‘Twisted stomach’ in dogs is a serious problem
Integrative Pet Vet
Gastric-dilatation-volvulus looks like a convoluted and complex name. This name however, gives a clear description of a serious, life-threatening problem that occurs in dogs. The condition affects the stomach (gastric), involves bloating of the stomach (dilatation), and finally, twisting or rotating of the stomach (volvulus). It is often abbreviated as GDV.
While the cause of GDV is unclear, it has often been associated with older, large-breed, deep-chested dogs that are fed one large meal a day and are related to other dogs that have experienced GDV. Any dog can be affected, but the most common breeds are Great Danes, Weimaraners, St. Bernards, Irish setters, and Gordon setters. Interestingly, aggressive dogs seem to be at higher risk. There also appears to be an increased risk if a susceptible dog is fed primarily dry kibble dog food in one or two large portions each day, compared with those that are allowed to eat smaller meals throughout the day or are fed canned foods. In addition, high fat content in foods has been associated with increased risk.
Many of the initial signs associated with GDV are general and do not conclusively indicate GDV. These signs include an anxious look, looking at the abdomen, standing and stretching, panting and drooling. As the GDV progresses, signs become more focused on the bloated stomach and include distended abdomen, retching, unproductive vomiting and difficulty breathing. With continued progression, the dog can collapse from poor blood circulation and difficulty breathing.
These later signs reflect the fact that GDV is a serious problem that affects the whole body. The bloating stomach puts pressure on the blood vessels, reducing the ability of the blood to properly circulate. Pressure on the diaphragm makes breathing difficult. When the stomach rotates, the blood circulation in the body and stomach is further compromised. Toxins begin to be released. Irregular heartbeats can occur. These events can lead to shock, collapse, coma and even death if not treated. GDV is an emergency and should be treated immediately. The sooner it is aggressively treated the better the outcome.
Diagnosis of GDV relies on a characteristic gas pattern in the stomach seen on X-rays. Initial treatment is focused on stabilizing with IV fluids and oxygen, and getting the gas and fluid out of the stomach. Once the dog is sufficiently stabilized, anesthesia and surgery will be performed. The surgery is intended to untwist the stomach and tack the stomach to the inside of the abdomen wall (gastropexy) to prevent reoccurrence of GDV. In addition, the stomach will be inspected for areas that have to be removed as a result of damage from poor blood flow during the GDV. If the spleen has also twisted, it must be untwisted. The spleen may also be removed if it has become too damaged. Antibiotics will be needed because bacteria can leak into the bloodstream from the compromised intestine. There may also be disturbances in the blood pH and electrolytes like potassium that need to be addressed. Irregularities in the heart rhythm can occur. These irregularities, if unmanaged, can sometimes be life-threatening.
After surgery, monitoring of the heart is important for the first 24 hours. Exercise restrictions will also be recommended for the first one to two weeks while the surgery site is healing. Frequent small meals of bland food are often advocated along with frequent small amounts of water. Monitoring of the kidneys may be important initially depending on the severity of poor blood circulation during the GDV.
Since GDV is an emergency that is best handled by stabilizing with decompression of the stomach, intravenous fluid therapy and surgical intervention, integrative approaches are best used to support the stabilization process and surgical recovery. These therapies may include acupuncture to help manage pain and promote return of normal stomach and intestine contractions after surgery, laser therapy may facilitate healing and reducing pain in the incision, probiotics help replace beneficial bacteria in the digestive tract, and nutritional supplements and herbs may be supportive of a compromised kidney.
GDV is a life-threatening emergency. Contact your veterinarian or veterinary emergency facility if you suspect your dog is experiencing GDV.
Ron Carsten, DVM, PhD, CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians, and has been a pioneer in the therapeutic use of food concentrates. He has a doctor of veterinary medicine, a Ph.D. in cell and molecular biology, and is a certified veterinary acupuncturist and canine rehabilitation therapist. He practices integrative veterinary medicine in Glenwood Springs.
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Last week’s column was about Will Bulsiewicz, M.D., a respected gastroenterologist who wrote “Fiber Fueled,” which came out in 2020. Today’s column is the first in a series of columns based on this book.