GDV in the dog: a twist in the tale

A twisted stomach, which vets call Gastric Dilatation and Volvulus (GDV), is a potentially life-threatening condition that can progress very quickly. Urgent veterinary care is needed to ensure your pet has the best chance of survival. We look at what you need to know to understand the condition and spot the signs promptly.

What is GDV / bloat in dogs?

In its early stage, bloat or the dilatation (or dilation) of Gastric Dilatation and Volvulus (GDV) occurs when the stomach fills up with gas and becomes distended. At this point your dog may look obviously bloated and seem uncomfortable. Some dogs really look as if they have swallowed a beach ball, their abdomen round and taut.

If the stomach then twists on its axis, it becomes a volvulus and thus a full GDV. Since the oesophagus (or gullet) at the entrance to the stomach and the intestine (gut) near the exit are fixed in place, when the stomach twists, both entrance and exit are blocked, like kinks in a hosepipe.

Now neither food nor gas can leave the stomach, either by passing down the gut or being vomited up. The distended stomach puts pressure on nearby blood vessels and limits the natural flow of blood to the heart, resulting in shock. Signs of shock can result: pale gums, rapid breathing, even collapse.

Which dog breeds are at risk of bloat and GDV?

Note that any breed can have GDV, but it is most likely to occur when there is plentiful space for the stomach to move or the ligament that holds the stomach in place is lax. Dogs at risk are usually large breeds with deep chests relative to their width. Breeds particularly prone include:

  • Great Dane
  • Irish Wolfhound
  • Weimaraner
  • Red (Irish) Setter

Also on the “at risk” list:

  • German Shepherd
  • Labrador
  • Boxer
  • St Bernard’
  • Greyhound and Lurcher
  • Dobermann
  • Standard Poodle
  • Other Setters and Retrievers

Your dog is at a significantly higher risk if a littermate or parent has suffered from GDV.

What are the signs of a twisted stomach/GDV in dogs?

  • A swollen, tense and painful abdomen
  • Retching, trying unsuccessfully to vomit
  • Drooling
  •  Restlessness, panting
  • In due course, signs of shock: pale gums, rapid breathing, collapse

Signs may occur after feeding or may occur at night well after the last meal. It has long been considered that exercise with a stomach full of food is a risk factor, though a major study failed to support this idea. We’ve looked at prevention in more detail below.

How is GDV diagnosed?

GDV is often suspected from the clinical signs alone; it can be confirmed by X-rays or an ultrasound scan, which show a hugely distended and gas-filled stomach and the characteristic folds of a twist.

How is GDV treated?

The treatment for GDV is surgical, an emergency operation to return the stomach to its normal position and place permanent internal stitches with the aim of preventing a recurrence – this is called gastropexy.

Before surgery the vet will attempt to decompress the stomach by letting out the gas, to reduce the pressure on the surrounding blood vessels and improve blood flow to the heart. This may be done by introducing a stomach tube through the mouth (only successful if there is not a full twist) or by inserting broad needles into the distended stomach through the skin.

Patients are given intravenous fluids to support the circulation and strong painkillers, as GDV is very painful. Blood tests can assess damage to other organs, such as the liver and kidneys.

Surgical success depends on how quickly GDV is diagnosed and whether there is damage to the stomach and surrounding organs. In some cases, the stomach can be damaged beyond repair from interruption to its blood supply, or may have ruptured.

In some cases, the spleen can become involved in the twist and may also have to be removed.

Sadly, in some cases, if the damage is too widespread or the pet has an underlying condition, they may not survive the corrective surgery. The vet may recommend euthanasia if the chance of recovery is deemed to be low and sudden death may occur in the days after surgery due to disturbances in the heart’s rhythm.  Even with swift action, approximately 1-in-5 affected dogs die during surgery or in the immediate recovery period.

How can you prevent GDV?

Surgical risk reduction:

If you have a breed known to be prone to GDV, you may consider having the same stomach-fixing procedure (gastropexy or “tack”, referred to above) performed on your dog as a preventative before any episodes of GDV occur.  Though this will not prevent bloat, it will often prevent the twist (volvulus) that is the life-threatening event.

In a bitch, this procedure could be performed at the same time as neutering. Increasingly the option for keyhole surgery exists, such as this referenced by the Royal Veterinary College among other first opinion and referral centres.

For dogs that have had an episode of GDV, there is a high risk of reoccurrence in the future without gastropexy – indeed, they are still at some risk even with gastropexy.

Diet and lifestyle:

Much has been written about how to reduce the chance of a GDV occurring. The Purdue study examined nearly 2000 dogs over 20 years and came to some interesting conclusions:

These factors increased the risk of bloat:

  • Feeding only dry food
  • Feeding a single, large daily meal
  • Feeding dry foods with fat as one of the first four listed ingredients
  • Dogs that ate fast
  • Dogs perceived as stressed, nervous or aggressive
  • Stressful events such as a long car ride or recent kennelling
  • Raising the height of food and water bowls in an attempt to stop gulping
  • Moistening dry foods (those that contain citric acid) before feeding
  • Being underweight

These factors made no difference:

  • The relationship between food and exercise
  • The relationship between drinking and eating
  • Feeding canned food versus dry food alone
  • Feeding ice cubes

These factors reduced the risk of bloat…

…and so make up the current recommendations:

  • Feed from floor level
  • Feed two to three small meals a day, not one large one
  • Slow down the bolters and gulpers by the use of puzzle feeders, slow feeders or scatter feeding
  • If feeding dry food, mix in canned food or table food i.e. small portions & scraps of our own foods.
  • Don’t feed small kibble designed for smaller breeds to larger breeds
  • Leave access to water for dogs to drink as they wish, including around feeding time
  • Keep your dog in good, optimum body condition – not overweight, because that increases the chance of other problems, but not too thin

In addition, if you consider your dog to be nervous or stressed, consider seeking professional advice from behaviourists who are on the registers of  Certificated Clinical Animal Behaviourists or the  Association of Pet Behaviour Counsellors. Your primary vet will need to refer you and may be able to recommend someone within a reasonable distance.

If the fear of such a serious condition leaves you concerned as to the right course of action, remember that the Vet on the Net team are here for you 7 days a week, giving reassurance and personalised advice by online video and telephone consultations.