Bloat in dogs is a life threatening condition, that requires immediately treatment by a veterinarian. Knowing it’s risk factors and symptoms is important for every dog owner, but especially for those of large, deep chested breeds as these are over proportionally affected by it. Before going into more details about gastric torsion in dogs symptoms and bloat in dogs treatment, here a short explanation of what dog bloat actually is.
Arrows mark the division line between the two characteristic bubbles seen in a typical x-ray of a twisted canine stomach. Image courtesy of (cc) Kalumet.
The term ‘bloat’ refers to the bloating of the canine stomach due to gases that can’t escape. There are several mechanisms, or combinations of them, that work together to cause the clinical symptoms. One is a dysfunction of the sphincter between the oesophagus and stomach, the circular muscle that regulates the flow between stomach and intestine. Another is the torsion of the stomach around its’ own axis that shuts off, at least partially, both, the stomach entrance, as well as the exit. Also known as GDV (Gastric Dilation Volvulus) this condition quickly worsens as the food that is trapped in the stomach starts fermenting and more gas is produced. This gas expands the stomach, also known as distention and, as the gas can’t escape, the dilated stomach will quickly affect other organs such as the heart, lungs, spleen and the blood vessels.
Typically the stomach will first dilate and then rotate around one of its two main axis, cutting off both entry and exit for its’ content, this is also known as gastric torsion. The x-ray on the right site shows a typical ‘double bubble’ with the gases trapped in the two parts of the twisted canine stomach. The reduced blood circulation to the stomach itself, and other vital organs, will quickly lead to a shock symptomatic together with tissue necrosis and, in rare cases, to a rupture of the bloated stomach.
As you can see, getting an affected dog as quickly as possible to a vet is paramount. The best case scenario would be to achieve this while the stomach is ‘only’ bloated, but has not yet twisted. Mortality rates range anywhere between 10 and 60%, depending on how quick treatment is started, after the onset of the very first symptoms. Dogs that received appropriate treatment in the first six hours after the first symptom occurred showed significantly higher survival rates than dogs that were treated later.
Prevention
While mainly large, deep chested dog breeds are affected, this doesn’t mean that bloat can’t also occur in other dogs. The highest risk to suffer from bloat tend to be the following breeds (in alphabetical order): Basset (greatest risk amongst the smaller breeds), Boxer, Doberman Pinscher, German Shepherd, Great Dane, Poodle (Standard), Rottweiler, St. Bernard, Setters and Weimaraner. Mixed breeds are also affected, if their chest is narrow but deep. Every dog whose chest has a pronounced V-form can be affected by bloat, it doesn’t matter if it is a pure or mixed breed! The older the dog gets, the higher the risk gets also, dogs under two years are rarely affected by bloat. True ‘puppy bloat’ is extremely rare, but still can happen. And, as a side note, male dogs seem to be more affected than bitches. When in doubt, ask your vet to assess the risk of suffering from bloat during its lifetime for your specific dog. Ask also your breeder if any of your dogs’ close relatives have suffered ever from bloat. Dogs that have one, or more, first degree relatives that suffered from bloat, have a significantly higher risk than those that don’t have any relatives with this kind of medial history. If your dog is considered to be at a high risk and you plan to let it be spayed or neutered, you might also want to consider having a preventive gastropexy (see below) done at the same time. This operation can be done laparoscopically and has a low risk. The following, practical tips might also be useful to reduce your dogs’ risk to suffer this, often fatal, illness:
Feeding, Drinking, Exercise and Rest
- No exercise, playtime or similar excitement for one hour before, and two hours after feeding.
- Train your dog to eat slowly and keep feeding time a calm time.
- Feed two, or better, three times a day a smaller meal instead of only one big meal.
- Use a ‘slow down’ food bowl or place some ‘too large to swallow’ and clean rocks into the bowl, to force your dog to eat around them and, as a result. slowing down it’s eating.
- Don’t use a raised bowl, studies have shown that they actually increase, not decrease, the bloat risk in dogs.
- Wet kibble to allow it to expand in the bowl, not in the stomach (but see next point!).
- Don’t feed kibble (dry food) that contains citric acid, and, if you do, never moisten it with water.
- Don’t let a dog drink immediately after exercise, playtime or other excitements, wait until it has calmed down.
- Feed a high quality dog food that is rich in protein (meat), low in carbohydrates (cereals) and doesn’t contain fat as one of the first four ingredients.
- Fearful, anxious or stressed dogs are at a higher risk, be especially careful in this case and try to reduce stress for your dog whenever possible.
- Never feed an overexcited or stressed dog, wait until its has calmed down.
Symptoms
Early bloat symptoms in dogs are restlessness, difficulty to breath, air licking, excessive drooling, not behaving like itself, pacing around, excessive panting, signs of pain, looking at own tummy and unusual behavior in general. The better you know how your dog behaves normally, the easier you will be able to notice when something is wrong. Even if you can’t put the finger on what this ‘something’ is.
Later other symptoms will follow, such as trying to throw up unsuccessfully, standing with an arched back, swelling of the stomach area, irregular heartbeat, weakness, lethargy, anemic, pale gums, trying to ‘go potty’ without success, praying mantis position (front legs down, hind legs up and apart), tense stomach and belly area. If still untreated, the dog will soon lose consciousness and die of circulation problems, heart problems like arrhythmia and tachycardia, kidney failure and of blood poisoning caused by necrotic tissue.
First Aid
The best first aid for a twisted intestine in dogs is to call your veterinarian ahead and tell the staff that you are on the way with a suspected bloat case. The best, and often only, treatment possible is to get your dog as quickly to the vet or veterinarian hospital as you can drive, without endangering yourself and others. Only in the case that you live in a truly remote area, and can’t reach a vet in a reasonable amount of time, should you consider first aid treatment at home.
Ask your vet, during a routine visit, for recommendations of prophylactic and early intervention medication such as Simethicone or Metoclopramide. Never buy and administer any medication without first consulting with your vet, different breeds might react differently to them. And, for the worst of scenarios, you might consider keeping a ‘bloat first aid kit’ at home (see >this website< for tips how to assemble one). Make sure you understand the instructions your vet gives you and that you are comfortable in carrying them out.
Again, all this applies only if you live in such a remote area that you can’t reach a vet in time. If you can reach a veterinarian hospital in time, please don’t waste your time with first aid, it may cost valuable time that could be used to save your dog!
Treatment
As soon as you arrive with your dog at the vet, the treatment will start, typically first aiming to stabilize your dogs’ vital functions and, simultaneously, to relieve the pressure in the bloated stomach. Painkillers will be also administered and the dog might be sedated to reduce stress and to prepare it for the operation which is in most cases necessary.
During this operation the stomach will be put back in it’s correct position, tissue that has died off will be removed and the stomach will be anchored (tacked) to the abdominal wall to prevent a reoccurrence of the twisting. Without this procedure, the rate for reoccurrence is 60%! After the operation the dog will be on IV fluids for at least 24-48h, or more, depending on the severity of the case and the extent of the operation performed. After that it will be allowed to start to eat slowly, following a careful dietary schedule.
Prognosis
As mentioned throughout this article, the single most important thing is to get a dog that might suffer from bloat as quickly as possible to a vet! The sooner treatment starts, the better are the dog’s chances to survive. But even then the mortality rate is still high, around 10-25% of the dogs that have been treated in the first six hours of the illness die. This rate jumps to up to 60% for those that have been treated later. Only in very rare cases will a dog survive a light bout of bloat without being treated. These cases are anecdotal and involve the spontaneous de-twisting of the stomach at an early stage. Apart of these, extremely rare, cases, the mortality rate for untreated bloat is 100%!