We received a fax one day from the Animal Emergency Clinic in Manchester. The fax was regarding a one hundred and twenty pound Bull Mastif named "Samantha". It read D.O.A.!
"Sam" had visited us several times over the past 12 months. We had done major abdominal surgery in February of 1995. My veterinary technician and I surgically removed pieces of a scatter rug that "Sam" had swallowed and eaten. They were lodged in her intestine. She spent another week with us in October of 1995. At that time, we surgically treated a grapefruit-sized infection in her jowl. Needless to say, "Sam" had become a regular at the hospital and a personal favorite.
"Sam" died over that weekend and the autopsy showed that she had died from "Bloat; a.k.a.- Twisted Stomach; Gastric-Dilatation-Volvulus". I hope this column will be informative and alert you about "Bloat". Prevention and early intervention can save lives. "Sam's" owners are wonderful and attentive people who didn't recognize the warning signs.
Bloat or Gastric Dilatation usually comes on in a matter of hours and is a medical and sometimes a surgical emergency. The syndrome is referred to as GDV (Gastric Dilatation-Volvulus) when the stomach distends and twists. The twist appears like the neck of a balloon and prevents inflow or outflow of stomach contents. A major blood vessel that returns blood to the heart becomes strangled. This depresses general circulation and causes the heart to beat irregularly. Shock and death can follow within hours.
We do not know the precise causes of bloat. However, certain similarities or risks exist among patients that bloat. The disease is most commonly seen in large, deep-chested dogs. Great Danes, Dobermans, Weimaraners, Saint Bernards, Gordon Setters, Irish Setters, and Standard Poodles are commonly affected. Other high risk breeds include, Irish Wolf Hounds, Borzois, Bloodhounds, Mastiffs, Akitas, German Shepherds, and Bull Mastifs. Researchers at Purdue University found bloat to be more common in dogs older than seven years. Other data show that the frequency of bloat is increased in purebred, high strung dogs. However, dilatation can occur in any breed and in almost any species. This past winter we had Guinea Pig that died from GDV. Cats and small dogs can bloat.
The hereditary problem in deep-chested dogs may be related to anatomy. There may just be extra room in the abdomen. Another thought is that the stomach may empty too slowly, thus delaying the movement of food through the intestine. Gastric dilatation results when animals swallow large amounts of air, often times after gulping their food. Exercise after eating a large meal can also bring on symptoms. When conditions are just right (or just wrong), the stomach twists on itself before the air and partially digested food get out. Then problems begin.
Recognizing bloat in early stages can be confusing. Pet owners think that their animal has indigestion or maybe even "got into something". A tell tale sign is a abnormally swollen, bulging abdomen. Early symptoms include unusual anxiousness, restlessness, and whining. Animals many attempt to vomit without success. Symptoms progress within hours and animals arch their backs, salivate heavily, retch and gulp as if to burp. They may pant continuously. The abdomen usually becomes enlarged and tight as the disease progresses. The spleen can become twisted and further complicate relief of the bloat. Within hours circulation is cut off. Gums become dark blue and then white as the animal goes into shock. At this point, most animals are panting, have an excessively high heart rate and are not able to stand. Immediate intervention will be required. Statistics on survival are not great after surgical correction. Mortality ranges are between thirty and fifty percent.
Owners of "high risk" animals may want to think about strategies that help prevent bloat. Feed smaller meals 2 to 3 times daily. Limit exercise and excessive water intake after meals. Soak food with water to help to prevent gulping food. Make food changes gradually over a 5 to 7 day period. Choose a quiet location and feed animals individually, rather than with other animals. Above all, watch "high risk" breeds for the signs of bloat mentioned above after eating.
On a positive note.... The last bloat case that I surgically treated was "Thor" - a Harlequin Great Dane weighing about two hundred pounds. "Thor" came to the emergency clinic at midnight vomiting pepto-bismol and in shock. You guessed it... Bloat. We put two intravenous catheters in, treated for shock, surgically decompressed his stomach, removed his spleen, and then sutured his stomach to his rib cage so that it couldn't happen again. After about two weeks "Thor" was doing well. He is one the fortunate ones.
We rarely see bloat in general practice. Unfortunately, this disease happens more frequently later in the evening when most practices are closed. The animal emergency clinics in Portsmouth and Manchester see a majority of the bloat cases. Emergency veterinarians and their staff have all the necessary training and equipment to handle even the most severe cases. Don't hesitate to call them at any hour.
Bloat can be a painful, life-threatening emergency that is an emotional and financial strain. Costs can range from $1500 to $3000 dollars. Be prepared. A good relationship with your veterinary hospital and knowledge of where your emergency clinic is located may ultimately save your animal's life.
Mark W. Richards, MS, PhD, DVM