GDV Burnese Mountain Dog – Animal Emergency Melbourne

Emergency  GDV

Georgy is a gorgeous Burnese Mountain Dog who presented to Animal Accident and Emergency Point Cook last week for severe abdominal pain, abdominal distension (bloated belly) and dry retching (attempting to vomit without producing any vomit).

This presentation and breed are typical of a disease commonly known as BLOAT. The technical name for bloat is “gastric dilation and volvulus” or “GDV” for short. 

In cases of GDV the stomach has become distended and has filled with gas and then twisted over on itself. This is a life threatening condition as all the blood vessels that supply the stomach get kinked off like a bent hose pipe and this stops the blood flow to the stomach wall. The stomach wall begins to die as a result of the lack of blood supply. The stomach then inflates further as gas cannot escape out of a twisted stomach. The inflating stomach blocks off blood that is returning to the heart via the large vessels in the abdomen. This causes shock. Another complication of the overly inflated stomach is that it puts pressure on the diaphragm (the muscle that makes you breath) thus making it very difficult for these poor doggies to breath!

Please see this link for an animation of what happens in GDV:

In summary, the main things that happen in a bloat case are: 

• distended stomach twists and loses blood supply causing the stomach wall to start dying 
• the distended stomach inflates even more and blocks off other blood vessels returning blood to the heart
• the now very distended stomach puts pressure on the diaphragm and prevents the dog from being able to breath properly. 

So now that we all know about GDV and what happens, what can we do to correct it and save your beloved dog? 

The first thing to do is confirm the vets suspicion of GDV with a x-ray of the patient’s belly. This is exactly what we did for Georgy. If the vet suspects that your dog has GDV, you may be asked if we can take an x-ray immediately to check if that is indeed what is happening. 

GDV XRAY VET EMERGENCY

Unfortunately, once the twisted stomach has been confirmed, the only way to fix what is happening is surgery. Before we get into what is done surgically to correct this condition we need to stabilise the dog first. Stabilisation involves deflating the stomach by either passing a tube down their throat or using a needle to let some gas out. Given that these patients are in shock fluids will need to be started immediately in order to help their heart and circulation. This condition is also painful and pain relief will be provided in this phase. 

The next step is surgery. Surgery involves anaesthetising the patient and an incision (cut) into the abdomen (belly). The stomach is untwisted and inspected carefully. Sometimes the stomach will be dead in places and these places will have to be removed because dead tissue cannot be left behind. The spleen (a blood storage organ) is closely attached to the stomach and sometimes this may have twisted with the stomach and may need to be removed as well- this may sounds like a big deal but dogs do just fine without their spleens. Once the stomach and spleen are dealt with, the stomach is then stitched to the abdominal wall to prevent it twisting over on itself again – this is called a GASTROPEXY and is a VERY IMPORTANT part of the surgery as this condition will recur if this is not done! 

The rest of the abdomen is inspected and then closed. 

RECOVERY

Recovery time for this surgery depends on a lot of different things. Minimum time in hospital after surgery is 24 hours but some patients may require a few days. The longer the stomach is twisted for before surgery is performed, the more complications are encountered and the longer the recovery period. 

WHAT TO LOOK OUT FOR?

1. BREED IS THE NUMBER ONE CONSISTENT FACTOR IN BLOAT. Certain breeds are far more at risk than others. These breeds are the bigger breeds of dog and tend to have “deep proud chests”. Breeds most at risk: Great Dane, German Shepherds, Standard Poodles, Dobermans, Boxers, Dalmatians, Weimaraner, Burnese Mountain Dogs, Saint Bernards, Newfounlands, Labradors, Retrievers, Chow Chows and Rhodesian Ridgebacks. However OTHER DOGS CAN HAVE GDV. 
2. Bloated belly 
3. Trying to vomit (dry retching). Some dogs with bloat may be able to produce some vomit so do not exclude bloat on the basis that your dog can vomit. A vomiting pet is always a concern and you should always seek veterinary advice if your pet is vomiting or trying to vomit. 
4. Sore belly- standing hunched, whining or yelping.

WHAT TO DO IF YOU THINK YOUR PET HAS BLOAT? 

Contact a vet immediately. As mentioned before, time is of the essence in both saving your dog and in minimising complications. AAE Essendon and Point Cook are open 24 hours a day 365 days of the year. 

HOW CAN YOU PREVENT GDV?

1. If your dog is an at-risk breed for GDV (see breeds above) there is the option to consult your general practice vet about prophylactic gastropexy (a surgery where they stitch the stomach to the abdominal wall before the GDV has occurred). This is the ONLY way to prevent your dogs stomach from twisting. This surgery is especially easy to do in females when they are spayed as puppies as the vet is already entering the abdomen and saves a separate anaesthesia and surgery. 
2. If you have an at-risk breed of GDV (see breeds above), it is recommended to feed your dog smaller meals more frequently as opposed to one large meal. 
3. It has long been thought that exercising your dog immediately after feeding may increase the risk of bloat. It is recommended that you avoid exercising your dog soon after you have fed them. 

DISPELLING THE MYTHS

• Feeding your dog antacids or de-gas medication does not decrease the risk of the development of GDV. 
• If your dog has a twisted stomach, surgery is the ONLY option in order to save your dog’s life, without the appropriate surgery THE VAST MAJORITY OF THESE DOGS WILL TWIST THEIR STOMACHS AGAIN!

Dr Tim Conolly & Georgy

We are happy to say that the lovely Georgy made a full recovery from her GDV and subsequent surgery with very few complications. 

www.animalemergency.com.au

Animal Accident Emergency: Gastric Dilation and Volvulus (Bloat)

Bloat or GDV is a heart breaking condition that we deal with in our Melbourne 24Hr Pet Emergency Centres.  The following article was prepared by Dr Emily Treweek.  Dr Treweek has worked in emergency and critical care for the last 10 years and is a Member of the Australian and New Zealand College of Veterinary Scientists in Emergency and Critical Care.  If at any time you believe that your pet may have bloat, we need to see them as soon as possible.  We are a 24 Hr Melbourne Animal Hospital.   We are open 7 days a week and we are a Vet Open Sunday.  Our Team are always available.

 

Gastric Dilation and Volvulus (or GDV as we will refer to it) is a life-threatening emergency where the stomach dilates with gas, and rotates within the abdomen, often 180 degrees, sometimes 360 degrees.  Normal build up of gas can be relieved by burping, however the rotation (‘volvulus’) starts near where the stomach meets the oesophagus, preventing burping.  The blood flow to the stomach is compromised, as the vessels are crushed when the stomach twists.  The spleen is an adjacent organ that may become tangled also.  Compromise to the blood flow causes inflammation due to reduced removal of waste from the cells of the trapped organs.  The stomach can get so big that it disrupts blood flow from the back end of the body to the heart, leading to reduced blood pressure, which leads to reduced blood supply to the rest of the body.  The size of the stomach can put pressure on the diaphragm, making it hard for the pet to breathe.  In turn, this can reduce the amount of oxygen available to the body.

With reduced blood pressure, reduced oxygenation and inflammation, it is easy to see how this can make a pet critically ill, and all of this can occur within only hours.

Symptoms of gastric dilation and volvulus may include an acute onset of discomfort, restlessness , salivation, retching or attempting to vomit, unproductively.  If you ever notice these symptoms, you must have your pet seen promptly by a veterinarian.  It will help if someone can call ahead so the veterinary team can be prepared.

It is a condition most often seen in large breed, deep chested dogs.  Deep chested dogs will have a very tall chest from their spine to their sternum (breastbone) while having a very narrow chest in the left-to-right dimension.  Some examples of dog breeds often affected are Great Danes, greyhounds, Irish Setters, Standard Poodles, St Bernards and Weimeraners, although any breed of dog, and even cats can occasionally be affected.

While there has been much speculation on the cause of GDV, there is little evidence to support what the cause may be.  Having a first degree relative with GDV, anxious or stressed dogs, eating very fast and having a raised feeding bowl are some factors that may be associated.

When presented with a patient with GDV, our veterinary team are required to act quickly.  Initial tests include clinical examination including palpation (feeling) the abdomen, blood tests and in most cases xrays (which can confirm whether the stomach is rotated rather than simply dilated).  Treatment requires the team to move swiftly to decompress the stomach, stabilize the patient with rapid intravenous fluids, pain relief and sometimes medication to stabilize the heart, in order to get the patient to surgery as fast as possible, where we are able to de-rotate the stomach and assess for damage in the abdomen.  In some cases parts of the stomach wall may need to be removed due to permanent loss of blood supply.  The spleen sometimes requires removal due to loss of blood supply also.  During the surgical procedure, the veterinarian will also perform a gastropexy, which is where the stomach is attached surgically to the inner abdominal wall, to significantly reduce the recurrence of GDV.

As you can probably imagine, it can take a few days to recover from such a major operation.  Patients are critical and require 24 hour monitoring for the next few days.  The veterinary team needs to treat the patient to ensure optimal hydration, oxygenation and circulation in the postoperative period.  The patient will be monitored for blood loss, blood clotting problems, heart problems (detected via ECG) and other complications from surgery.  They may need blood or plasma transfusions, medications to reduce abnormal heart beats, improve blood pressure or electrolyte supplementation.  Getting the pet to eat again after surgery often requires medication to promote movement of the gut, medication to reduce stomach acid and carefully balanced pain relief.  Pets that do well through to stitch removal go on to lead a normal healthy life.

Survival depends on the amount of internal damage.  One of the advancements in recent years is the ability to monitor progress with Cage Side Testing.  Our Emergency Centres are equipped with the latest blood testing machines, which allows us to obtain blood results acutely.  We treat numerous GDV patients each year and are more then aware of the complications that can occur.

If you believe that your pet may have Bloat or a GDV, then you need to contact us directly.  We have two convenient emergency centers.  Our Emergency Centres run 24Hr Intensive Care Units.  We service many suburbs in Melbourne.

Animal Accident & Emergency Essendon – 9379 0700

Animal Accident & Emergency Point Cook – 8368 7400

 

http://www.animalemergency.com.au/home-1.html

Gastric Dilation and Volvulus

Gastric Dilation and Volvulus
(Commonly known as bloat)

What is GDV?
Gastic dilation and Volvuous (GDV) is a true medical emergency. This is a condition where the stomach becomes distended and twisted upon itself. Twisting of the stomach causes an occlusion of the gut and associated blood supply. Consequently, affected tissue may die; this will cause serious, life threatening disease.

This condition requires immediate veterinary attention.

It is true that deep chested dog are generally predisposed to GDV (e.g. Great Dane, German Shepard, Irish Setter, Basset Hound, Doberman) but this does not mean that other dog breeds or dog sizes cannot be effected. It is also true that older dogs are at a higher risk of developing GDV; however, this has not been shown to affect their chances of survival.

GDV vs. Gastric dilation?
Occasionally, dogs of all sizes will experience gastric dilatation without volvulus – this is usually caused by gluttony. Although this condition is generally less harmful to your pet it does still require immediate veterinary attention.

So what will I notice at home?
Patients that experience either GDV or Gastic dilation will usually appear off colour, restless, painful, distended in the abdomen, they may have retching, with or without producing vomitus, panting, drooling and pale or bright red gums.

These symptoms usually progress, and develop suddenly. So if you believe your dog is showing any of the above signs they need to be seen by a vet as soon as possible.

What can I do from home?
It is likely that feeding two to three smaller meals two-three times daily, as compared to one large meal, may reduce the risk of developing GDV in your pet.

Providing a comforting environment to your pet is beneficial for many reasons. Stressful environments are likely to increase the incidence of GDV.

Dry dog feed diets high in fat may also be associated with an increased incidence of GDV, thus restricting these may be beneficial.

Restricting exercise after meals may aid in the prevention of GDV.

Feeding from an elevated position will increase the amount of air that your dog ingests with its meal. Increased amounts of air in the stomach is also likely to increase the risk of GDV developing.

Common misconceptions:
• My dog cannot get GDV, because it isn’t the right age, breed, sex, or size.
• My dog appears a little bloated in the abdomen but doesn’t appear too restless, I’ll wait and see how it does at home for the next hour.
• Someone other than a vet told me that my dog will be fine.
• My dog is quite old and wouldn’t survive surgery if required.

If you think your animal is showing any of the symptoms listed please seek veterinary advice immediately, regardless of the time of day. Remember, the best thing that can happen is a false alarm.

If you have any concerns please call one of our 24 hour Animal Hospitals at Essendon or Point Cook.