Bloat is most likely to occur a few hours after eating a large meal, but it can occur at any time. If you notice any signs of bloat in dogs, act immediately and call your veterinarian or a veterinary emergency hospital.

Symptoms of bloat in dogs include:

• Distended abdomen
• Dry heaving and attempting to vomit without much coming up
• Panting and difficulty breathing
• Swollen abdomen sounds hollow when tapped on
• Pacing, unable to get comfortable
• Looking at the stomach
• Drooling
• Collapse
• Death

Dogs at Risk for Bloat

You may see signs of bloat in any dog, but bloat most commonly occurs in large dogs with a deep chest, such as Dobermans and Great Danes. Male dogs are more likely to bloat than females, and anxious dogs also seem to have an increased risk.

A genetic element to bloat is possible. If your dog has close relatives who have bloated, he is more likely to bloat during his own lifetime.

Causes of Bloat in Dogs

While it’s unclear exactly what causes bloat in dogs, the suspected causes of bloat are:

• History of bloat in a particular breed line (hints to a possible genetic predisposition)
• Dogs who eat too fast (ingest excess air with the meal)
• Using elevated feeding bowls (promotes ingestion of excess air with the meal)
• Feeding dry food with heavy fat/oil content
• Feeding a large meal vs. multiple smaller meals
• Exercising on a full stomach
• Drinking excessive amounts of water at one time

Signs of Bloat in Dogs

The first stage of bloat is pain. If the stomach is twisted, things get really bad. As the stomach twists, blood vessels are cut off and circulation is lost to the stomach and possibly the spleen. Eventually these tissues will die.

The stomach also becomes completely sealed at both ends, meaning that the gas has no outlet to escape. In extreme cases the stomach can rupture.

Treating Bloat in Dogs

The vet will likely take at least one X-ray. This will show if the stomach is filled with gas, and whether it has twisted and become a full GDV.

If the stomach has not twisted, your vet may be able to release the gas by passing a tube into your dog’s stomach. This may require sedation.

If your dog’s stomach twisted, he will need emergency surgery. The veterinary team will first take measures to stabilize his condition, then open the abdomen to untwist the stomach and make sure that all the tissues appear healthy. Your dog’s stomach will also be tacked to the abdominal wall to prevent it from twisting again in the future.

Dogs at high risk for bloat sometimes have their stomachs tacked as a preventive measure. This is usually done at the same time as a spay or neuter procedure.

The post Signs of Bloat in Dogs appeared first on Whole Dog Journal.

Bloat is the nontechnical term for gastric dilatation and volvulus (GDV), a condition in which the stomach rotates around itself to become twisted. The stomach can twist halfway (a 180-degree torsion), all the way leading to a 360-degree torsion, or anywhere in between. Once twisted, the stomach becomes stuck, and fluid and gas cannot exit. A dog cannot vomit, as the entrance to the stomach (the cardia) is obstructed, and nothing can leave the stomach via the intestines, because the exit (pylorus) is also blocked.

Due to this twisting, the stomach rapidly fills with fluid and gas, leading to abdominal distention. As the stomach quickly expands, blood vessels supplying it rupture and lead to hemorrhage. The massive stomach pushes on the diaphragm, making it hard for the dog to breathe. It also causes pressure on the caudal vena cava, which brings deoxygenated blood from the body back to the heart. Without blood circulating, shock occurs rapidly.

Bloat Symptoms in Dogs

The symptoms of bloat are classic and include restlessness, discomfort, pacing, abdominal distention, gagging, salivating, and non-productive retching.

The earliest signs may be as subtle as increased drooling and pacing/restlessness. Frequently, this occurs soon after a meal, especially if the meal is followed by exercise. Certain breeds are more likely to develop bloats such as Great Danes, Standard Poodles, and Dobermans, but any breed can bloat. Sex does not seem to be related.

Bloat is an immediate emergency. The longer the stomach stays twisted, the more damage is done. If twisted long enough, the stomach tissue will die and rupture, leading to spillage of stomach contents into the abdomen.

If you suspect your dog is bloated, an emergency trip to the veterinarian is a necessity. Do not wait overnight to see your veterinarian in the morning. The sooner that GDV is addressed, the better the chances for recovery.

At the Veterinary Clinic

When you arrive, the technical staff should take your dog directly to the treatment area for examination. Bloat can often be determined based simply on signalment (age and breed) and physical examination. The belly will be tight and tympanic (meaning like a drum).

To confirm the diagnosis, your veterinarian may take a right lateral abdominal x-ray. This will reveal a classic “double bubble” – a folded, compartmentalized stomach. They are often called “Smurf hats” or “Popeye arms” because of their characteristic appearance.

Time is of the essence, so your veterinarian will treat your dog immediately. A quick physical exam generally will reveal the following abnormalities: an elevated heart rate, panting or fast breathing, a tight, drum-like abdomen, and abdominal pain.

An IV catheter will be placed to administer fluids and correct shock. Pain medications are needed as soon as possible and may include an opioid such as hydromorphone, morphine, or fentanyl.

As your veterinarian and the technical staff work to stabilize your dog, they will also conduct diagnostic testing. This will include bloodwork to evaluate for internal organ damage, as well as checking blood pressure. In a specialty setting, it’s likely that the veterinarian will also check coagulation factors (your dog’s ability to clot) and blood lactate levels.

Lactate has been extensively studied in GDV. It is produced as a backup source of energy in the body. Lactate is always being produced, but in shock, when oxygen levels are decreased, lactate production is much higher. It can be measured with a hand-held device much like a blood glucose monitor. Many studies have been done to evaluate how helpful this is in determining outcome in GDV patients. Currently, it is thought that a high lactate level that decreases with IV fluids and surgery is a good indication for recovery.

GDV often occurs in older dogs, so your veterinarian also may recommend three-view chest x-rays to evaluate for the presence of any abnormalities. One study showed that 14 percent of dogs with GDV have concurrent aspiration pneumonia, likely from gagging and inhaling drool and watery stomach fluid that can escape the twisted stomach. Many GDV patients are older, and three-view x-rays can also evaluate for metastatic cancer that would make the surgery prognosis poorer. This recommendation is dependent on the vet who treats your dog. Any delay in surgery can be detrimental to your dog, so in cases of elderly dogs (greater than eight years of age) in particular, this recommendation must be weighed carefully.

Stomach Decompression for Dogs

Before surgery, your veterinarian will likely try to decompress the stomach – that is, relieve the gas buildup in the stomach. This can be done in one of two ways. The first is to pass a tube down the esophagus into the stomach – an older but still accepted method. It can often be done in an awake patient. This rapid decompression can help buy time for the twisted stomach. In some rare cases, passing a tube can untwist the stomach, but the procedure also poses the risk of puncturing through the twisted stomach entrance (cardia).

Another method of decompression is called trocarization. In this technique, large gauge needles are inserted through the skin into the stomach to relieve the air. This is currently the more commonly used approach because it is quick, doesn’t require multiple staff members, and can be very effective. It poses a much lower risk to the dog, but is not without risk altogether: it’s possible to lacerate the spleen during this procedure.

There is a great video online of a veterinarian performing trocarization on a Bernese Mountain Dog with GDV.

Surgery for Bloat

The goal in a GDV is to stabilize the patient as quickly as possible before surgery. A GDV can be successfully treated only with surgical intervention. This often puts the veterinarian and owner in a very difficult spot. Decisions must be made quickly and with decisiveness to allow for the best outcome. GDV surgery can be very costly, and most dogs will remain in the hospital for two to three days post-operatively. The prognosis is dependent on each dog and how long the torsion has been present. In general, survival rates for the surgery are high.

Your veterinarian will take your dog to surgery as soon as possible. This should not be done until the patient is as stable as can be expected. To some extent, full treatment of shock is impossible until the stomach is de-rotated in surgery. The patient’s condition should be optimized. This means stabilizing blood pressure, bringing heart rate down to normal or near normal, controlling pain, and decompressing the abdomen either via stomach tube or trocarization.

In surgery, your veterinarian will open the abdomen, identify the twisted stomach, and then de-rotate it. Once de-rotated, the stomach is checked for damage. In some cases, part of the stomach tissue has died and must be removed. The spleen will be checked next. It lies alongside the stomach and shares some blood vessels. When the stomach twists, the spleen does as well. Damage to those blood vessels can lead to a damaged spleen. In some cases, the spleen must also be removed.

Once the stomach and spleen are addressed, the stomach is sutured to the right body wall. This is called a gastropexy. This will prevent the stomach from rotating again in 90 percent of cases. However, in about 10 percent of cases, a dog can still develop a bloat. It is imperative to always monitor your dog for the symptoms of bloat, even when they have undergone gastropexy.

There are several different techniques for gastropexy. The most common is the incisional. This is when an incision is made into the outer layer of the stomach (serosa) and a matching one made on the wall of the body. The two are then sutured together, holding the stomach in place.

Surgery generally lasts about an hour to an hour and a half.

Post-Operative Care

Most dogs will remain hospitalized for one to three days after surgery. Post-operative care will include IV fluids to maintain hydration, pain relief, and close monitoring. Complications can include arrhythmias, hemorrhage, and infection. In some cases, a syndrome called systemic inflammatory reaction syndrome (SIRS) can occur. Disseminated intravascular coagulation (DIC), a massive and fatal collapse of the ability of the body to clot blood, can also occur.

Patients should be monitored around the clock after surgery, preferably at an emergency and/or referral hospital. Not all veterinary hospitals have staff on duty all night, so be sure to ask your veterinarian if this is something that will be available, or whether a transfer to a clinic with a night staff is possible.

Excellent attention to recovery is important. This will include monitoring of heart rate and rhythm (by ECG), temperature, and comfort level. Most patients are fasted for about eight to 12 hours after surgery. They are then offered a bland, easily digestible diet.

Arrhythmia and Bloat in Dogs

It is very common for a dog that has GDV to suffer from arrhythmias during or after surgery.

The most common are ventricular tachycardia and slow idioventricular rhythm. The ventricles are the lower chambers of the heart. When a dog goes into shock, the heart muscle becomes irritable and can develop irregular beats, particularly in the ventricles. Tachycardia occurs when the heart rate is faster than 150-160 beats per minute. When the heart rate is normal but the rhythm is abnormal, this is a slow idioventricular rhythm.

In most cases, these resolve within a week without specific treatment. If the arrhythmia persists, it is important to have the heart evaluated by a cardiologist. Since Great Danes in particular are prone to both GDV and cardiomyopathies, concurrent heart disease could be present.

Bloat Prevention

Much research has been devoted to this topic. The causes for GDV are poorly understood. At various times, an array of different recommendations have been made to prevent bloat, including the use of raised food dishes, the avoidance of raised food dishes, avoiding exercise after meals, and feeding smaller, more frequent meals rather than one large meal. More recent research has identified a possible link between motility disorders and GDV. At this time, unfortunately, there are no hard and fast rules for preventing bloat.

Prophylactic gastropexy is strongly recommended for the highest risk breed, the Great Dane, as some estimates show one in three will experience GDV. This can be done at the time of spay for females. It can also be done laparoscopically for males at practices that offer this modality.

Standard Poodles, Rottweilers, Irish Setters, and Weimaraners are also considered at-risk breeds for which prophylactic gastropexy should be considered. In other breeds, the benefits versus risks of preventative gastropexy are less clear. But one thing is certain:

No matter what type of dog you own, if you observe the classic symptoms of bloat – restlessness, discomfort, pacing, abdominal distention, gagging, salivating, and non-productive retching – you need to get your dog to a veterinary emergency room ASAP.

Mesenteric Volvulus: A Diagnostic Puzzle

While less common than GDV, mesenteric volvulus is a similar condition that requires immediate veterinary care and can be deadly in a matter of hours. For owners of German Shepherd Dogs and Pit Bulls (the most predisposed breeds) it is especially imperative to know about this condition.

With a mesenteric volvulus, the small intestines twist at their origin (called the root of the mesentery). This leads to obstruction of blood flow and death of the upper GI tract. The cause of MV is unknown. There seems to be an association with exocrine pancreatic insufficiency (EPI) in which the pancreas does not produce digestive enzymes. However, this has been shown in only one study. Other causes have not been identified.

The symptoms are frequently very sudden in onset and include vomiting, extremely bloody diarrhea, abdominal pain and distention, and collapse in a dog that was previously normal. The gums will be pale, and the heart rate and breathing rapid. The abdomen may be distended and extremely painful. An emergency trip to the veterinarian is warranted. Do not wait!

Unfortunately, these symptoms present a diagnostic dilemma for the veterinarian. Acute collapse can represent several conditions including Addisonian crisis, anaphylaxis, and acute hemorrhagic diarrhea syndrome. If mesenteric volvulus is not identified within one to two hours, death often results. Therefore, if your dog exhibits these symptoms, your veterinarian should conduct treatment and diagnostics immediately.

Treatment for Mesenteric Volvulus

Initial treatment and testing should happen simultaneously when possible. An IV catheter will be placed to administer fluids and correct shock (manifested by low blood pressure, high heart rate, and rapid breathing). Oxygen may also be given by face mask or nasal prongs. MV is an extremely painful condition, so pain medications should be given.

Your veterinarian should also be conducting diagnostics at the same time. X-rays and/or ultrasound of the abdomen are critical in diagnosing MV. Bloodwork should also be done concurrently to evaluate internal organ function, as well as determine the severity of shock and to rule out other diseases. Most MVs are readily apparent on x-ray, but this is not always the case. Ultrasound also can be helpful.

Surgery for Mesenteric Volvulus

The treatment for mesenteric volvulus is immediate surgery. Even with prompt surgery, the prognosis is extremely guarded for survival. While the stomach can be twisted for hours in a GDV and the patient recover, the intestines do not tolerate the lack of blood flow for long. As a result, the veterinarian must intervene quickly and decisively.

This can lead to a hard decision for both owners and veterinarians. The diagnosis often cannot be definitively made on x-rays and ultrasound. It can be heavily suspected based on clinical signs, breed, and testing, but until the doctor performs surgery, it is not always a certainty. As a result, owners are often forced to make a major decision with an ambiguous diagnosis and recovery. Like any major emergency surgery, it is expensive. MV surgery and post-operative care can cost several thousand dollars. This is an excellent example of why it is important that you have a close and trusting relationship with your veterinarian, as well as an emergency fund and/or pet insurance, which can help offset the cost and stress in the case of MV.

If mesenteric volvulus is suspected, your dog will undergo rapid emergency surgery to de-rotate the intestines. If too much damage has occurred and the intestines cannot be saved, a resection and anastamosis (removal of intestines and sewing ends together) can sometimes be done. However, in some cases, the damage is too extensive, and euthanasia is necessary.

Post-operatively, the patient will likely be hospitalized for several days and undergo careful monitoring. After surgery, complications such as sepsis, systemic inflammatory response syndrome, disseminated intravascular coagulation, and organ failure can occur. Thus, it is imperative that patients are observed closely after surgery. Complications can occur for several days to a week afterward.

Mesenteric volvulus carries a very guarded prognosis for recovery. It is critical that owners of German Shepherds and American Pit Bull Terriers be aware of the symptoms and act rapidly if they are noted.

The post Bloat: The Mother of All Canine Emergencies appeared first on Whole Dog Journal.

It can be hard to tell in this situation, so an immediate visit to the veterinarian is in order. While knowing that your pet likely ingested a large quantity of food makes gastric dilatation more likely, it is also possible your dog is suffering from GDV. Therefore, this is an emergency; taking a “wait and see” approach is not safe in this scenario.

Food Bloat is Sadly All Too Common in Dogs

As an ER veterinarian, I routinely treated food bloat. The perpetrators were frequently left alone with an easily accessible, large amount of dog (or cat or goat or horse) food. Many dogs will eat until they can hold no more. Beagles and Labradors seem particularly prone to this type of scenario, as they are breeds known to rarely turn down a meal.

Kibble is the most commonly fed type of diet, and unfortunately for our dogs, once it enters the dog’s stomach, it starts absorbing stomach acid and begins to swell. The wet kibble becomes dense and heavy. While your dog may feel the urge to vomit, he may not be able to successfully retch up the mass of food. Thus, the symptoms of a food bloat: abdominal distention, drooling, discomfort, restlessness, and non-productive retching.

You may be wondering, “Shouldn’t I make my dog vomit if this happens?” Unless you know that the gorging happened within the last five to 10 minutes, forcing your dog to retch is unlikely to be successful. Once moisture gets into a huge amount of kibble, it becomes difficult or impossible for the dog to bring it back up; the sodden mass becomes too heavy for the muscles that, ordinarily, cause vomiting easily.

Hydrogen peroxide, once widely recommended for the induction of vomiting in dogs, has recently fallen out of favor. The use of peroxide can lead to ulcers in the mouth, esophagus, and into the upper and lower GI system. In cases of food bloat, induction of vomiting is best left to the discretion and experience of veterinary professionals, who can use an injectable medication (usually apomorphine) to quickly and more safely induce vomiting.

Food Bloat Treatment: Not as Scary as GDV Treatment

Luckily for your canine friend, food bloat is relatively simple to treat and rarely results in long-term consequences. Your veterinarian will likely x-ray your dog’s abdomen to ensure that this is just gastric dilatation and not a GDV, which calls for immediate surgery to untwist the twisted stomach and/or bowel and perhaps surgically remove damaged intestine.

The veterinarian will also likely start an IV catheter, which allows rapid administration of fluids to correct dehydration and replace electrolyte losses, and to administer medications. In the case of food bloat, if a dog has vomited repeatedly or retched up fluid, he is losing electrolytes and water. This causes dehydration, which is worsened by the stomach pulling in large amounts of fluid to soften and digest the mass of kibble.

Along with rehydration, your veterinarian may use Cerenia (an anti-emetic) to treat ongoing nausea, and sometimes metronidazole, an antibiotic that that can soothe the GI tract by decreasing inflammation. It can also help prevent diarrhea. Other treatments might include probiotics and a bland diet for several days.

Most importantly, your dog will be walked frequently. The exercise stimulates the intestines to move and helps to pass the dog food through the system quickly. Generally 12 to 24 hours in the hospital is all that’s required to help a dog feel better after over-indulging. Just remember to put the food out of reach next time!

What if my Dog Gorged on Something Else?

It’s not uncommon for dogs to gorge on ANY food items when given the opportunity. As an emergency veterinarian, I’ve seen it all. Dogs like to eat corn cobs, rib bones, discarded food, even empty crab and shrimp shells. If you enjoyed eating it, your dog will likely enjoy it, too.

So what will your veterinarian do if your dog has gorged on something unusual? The quick answer is that it depends. If your pet ingested something that could be sharp or cause damage to the esophagus, the veterinarian likely will not induce vomiting. Bones, shells, and corn cobs can be highly traumatic if a dog regurgitates them. They can also cause problems such as pancreatitis, obstruction of the intestines, and perforation. In those cases, your veterinarian may recommend endoscopy to remove the items carefully and in a controlled manner or even an exploratory surgery.
danger!

Rising Bread Dough

Of special note is the danger caused by rising bread dough. Most dogs will eat rising bread left within reach; it apparently smells irresistible to dogs. This can cause symptoms of food bloat, but it is a much more serious concern.

The yeast in bread dough will continue to ferment in a warm, moist environment (like the dog’s stomach). The fermentation process yields ethanol alcohol and a rapidly growing ball of dough. Your dog will be very bloated and uncomfortable, and he may also be drunk!

Bread-dough ingestion can be very serious and requires more aggressive intervention than a standard food bloat. In some cases, the bread can double or triple in size, necessitating surgery to remove it.

Whole Dog Journal covers yeast dough in 13 Household Items Toxic to Dogs, along with twelve other common and dangerous things your dog may decide to eat.

Catherine Ashe graduated the University of Tennessee College of Veterinary Medicine in 2008. After a small-animal intensive emergency internship, she has practiced ER medicine for nine years. She is now working as a relief veterinarian in Asheville, North Carolina, and loves the GP side of medicine. In her spare time, she spends time with her family, reads voraciously, and enjoys the mountain lifestyle.

The post Food Bloat in Dogs appeared first on Whole Dog Journal.

Thankfully, this was a group of highly experienced dog people, and the dog’s handler immediately ran to her van to procure the bloat kit that she always traveled with. As several people helped hold the dog, she inserted a tube down his esophagus to help expel the trapped gas that was causing his ribs to expand like barrel hoops, taped the tube in place, and sped off to the nearest emergency vet. I heard through the grapevine later that the dog had, mercifully, survived.

There’s good reason why veterinarians call bloat “the mother of all emergencies.” It can come on suddenly and, if left untreated for only a handful of hours, can spell a death sentence for a dog.

Symptoms of bloat, which is incredibly painful for the dog, include pacing and restlessness; a distended abdomen; turning to look at or bite at the flank area; rapid, shallow breathing; retching without actually vomiting up any food, and excessive drooling.

Bloat is a two-part disorder, telegraphed by its formal name: gastric dilatation and volvulus. The first part, gastric dilatation, refers to an expansion of the stomach due to the presence of gas and/or food. The second part, volvulus, is the fatal blow: The distended stomach begins to twist, cutting off the blood supply and causing its tissue to die off. As if that wasn’t trouble enough, the enlarged stomach may press on the blood vessels that transport blood back to the heart, slowing circulation, creating cardiac arrhythmia, and sending the dog into shock.

Once the stomach has torsioned, emergency surgery is required to restore it to its normal position, and to evaluate whether so much tissue has died off that the dog has any hope of surviving.

This was precisely the scenario that the quick-thinking Greyhound handler had sought to avoid: By inserting the bloat tube down the esophagus and into the stomach, she not only created an avenue of escape for the trapped stomach gases, but also ensured that the stomach could not twist while the tube was inserted. As you can imagine, this is not something that most dogs entertain willingly, and, indeed, on the ride to the veterinarian, the dog struggled and the tube was dislodged. Still, it bought enough time for his survival.

Many owners, however, don’t have the inclination or the fortitude to stick a tube down their dog’s throat, even if he is bloating. And for those who have breeds that are at a higher risk for bloat, the constant stress of worrying “Will she bloat?” after each meal is enough to prompt them to consider gastropexy, a preventive surgical procedure where the stomach is sutured to the body wall. While gastropexy won’t prevent a dog from dilating, it does greatly reduce the likelihood that the stomach will flip – which is the life-threatening “volvulus” part of gastric dilatation and volvulus.

Dog Bloat Risk Factors

Owners who are determined to prevent bloat nonetheless want to understand its causes before submitting their dogs to an elective surgery like gastropexy. The problem is, veterinary science is still unclear about precisely what triggers an episode, and instead can only offer a long and varied list of risk factors.

The mother of all bloat studies was done two decades ago by Dr. Lawrence T. Glickman and his colleagues at the Purdue University Research Group, and is still being discussed and quoted today. The 1996 study and its follow-up research found that many food-management practices that were initially believed to help reduce the risk of bloat – like feeding from a raised food bowl, moistening dry food before serving, and restricting water access before and after meals – actually increased the odds of a dog bloating.

Other risk factors include eating only one meal a day; having a close family member with a history of bloat; having a nervous or aggressive temperament; eating quickly; being thin or underweight; eating a dry-food diet with animal fat listed in the first four ingredients, and/or eating a moistened dog food, particularly with citric acid as a preservative.

Not surprisingly, certain breeds were found to be at high risk for bloat, particularly large or giant breeds. Topping the list were Great Danes, followed by St. Bernards and Weimaraners. The study found that breeds with deep and narrow chests – like the Greyhound that started this story – are also at higher risk for bloating, as are males and older dogs.

Also according to the Purdue study, the risk of bloat was more than twice as high in dogs seven to 10 years old compared to dogs two to four years old, and more than three times as high in dogs age 10 and older.

Reducing the Risk of Bloat

While not a guarantee that your dog will avoid experiencing an episode of bloat, these steps can help lower the risk.

1. Feed several smaller meals per day.

Feeding a large, once-a-day meal can extend the stomach and stretch the hepatogastric ligament, which keeps the stomach positioned in the abdominal cavity. Dogs that have bloated have been found to have longer ligaments, perhaps due to overstretching.

2. Slow down fast eaters.

Some theories suggest that air gulping can trigger bloat. To keep your dog from gobbling down his meals, invest in a slow-feeder bowl, which has compartments or grooves to require dogs to pace themselves; there are several brands available. For a low-tech version, try placing a large rock in the middle of your dog’s food bowl, which will force him to eat around it. (Of course, make sure the rock is large enough so it can’t be swallowed.)

3. If you feed kibble, add some variety.

Dogs that are fed canned food or table scraps have a lower incidence of bloat. If you feed kibble, try to avoid food with smaller-sized pieces, and opt for brands that have larger-sized pieces. While some raw feeders maintain that feeding a raw diet prevents bloat, there are no studies to support this, and raw-fed dogs are not immune to bloating.

4. Don’t go for lean and mean.

Studies show that thinner dogs are at greater risk for bloat; in fatter dogs, the extra fat takes up space in the abdomen and doesn’t give the stomach much room to move. While no one is advocating that you make your dog obese, keeping a bloat-prone dog on the slightly chunkier side might have some merit.

5. Reduce your dog’s stress.

Easier said than done, of course. But if at all possible, opt for a house sitter instead of taking your dog to a kennel. If you have multiple dogs, feed your bloat-prone dog separately, to avoid the stress (and resultant gulping) from worrying that his meal might be snagged by a housemate.

6. Don’t eat and run.

Veterinary experts recommend that you avoid giving your dog hard exercise one hour before and two hours after he eats. Many give the green light to walking, however, as it does not jostle the full stomach and in fact can help stimulate digestion.

Assembling a Bloat Kit

Because bloat strikes when you least expect it – often at night, when most veterinary practices are closed, and the nearest emergency vet might be a distance away – a bloat kit can be a literal lifesaver.

Some dog-care sites sell pre-assembled bloat kits. (One option is available from A Better Way Pet Care.) Most include clear vinyl tubing (the kind sold by aquarium stores); a wooden mouth block, to keep the mouth open while the tube is being inserted (a piece of PVC pipe can work in a pinch), and water-soluble lubricant.

Ask your vet to show you how to measure the tubing so that it is the correct length, how to insert it, and how to tell if you are passing the tube down the trachea rather than the esophagus.

Remember that a gastric tube is not a treatment for bloat; it is a first-aid measure. If you are unsure of how to use the kit, or if you are alone and don’t have someone to transport you while you work on the dog, make getting to the vet your first priority.

Deciding on Surgery

If your dog bloats and her stomach has torsioned, surgery is the only recourse if you want her to survive. And if you get to the vet in time, the odds are with you: In a retrospective study of 166 cases between 1992 and 2003, researchers found that short-term mortality resulting from bloat surgery was a relatively low 16.2 percent.

Risk factors for a fatal outcome included having clinical signs more than six hours before surgery (i.e., the longer you wait, the worse your dog’s prognosis), hypotension during any time of the hospitalization, peritonitis, sepsis, and administration of blood or plasma transfusions. Dogs whose tissue damage was so advanced that they required part of their stomach or their spleen removed (partial gastrectomy or spleenectomy, respectively) also had worse prognoses.

But the decisions regarding a gastropexy – essentially, “tacking” the stomach so it cannot torsion – are not as clear-cut. If your dog has never bloated, you’ll need to weigh the risk factors: Is your dog’s breed prone to bloat? (Great Danes, for example, have a whopping 42.4 percent chance of bloating in their lifetime.) Do you know of any siblings, parents, or other close relatives who have bloated? Is your dog nervous, aggressive, or a super-fast eater?

And, most important, has your dog bloated before? Studies indicate that such dogs have a recurrence rate of more than 70 percent, and mortality rates of 80 percent.

Types of Tacks

There are several kinds of gastropexy surgery. Securing the bottom of the stomach to the right side of the body so it cannot rotate during an episode of bloat is the common goal of each type of surgery, but slightly different methods are used to accomplish this. There are no studies that compare the efficacy of the various types of gastropexy, but the general consensus is that there is not a huge difference between them. Most veterinarians will choose one over the others based on their own preference and amount of experience.

Incisional gastropexy is a straightforward procedure in which the bottom of the stomach (the antrum) is sutured to the body wall. It relies on only a few sutures until an adhesion forms.

Belt-loop gastropexy involves weaving a stomach flap through the abdominal wall. Though a relatively quick procedure, it requires more skill than an incisional gastropexy.

In a circumcostal gastropexy, a flap from the stomach is wrapped around the last rib on the right side and then secured to the stomach wall. Proponents of this approach note that the rib is a stronger and more secure anchor for the stomach. This type of gastropexy requires more time and skill to perform; risks include potential rib fracture and pneumothorax, in which air leaks into the space between the lung and chest wall.

Gastropexy is now being performed with minimally invasive approaches such as laparoscopy and endoscopy, which shorten surgery and anesthesia times, as well as the time needed for recovery. Though both use remote cameras to visualize the surgery area, the laparoscopic-assisted approach requires an extra incision through the navel, which allows the surgeon to directly visualize the position of the stomach and make any modifications necessary.

A 1996 study of eight male dogs compared those that had laparoscopic gastropexy with those that had belt-loop gastropexy, and concluded that the laparoscopic approach should be considered as a minimally invasive alternative to traditional open-surgery gastropexy.

Complications from gastropexy are relatively minor, especially for young, healthy dogs who are undergoing the surgery electively, before any incidence of bloat. As always, be sure that your dog has a complete pre-surgical work-up to ensure there are no chronic or underlying conditions that might compromise her ability to successful recover from surgery. And again, while gastropexy isn’t foolproof, Dr. Glickman has been quoted as saying that the risk of bloat and torsion after the procedure is less than five percent – not bad odds at all.

If you do elect to have a gastropexy performed on your dog, many veterinarians do the procedure at the same time as spaying or neutering. That way, the dog doesn’t have to go under anesthesia again, or, in the case of conventional surgery, be “opened up” another time.

In the end, the question of whether or not to have a gastropexy done is arguably tougher for those whose dogs who are not at very high risk: The owner of a Great Dane has a greater incentive for getting a gastropexy than, say, the owner of a Shih Tzu, whose bloat rates are not as comparably high.

A 2003 study that looked at the benefits of prophylactic gastropexy for at-risk dogs used a financial metric to assess the benefits of surgery: Working under the assumption that elective gastropexy surgeries cost about $400 and emergency bloat surgeries cost at least $1,500 – or as much as four times that – the study concluded that the procedure was cost effective when the lifetime risk of bloat with torsion was greater than or equal to 34 percent.

As with any complex decision, assess your dog’s risk factors, as well as your individual circumstances, and then make the choice that seems right for the both of you.

Denise Flaim raises 12-year-old triplets and Rhodesian Ridgebacks, on Long Island, NY.

The post Bloating in Dogs Treatable with Gastropexy appeared first on Whole Dog Journal.

In subsequent issues, there have been occasional letters to the editor thanking Whole Dog Journal for the article and for saving a dog’s life. Those letters kept the memory of the disorder fresh in my mind.

So, when my dog Nick came back from his post-dinner walk gagging up foam, I touched his belly and it was as tight as a drum, I thought, “He’s got that thing!” I called the vet, grabbed my purse and my back issues of Whole Dog Journal, loaded Nick in the car and raced off.

I found the article on GDV while my friend drove, confirmed my suspicions, canceled the vet appointment, and instead went to an animal emergency hospital where they had a surgeon ready.

When the surgeon warned me of the slim likelihood of success, I had an overwhelming feeling that Nick was going to be okay. During the operation, I visualized great things about Nick’s recovery and I mentally drafted my letter of thanks to you.

The surgeon was exceedingly surprised that Nick’s surgery was so successful. She said that my prompt diagnosis and action saved Nick’s life, but I couldn’t have done it without you. So again, I thank you, and I hope my letter reminds Whole Dog Journal readers about GDV and saves another life.
Maureen Ragan
Baltimore, MD

Sheesh! That’s a letter I have to print! I’m so glad Nick is well.Every dog owner should be familiar with the classic symptoms of bloat/GDV, which include the following:

•Unproductive vomiting
•Apparent distress
•Distended abdomen, which may or may not be visible
•Restlessness
•Excessive salivation/drooling
•Panting
•The dog’s stomach feels taut to thetouch, like a drum
•Pacing
•Repeated turning to look at flankand/or abdomen
•Owner feels like something just isn’t right!

Don’t forget that many owners of large-breed dogs (the most frequent victims of GDV) swear by an over-the-counter anti-gas product called Phazyme for emergency (and interim) use when bloat is suspected – to be given on the way to the veterinarian’s office. Phazyme is the brand name of gelcaps containing simethicone, a gas remedy for humans.

While some veterinarians demur, worried that the dog’s consumption of anything could be aspirated (enter into the lungs) when the dog is bloated, others agree that anything the dog can be given to reduce the build-up of gas in his stomach will help. Talk to your veterinarian about using this remedy as an interim treatment for a suspected case of bloat.

I decided to try coconut oil for my Olde English Bulldogg after reading “Crazy About Coconut Oil” (October 2005). Since we rescued him, my dog has had terrible dandruff that did not respond to several different dandruff shampoos. His shedding was worse than my Frenchie and American Bulldogs, combined.

I began including one, then two, teaspoons of virgin coconut oil in his food daily, about one month ago. He loves it. His dandruff has completely disappeared, and his shedding is about 10 percent of what it used to be. I wouldn’t have believed such a quick response if I hadn’t seen it with my own eyes.

Bulldogs have so many health problems I’m not sure it’s fair to keep breeding them, but anything that helps is really appreciated. Thanks to your magazine for intelligent suggestions!
Ellen Cooper
Via e-mail

The April issue devoted a whole article to the potential benefits of lemon balm for dogs (“It’s the Balm!”), but I was dismayed to discover that the invasiveness of this popular herb was mentioned only in a brief aside. As a botanist, I am pleased about your efforts to promote your readers’ interest in plants, but I am hoping you will also pass on detailed instructions on how to prevent these same plants from becoming a danger to the native plant communities across the U.S.

Readers who choose to grow lemon balm should be encouraged to keep it in a pot, rather than transplanting it to the yard, and they should never allow it to flower. Keep an eagle eye on the plant and give it a severe “haircut” as soon as you notice any buds. As a member of the mint family, it will grow back quickly even if you cut it to the ground.

Rather than putting flowering lemon balm branches or plants on the compost, these should go into the garbage or be burned. Once your lemon balm sets seeds, young lemon balm plants will spring up across the neighborhood in the most unlikely (and often undetected) locations, and from there it is just about impossible to put this genie back into the bottle.

Just as responsible pet owners will not allow their pets to populate the neighborhood with feral offspring, we need to keep invasive plants safely under control. Readers who can’t closely supervise their lemon balm should be advised to buy their supply from responsible growers instead.
Catharina Coenen
Pennsylvania

CJ Puotinen, who authored our article on lemon balm, agrees. “Lemon balm grows so well, that where conditions favor its growth, it can take over. In parts of Oregon, it has been listed as a medium-impact invasive weed. Lemon balm enthusiasts should keep their plants spayed, neutered, and on a short leash by planting lemon balm in pots rather than in the ground (to prevent spreading roots), prevent it from flowering by keeping it cut back, and by disposing of flowering stalks that may contain seeds instead of composting them.”

Your editorial in the April issue was really interesting. My dog has been yelping occasionally as well, and sometimes limps and walks gingerly and other times seems fine and peppy. Since this behavior is recent, I took her to the vet to get checked out, but the x-ray showed no fractures or arthritis. The vet thought she showed sensitivity in her lower back when she was pressing down on it, but had no further recommendation than to keep an eye on her. I’d be really interested in a chiropractic exam; would you be able to name the practitioner you mentioned in the article?
Lana Martin
Sacramento, CA

Since the chiropractor who helped Mokie already has a very busy practice, and does not see small animals out of her immediate area, I didn’t want to list her number and unleash a torrent of calls on her. There are many talented veterinary chiropractors; you can contact the American Veterinary Chiropractic Association (AVCA) for information about practitioners near you. Call (918) 784-2231 or see animalchiropractic.org.

I was surprised to read “Don’t Bite on the Veggie Dog” in the April issue. My daughter’s Collie has been on a vegan diet for more than three years. She is seven years old and healthy. Our vet is amazed and has done bloodwork, etc. It is common knowledge that if you choose a vegetarian diet you need to supplement.
Nancy Bersani
Milton, MA

In our opinion, and that of the nutrition experts we most respect, dogs should eat biologically appropriate diets. There is no such thing as a vegetarian or vegan wild dog. We don’t think that dogs who can eat animal products should be denied them for reasons relating to the owner’s ethical or philosophical values. Formulating a “complete and balanced” vegan diet for dogs is far more difficult than feeding an animal-based diet, partly because there is a great deal more research and anecdotal evidence about “what works”

regarding animal-based diets for dogs than there is for vegan diets. That said, we are aware that a very few dogs are allergic to or intolerant of animal proteins and fats; these dogs can clearly benefit from a diet that excludes the problematic ingredients, yet contains appropriate and balanced amounts of the protein, fat, vitamins, and minerals that dogs require.

I just received the May issue and wanted to respond to the letter complaining that you don’t provide your “top foods” lists for free on your website. As you pointed out, you don’t sell advertising – a practice I applaud.

I couldn’t disagree more with the writer’s opinion that Whole Dog Journal cares “more about profits than saving the lives of dogs.” From your in-depth articles about wholesome foods to the excellent articles on humane, joyful training, it is clear that you put dogs at the very top of your priority list. Anyone with an ounce of sense would understand that in order to gather this information and make it available to dog owners, you need to have financial support.

Like most of your readers, I want to do the best I can for my dogs so that they enjoy long, healthy lives. Other dog publications, while at times informative, include too many articles about irrelevant topics such as dresses and jewelry for dogs and the majority are at least 50 percent ads.

I’ve been a subscriber for five years and keep every issue. I’ve always deeply appreciated the information in Whole Dog Journal but with the recent, widespread pet food recalls, I feel more than ever that Whole Dog Journal is a potential lifesaver.

I’m sure that you don’t crumble in the face of the occasional criticism – this is obvious by your publishing that letter – but I wanted to take a moment to let you know that your efforts are appreciated and the price of a subscription is well worth it.
Yogi Cutitta
Salem, MA

I really appreciate your warm words; thanks so much. – Editor

The post Catching Up appeared first on Whole Dog Journal.

1. If your dog is a breed at high risk for bloating, discuss with your vet the merits of a prophylactic gastropexy at the time of neutering.

2. Familiarize yourself and your dog with the emergency veterinary services in your area, or anywhere you’ll be traveling with your dog. You never know when you’ll need to rush your bloating dog to the animal hospital.

3. Feed your dog several smaller meals daily rather than one or two bigger meals to reduce your dog’s risk of gastric dilatation.

4. Consider feeding your dog a home-prepared diet; while there have not been studies that support the assertion, many dog owners who make their dogs’ food swear that it prevents GDV.

Imagine seeing your dog exhibit some strange symptoms, rushing him to the vet within minutes, only to have the vet proclaim his case to be hopeless and recommend euthanasia. For too many pet parents, that’s the story of dog bloat, an acute medical condition characterized by a rapid accumulation of gas in the stomach.

In fact, that was exactly the case with Remo, a Great Dane owned by Sharon Hansen of Tucson, Arizona. “He was at the vet’s in under seven minutes,” says Hansen, in describing how quickly she was able to respond to Remo’s symptoms. He had just arisen from an unremarkable, hour-long nap, so Hansen was stunned to see Remo displaying some of the classic symptoms of dog bloat, including restlessness, distended belly, and unproductive vomiting.

Despite Hansen’s quick action, Remo’s situation rapidly became critical. Radiographs showed that his stomach had twisted 180 degrees. Remo was in great pain and the vet felt the damage was irreversible. Hansen made the difficult decision to have Remo euthanized at that time.

Canine bloat, or more technically, gastric dilatation and volvulus (GDV), is a top killer of dogs, especially of deep-chested giant and large breeds, such as Great Danes and Standard Poodles. A study published in Veterinary Surgery in 1996 estimated that 40,000 to 60,000 dogs in the United States are affected with GDV each year with a mortality rate of up to 33 percent.

Gas accumulation alone is known as dog bloat, or dilatation. The accumulation of gas sometimes causes the stomach to rotate or twist on its axis; this is referred to as torsion or volvulus. Bloat can occur on its own, or as a precursor to torsion. In this article, to simplify the terms, bloat and GDV are used interchangeably.

Both conditions can be life-threatening, although it often takes longer for a straightforward gastric dilatation without volvulus to become critical. “Bloats without torsion can last for minutes to hours, even days in low-level chronic situations, without it becoming life-threatening. But with torsion, the dog can progress to shock rapidly, even within minutes,” explains Alicia Faggella DVM, DACVECC, a board-certified specialist in veterinary emergency and critical care.

“A dog can go into shock from bloat because the stomach expands, putting pressure on several large arteries and veins. Blood does not get through the body as quickly as it should,” continues Dr. Faggella. In addition, the blood supply gets cut off to the stomach, which can cause tissue to die, while toxic products build up.

While some less acute cases of dog bloat may resolve themselves, it often takes an experienced veterinarian to know just how serious the problem may be, and whether surgical intervention is required to save the dog’s life.

Symptoms of Bloat in Dogs

– Unproductive vomiting
– Apparent distress
– Distended abdomen, which may or may not be visible
– Restlessness
– Excessive salivation/drooling
– Panting
– The dog’s stomach is hard or feels taut to the touch, like a drum
– Pacing
– Repeated turning to look at flank/abdomen
– Owner feels like something just isn’t right!

Dog Bloat is Frighteningly Deadly

Various studies have estimated the mortality rate for dogs who have experienced an episode of GDV, and while the results varied, they were all frighteningly high – from about 18 percent to more than 30 percent. The rates used to be much higher, however.

“Veterinarians over the past two decades have reduced dramatically the postoperative fatality rate from gastric dilatation-volvulus from more than 50 percent to less than 20 percent by using improved therapy for shock, safer anesthetic agents, and better surgical techniques,” says Lawrence Glickman, VMD, DrPH, and lead researcher on a number of studies related to GDV at Purdue University in West Lafayette, Indiana.

In many acute cases of GDV, surgery is the only option to save the life of the animal. In addition to repositioning the stomach, it may also be “tacked” to the abdominal wall in a procedure called gastropexy. While dogs who have had gastropexy may experience gastric dilatation again, it is impossible for the stomach to rotate, as in volvulus or torsion.

What Causes Bloat in Dogs?

Theories about the causes of bloat in dogs abound, including issues related to anatomy, environment, and care. Research from Purdue University, particularly over the past 10 years, has shown that there are certain factors and practices that appear to increase the risk of GDV, some of which fly in the face of conventional wisdom.

“We don’t know exactly why GDV happens,” says Dr. Faggella. Some people do all of the “wrong” things, and their dogs don’t experience it, she says, while some do all of what we think are the “right” things, and their dogs do.

The most widely recognized and accepted risk factor is anatomical – being a larger, deep-chested dog. When viewed from the side, these dogs have chest cavities that are significantly longer from spine to sternum, when compared to the width of the chest cavity viewed from the front.

This body shape may increase the risk of bloat because of a change in the relationship between the esophagus and the stomach. “In dogs with deeper abdomens, the stretching of the gastric ligaments over time may allow the stomach to descend relative to the esophagus, thus increasing the gastroesophageal angle, and this may promote bloat,” says Dr. Glickman.

Can Small Dogs Get Bloat?

It isn’t just large- and giant-breed dogs that can bloat; smaller breeds do as well. “I’ve seen Dachshunds, Yorkies, and other small Terrier breeds with bloat,” says Dr. Faggella. She emphasizes that all dog guardians should be familiar with the signs of bloat, and be ready to rush their dog to the vet if any of the symptoms are present.

Likelihood of an incident of dog bloat seems to increase with age. Purdue reports that there is a 20 percent increase in risk for each year increase in age. This may be related to increased weakness, over time, in the ligaments holding the stomach in place, Dr. Glickman explains.

Another key risk factor is having a close relative that has experienced GDV. According to one of the Purdue studies that focused on nondietary risk factors for GDV, there is a 63 percent increase in risk associated with having a first degree relative (sibling, parent, or offspring) who experienced bloat.

Personality and stress also seem to play a role. Dr. Glickman’s research found that risk of GDV was increased by 257 percent in fearful dogs versus nonfearful dogs. Dogs described as having a happy personality bloated less frequently than other dogs. “These findings seem to be consistent from study to study,” adds Dr. Glickman.

Dogs who eat rapidly and are given just one large meal per day have an increased susceptibility to GDV than other dogs. The Purdue research found that “for both large- and giant-breed dogs, the risk of GDV was highest for dogs fed a larger volume of food once daily.”

The ingredients of a dog’s diet also appear to factor into susceptibility to bloat. A Purdue study examined the diets of over 300 dogs, 106 of whom had bloated. This study found that dogs fed a dry food that included a fat source in the first four ingredients were 170 percent more likely to bloat than dogs who were fed food without fat in the first four ingredients. In addition, the risk of GDV increased 320 percent in dogs fed dry foods that contained citric acid and were moistened before feeding. On the other hand, a rendered meat meal that included bone among the first four ingredients lowered risk by 53 percent.

Another study by Purdue found that adding “table foods in the diet of large- and giant-breed dogs was associated with a 59 percent decreased risk of GDV, while inclusion of canned foods was associated with a 28 percent decreased risk.” The relationship between feeding a home-prepared diet, either cooked or raw, hasn’t been formally researched.

Anecdotally, however, many holistic vets believe that a home-prepared diet significantly reduces the risk of bloat. “I haven’t seen bloat in more than five years,” says Monique Maniet, DVM, of Veterinary Holistic Care in Bethesda, Maryland. She estimates that 75 to 80 percent of her clients feed a raw or home-cooked diet to their dogs.

Dr. Faggella also noticed a difference in the occurrence of bloat while in Australia, helping a university set up a veterinary critical care program. “I didn’t see bloat as commonly there [as compared to the US],” she says. They feed differently there, with fewer prepared diets and more raw meat and bones, which may contribute to the lower incidence of GDV, she adds.

It is often recommended that limiting exercise and water before and after eating will decrease the risk of bloat. However, in one of the Purdue studies, while exercise or excessive water consumption around meal time initially seemed to affect likelihood of GDV, when other factors were taken into account, such as having a close relative with a history of GDV, in a “multivariate model,” these factors were no longer associated with an increased risk of bloat.

Or, more simply put, “there seems to be no advantage to restricting water intake or exercise before or after eating,” says Dr. Glickman.

How to Prevent Bloating in Dogs

Because the theories and research on what causes bloat aren’t always in agreement, the ways to prevent GDV can conflict as well. One thing that everyone can agree on, though, is that feeding smaller meals several times a day is the best option for reducing the risk.

One of the top recommendations to reduce the occurrence of GDV from the Purdue researchers is to not breed a dog that has a first-degree relative that has bloated. Results of their study suggest that “the incidence of GDV could be reduced by approximately 60 percent, and there may be 14 percent fewer cases in the population, if such advice were followed.”

In addition, Glickman says they recommend prophylactic gastropexy for dogs “at a very high risk, such as Great Danes. Also, we do not recommend that dogs have this surgery unless they have been neutered or will be neutered at the same time.”

The concern about performing a gastropexy on an unneutered dog is that it “might mask expression of a disease with a genetic component in a dog that might be bred.”

While gastropexy hasn’t been evaluated in its ability to prevent GDV from happening the first time, research has shown that just five percent of dogs whose stomachs are tacked as a result of an episode of GDV will experience a repeat occurrence, whereas up to 80 percent of dogs whose stomachs are simply repositioned experience a reoccurrence.

Raised Bowls Raise the Risk of Bloating

It has long been an accepted practice to elevate the food bowls of giant-breed and taller large-breed dogs. The theory is that, in addition to comfort, a raised food bowl will prevent the dog from gulping extra air while eating, which in turn should reduce the likelihood of bloat. However, this recommendation has never been evaluated formally.

It was included in the large variety of factors followed in a Purdue study,* and one of the most controversial findings. The research suggests that feeding from an elevated bowl seems to actually increase the risk of GDV.

The researchers created a “multivariate model” that took into account a number of factors, such as whether there was a history of GDV in a first-degree relative, and whether the dog was fed from an elevated bowl. Of the incidences of GDV that occurred during the study, about 20 percent in large-breed dogs and 52 percent in giant-breed dogs were attributed to having a raised food bowl.

The raw data, which doesn’t take into account any of the additional factors, shows that more than 68 percent of the 58 large-breed dogs that bloated during the study were fed from raised bowls. More than 66 percent of the 51 giant-breed dogs that bloated during the study were fed from raised bowls.

* These findings were reported in “Non-dietary risk factors for gastric dilatation-volvulus in large- and giant-breed dogs,” an article published November 15, 2000, in Volume 217, No. 10 of Journal of the American Veterinary Medical Association. The study followed more than 1,600 dogs from specific breeds for a number of years, gathering information on medical history, genetic background, personality, and diet.

Phazyme: The Controversial Gas-Reliever

After Remo’s death, Sharon Hansen learned that some large-breed dog owners swear by an anti-gas product called Phazyme for emergency use when bloat is suspected. Phazyme is the brand name of gelcaps containing simethicone, an over-the-counter anti-gas remedy for people. GlaxoSmith-Kline, maker of Phazyme, describes it as a defoaming agent that reduces the surface tension of gas bubbles, allowing the gas to be eliminated more easily by the body.

Less than a year and a half later, Hansen had an opportunity to try the product when her new rescue dog Bella, a Dane/Mastiff mix, bloated. “Bella came looking for me one afternoon, panting and obviously in distress,” explains Hansen, who immediately recognized the signs of bloat.

Hansen was prepared with caplets of Phazyme on hand. “I was giving her the caplets as we headed out to the car,” says Hansen. Almost immediately, Bella began to pass gas on the short ride to the vet. “She started passing gas from both ends,” Hansen says. By the time they arrived at the vet, Bella was acting much more comfortable, and seemed significantly less distressed.

At the vet’s office, gastric dilatation was confirmed, and luckily, there was no evidence of torsion. Hansen credits the Phazyme for reducing the seriousness of Bella’s episode. This is a generally accepted practice among guardians of bloat-prone dogs, but not all experts agree with it.

Dr. Faggella cautions against giving anything by mouth, as it could cause vomiting, which could lead to aspiration. “If you suspect bloat, simply bring your dog to the vet immediately. The earlier we catch it, the better,” she says.

Dr. Nancy Curran, DVM, a holistic vet in Portland, Oregon, agrees that trying to administer anything orally could lead to greater problems. However, she suggests that Rescue Remedy, a combination of flower essences that is absorbed through the mucous membranes of the mouth, may help ease the shock and trauma. “Rescue Remedy helps defuse the situation for everyone involved. It won’t cure anything, but it can be helpful on the way to the vet,” she says, recommending that the guardian take some as well as dosing the dog.

Holistic Prevention of Dog Bloat

“We may be able to recognize an imbalance from a Chinese medical perspective,” says Dr. Curran. She’s found that typically dogs prone to bloat have a liver/stomach disharmony. Depending on the dog’s situation, she may prescribe a Chinese herbal formula, use acupuncture, and/or suggest dietary changes and supplements to correct the underlying imbalance, thereby possibly preventing an episode in the first place.

Dr. Maniet also looks to balance a dog’s system early on as the best form of prevention. Each of her patients is evaluated individually and treated accordingly, most often with Chinese herbs or homeopathic remedies.

Both holistic vets also recommend the use of digestive enzymes and probiotics, particularly for breeds susceptible to canine bloat, or with existing digestive issues. “Probiotics and digestive enzymes can reduce gas, so I’d expect that they will also help reduce bloat,” explains Dr. Maniet.

Another avenue to consider is helping your fearful or easily stressed dog cope better in stressful situations. While no formal research has been conducted to confirm that this in fact would reduce the risk of bloat, given the statistics that indicate how much more at risk of GDV fearful dogs are, it certainly couldn’t hurt. Things to consider include positive training, desensitization, Tellington TTouch Method, calming herbs, aromatherapy, or flower essences.

While there is an abundance of information on how to prevent and treat bloat, much of it is conflicting. The best you can do is to familiarize yourself with the symptoms of GDV and know your emergency care options. While it may be difficult to prevent completely, one thing is clear. The quicker a bloating dog gets professional treatment the better.

Case History: Laparoscopically Assisted Gastropexy

On May 6, 2004, Dusty, a nine-year-old Doberman, was in obvious distress. “He was panting, pacing, and wanting to be near me,” his guardian, Pat Mangelsdorf explains. Dusty didn’t have any signs of tenderness or injury, and his appetite and elimination were fine. Mangelsdorf wasn’t sure what the problem could be. After a few hours, his behavior didn’t improve, so she took Dusty to the vet.

“By that time, he had calmed a bit, and there still wasn’t any tenderness or distension. Radiographs showed some arthritis in his spine, so we thought that was causing him pain,” she says. A few hours later, Dusty lay down to rest and seemed normal.

Three days later, Mangelsdorf received a surprise call. “A radiologist had reviewed the X-rays and noticed that Dusty had a partial torsion,” she says. The vet suggested that to help prevent another incident of torsion, Dusty’s activity level, food, and water should be more tightly controlled, and a gastropexy should be considered to rule out future occurrences.

Mangelsdorf began researching her options. Was the surgery necessary? If so, which would be best, the full abdominal surgery or the laparoscopic procedure? Before she could decide, Dusty had another apparent torsion episode. “He had exactly the same symptoms,” says Mangelsdorf. Dusty spent a night at the emergency clinic, and more radiographs were taken, but they were inconclusive. Nevertheless, Mangelsdorf had made up her mind.

After reviewing the options and the potential risks and rewards, Mangelsdorf opted for a laparoscopically assisted gastropexy, rather than a traditional gastropexy with a full abdominal incision. “A laparoscopic gastropexy is minimally invasive, with just two small incisions,” explains Dusty’s surgeon, Dr. Timothy McCarthy, of Surgical Specialty Clinic for Animals in Beaverton, Oregon. Dr. McCarthy, who specializes in minimally invasive surgeries and endoscopic diagnostic procedures, has been performing this type of gastropexy for about four years.

This specialized procedure for gastropexy was developed by Dr. Clarence Rawlings, a surgeon and professor of small animal medicine at University of Georgia. The technique involves two small incisions. The first incision is to insert the scope for visualizing the procedure, the second incision is used to access the stomach for suturing. After palpating the stomach, it is pulled up toward the abdominal wall, near the second incision. The stomach is then sutured directly to the abdominal wall, as in a standard gastropexy. The incisions are then closed as normal, usually with staples.

“This is a very quick procedure. An experienced surgeon can do it in 15 minutes,” says McCarthy. While quick, the surgery isn’t inexpensive. It costs about $1,500 at McCarthy’s clinic.

On July 27, Dusty underwent surgery. The procedure went well, without any complications. Later that evening, Dusty started heavy panting and shivering, but X-rays and bloodwork showed everything normal. With IV fluids, he was more settled in a few hours, and back to normal by morning.

“Afterwards, we did short walks, no stairs, and three or four small meals a day for two weeks,” says Mangelsdorf. Gradually, she increased Dusty’s exercise until he was back to normal levels. She added acidophilus as well as more moisture into his diet, including cottage cheese and canned food, while keeping his water bowl at lower levels so he doesn’t drink excessive amounts at any one time.

Shannon Wilkinson, of Portland, Oregon, is a freelance writer, life coach, and TTouch practitioner.

The post Dog Bloat: Causes, Signs, and Symptoms appeared first on Whole Dog Journal.

Knowing what bloat is, and learning to recognize its clinical signs early is important for all dog owners so you can ensure prompt treatment before simple bloat progresses to irreversible and fatal whole body shock. Certain dogs are more likely to become a victim of this horrible stomach disorder, so it helps to know what those breeds are in case your dog is one of the more statistically likely candidates for the illness. And finally, it also helps to know how it is treated, and whether there are any preventive measures that can be taken to keep your dog from ever becoming a victim of bloat.

What is Bloat in Dogs?

The technical term for bloat is gastric dilatation. Simply put, this means the stomach dilates and enlarges. The main constituent of this dilation is air, although food and water are usually present in the stomach as well. This makes bloat quite different from a simple case of over-eating, where the pet engorges on food and the stomach fills rapidly with the last meal eaten.

Why does the stomach fill rapidly with air? The main cause seems to be aerophagia, where the pet literally swallows a large amount of air. Most commonly this is from eating too quickly. Unfortunately, for some reason, the air is not passed into the intestines or belched back out the esophagus. No one knows what causes the stomach to retain air.

Another theory is that after eating, some pets swallow air as they exercise, causing the stomach to bloat. While many doctors advise clients not to allow their dogs to exercise immediately after eating, I do not know of any controlled studies that show conclusive proof that exercise restriction prevents bloat. In many of my patients there was no history of exercise immediately after eating that contributed to the bloating. And since wild dogs and their ancestors (wolves) may need to be on the move after a meal (although, given the chance they usually rest to digest their food and recover from the recent kill), I doubt that exercise is a major factor in bloating. Still, until evidence proves otherwise, many veterinarians discourage exercise for 30-60 minutes after eating.

One of the myths regarding bloat is that only large dogs can develop bloat. It is true that bloat is more commonly found in large and giant breed dogs and deep chested dogs, usually two to 10 years old. The most commonly affected dogs include Great Danes, German Shepherds, Saint Bernards, Labrador Retrievers, Irish Wolfhounds, Great Pyrenees, Boxers, Weimaraners, Old English Sheepdogs, Irsih Setters, Bloodhounds, and Standard Poodles. However, any dog can develop bloat.

Another myth involves feeding your dog from a raised bowl as a way to prevent bloat. Feeding from a raised bowl can be very helpful in some dogs with a disorder called megaesophagus (where the dog repeatedly vomits up his food because the food has difficulty passing into the stomach). However, I have not seen anything in the veterinary literature that confirms that a high feeding table can prevent bloat (although, as you’ll see, there are some things you can do to minimize the chance of your dog bloating).

Some owners feel that feeding only cereal-based foods will cause bloat, or that dogs eating raw diets will not bloat. It is true that cereal-based foods ferment more in the gastrointestinal tract, which can cause excess gas, but this occurs further along in the intestinal tract (mainly the large intestine.) The only thing I have seen repeatedly suggested in the literature is that excess calcium in the diet, and excess air being ingested with the diet, may contribute to bloating in some dogs. Dogs can develop bloat no matter what diet is fed.

Bloating is a Life-Threatening Condition

Regardless of the actual cause, bloating in dogs is one of the few true emergencies in veterinary medicine. Dogs can and do die if not treated promptly. As I’ve mentioned, with bloat the stomach fills with air that it cannot expel. The bloated stomach compresses blood vessels in the stomach wall and abdominal cavity, causing hypovolemic shock. In severe cases, this bloated stomach can actually twist on its longitudinal axis. This twisting or torsion is called volvulus. As the stomach twists, it may pull the spleen with it, causing torsion of the spleen. If not treated promptly, both the spleen and stomach will die as the twisting cuts off the blood supply to these organs. Treatment involves decompression of the air-filled stomach and surgery to reposition the stomach if rotation occurs.

In an emergency case of bloat, pressure may be quickly relieved by inserting a large gauge needle (14-18 gauge) through the skin and right into the bloated stomach. This is only temporary treatment, but it does buy time and give the dog quite a bit of relief. After this temporary needle decompression, the dog is lightly anesthetized with an intravenous anesthetic (due to the shocky condition of most patients, less than half of a normal dose of anesthetic is usually all that is necessary to cause anesthesia).

Then two tubes are passed into the dog’s mouth: one goes into the trachea (windpipe) and one goes down the esophagus into the stomach. The stomach tube will be used to “pump the stomach,” removing food, water, and any remaining air. The tracheal tube is used to protect the airway so that no food or water accidentally enters the lungs. Other conventional therapies that may be used include IV fluids and corticosteroids (for shock) and antibiotics to prevent secondary infections. Homeopathic therapies such as Arnica can be used in the post-operative period to assist healing, and acupuncture can be used for pain control.

Surgery for Bloated Dogs

Dogs with volvulus will require surgery. Surgery has two objectives: to assess the damage done to the stomach, spleen, and other organs, and to reposition the stomach into the proper position. Stomachs that sustain severe damage cannot be repaired, and these patients must be euthanized. Stomachs with mild damage can usually heal after repositioning. Veterinarians hope that the surgery prevents future occurrences, as well.

The techniques to reposition the stomach is called a gastropexy, and involves literally sewing the stomach to some part of the body. Most commonly a circumcostal gastropexy is performed. In this technique, the stomach is sewn to the rib cage. The surgery is quite effective in preventing future episodes of volvulus, but no surgery can prevent bloating.

Owners of larger breed dogs (who might be prone to bloat and volvulus) have asked me about the feasibility of performing a gastropexy to prevent any episodes of bloating. I advise against this for several reasons:

• We can’t prevent bloat with this surgery, only the torsion (volvulus) that can accompany episodes of bloat.

• While nothing is guaranteed, following certain prevention tips can help reduce the incidence of bloat.

• I prefer not to subject pets to the inherent risk of unnecessary surgeries.

• I have seen no evidence that this prophylactic approach is worthwhile since gastric dilatation volvulus may never occur in any given pet.

If you are considering such a prophylactic surgery, I would advise you to talk with your veterinarian and carefully consider all options first.

Preventing Dogs from Bloat

This is one of those conditions where prevention is much preferred to treatment. While there is no 100 percent effective prevention, here are the guidelines I use in my practice.

• Avoid feeding your dog too much calcium. Many supplements contain calcium. If you are feeding your dog more than one type of supplement, check the labels carefully and “do the math” the determine how much calcium he receives from his diet and supplements.

• Feed small, frequent meals (2-4 meals per day). It’s a hassle, but the payoff is worth it. (There are some trainers who never feed their dogs out of a bowl, but who feed their dog its food as rewards for doing certain requested behaviors!)

• For dogs who tend to gulp their food, try placing large bricks or rocks in the food bowl. This forces the dog to eat around these obstacles, and slows the eating. Also check out these tips to slow down a fast eater from Dogster.

• No exercise for 30-60 minutes after a meal, and nothing hard (no hard running or playing.)

Because bloat is a true emergency, I encourage owners to be prepared at home. Ask your doctor for several large gauge needles to add to your first aid kit, and have the doctor show you how to properly perform needle decompression. This technique could save your pet’s life!

Dr. Shawn Messonnier is a holistic veterinarian in Plano, Texas.

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