastrostomy tube may be left in place for a week and can be removed without further surgery when your vet feels that your dog is making good progress. After removal a small hole will be left in the body wall but this soon heals over.

Once a dog has had gastric dilation we know that they are at risk of developing it again. In fact 8 out of 10 dogs with bloat will have a recurrence if preventative measures are not taken. At the time of surgery your vet will attach the stomach wall loosely to the inside of the body wall (known as gastropexy). This prevents the stomach from moving and twisting and significantly reduces the risk of a recurrence. In fact only 3 of a hundred dogs with bloat will have a second episode after this procedure.

If your dog had a gastrostomy tube placed then this also causes the stomach to stick to the body wall at the scar site once the tube is removed and the wound has healed.

Bloat is a life-threatening condition in dogs and emergency treatment is important to ensure the best outcome. You may want to discuss risk factors for your dog and possible preventative measures with your own vet.