Gastric Torsion

This information is being passed to ALL dog owners...

One of my friends recently sent me an e-mail telling me about her loving Poodle, Huck, who had passed away that day, and what had taken place.

Since I have never heard of this condition, I Googled it and read about it. When I finished, I decided this was way to important not to share...

Her e-mail, in short:

I've cried and though I will cry some more I've got to pick it up and get moving. Huck died of gastric torsion. I've done research and his symptoms were classic. I was not familiar with the malady and thus was blind to the danger signs. They were there. I was oblivious. Had I gotten him to the vet before 2:30 this morning, between the time I got home and Panda woke me, he might have made it. So I have that to live with. It was perhaps his time to go. But wallowing in my grief won't bring him back. He lived 7 good years and he was richly loved and he loved richly. Thanks for your understanding words this morning. People who are dog people don't understand how painful it is to lose a trusted canine friend. I consider you a friend and not just a business man... I'm going to bathe panda and love on her because she's lost a friend, too.

Enough to make you all cry... so here is the information I can pass along:

Bloat is a medical condition in which the stomach becomes overstretched by excessive gas content. It is also commonly referred to as torsion, gastric torsion, and gastric dilatation-volvulus (GDV) when the stomach is also twisted. The word bloat is often used as a general term to cover gas distension of the stomach with or without twisting. The name comes from the Middle English blout, meaning soft or puffed, which is from the Old Norse blautr, meaning soft or soaked. Meteorism, its name derived from the writings of Hippocrates, is now rarely used in English. The condition occurs most commonly in domesticated animals, especially ruminants and certain dog breeds.

In dogs, gas accumulation in the stomach is usually associated with volvulus of the stomach, which prevents gas from escaping. Deep-chested breeds are especially at risk. Mortality rates in dogs range from 10 to 60 percent, even with treatment. With surgery, the mortality rate is 15 to 33 percent.

Bloat in dogs is likely caused by a multitude of factors, but in all cases the immediate prerequisite is a dysfunction of the sphincter between the esophagus and stomach and an obstruction of outflow through the pylorus. Some of the more widely acknowledged factors for developing bloat include increased age, breed, having a deep and narrow chest, stress, eating foods such as kibble that expand in the stomach, overfeeding, and other causes of gastrointestinal disease and distress. Studies have indicated that the risk of bloat in dogs perceived as happy by their owners is decreased, and increased in dogs perceived as fearful. This may be due to the physiological effects of the dog's personality on the function and motility of the gastrointestinal system. Dogs with inflammatory bowel disease may be at an increased risk for bloat.

Breed susceptibility
The five breeds at greatest risk are Great Danes, Weimaraners, St. Bernards, Gordon Setters, and Irish Setters. In fact, the lifetime risk for a Great Dane to develop bloat has been estimated to be close to 37 percent. Standard Poodles are also at risk for this health problem as are Doberman Pinschers and Rottweilers.[14] Basset Hounds have the greatest risk for dogs less than 23 kg/50 lbs.

Symptoms
Symptoms are not necessarily distinguishable from other kinds of distress. A dog might stand uncomfortably and seem to be in extreme discomfort for no apparent reason. Other possible symptoms include firm distension of the abdomen, weakness, depression, difficulty breathing, hypersalivation, and retching without vomiting. A high rate of dogs with bloat have cardiac arrhythmias (40 percent in one study).[16] Chronic bloat may occur in dogs, symptoms of which include loss of appetite, vomiting and weight loss.

Diagnosis

Bloat in a dog, with "double bubble" signA diagnosis of bloat is made by several factors. The breed and history will often give a significant suspicion of bloat, and the physical exam will often reveal the telltale sign of a distended abdomen with abdominal tympany. Shock is diagnosed by the presence of pale mucous membranes with poor capillary refill, increased heart rate, and poor pulse quality. X-rays (usually taken after decompression of the stomach if the dog is unstable) will show a stomach distended with gas. The pylorus, which normally is ventral and to the right of the body of the stomach, will be cranial to the body of the stomach and left of the midline, often separated on the x-ray by soft tissue and giving the appearance of a separate gas filled pocket (double bubble sign).

Treatment
Bloat is an emergency medical condition: having the animal examined by a veterinarian is imperative. Bloat can become fatal within a matter of minutes.

First Aid
At the first signs of bloat (restlessness and inability to sit or lie down comfortably) a dog owner can administer 1-2 tablets of Famotidine also known commercially as Pepcid down the dog's throat. Some dog owners advise giving Simethicone during the early signs of a bloat emergency.


A more invasive measure could include passing a tube down the dog's throat, as an emergency first aid technique. This is not an easy task and cannot readily be improvised; some web sites document so-called bloat first aid kits and contain descriptions of the first aid a dog owner can provide at the time an attack of bloat is discovered. This is not a substitute for immediate veterinary treatment. There is risk of esophagus or stomach rupture if the tube is inserted too forcefully, or if the stomach is necrotic.


X-ray from the side of a dog with intestinal GDV. Veterinary treatment

Treatment usually involves resuscitation with intravenous fluid therapy, usually a combination of isotonic fluids and hypertonic saline or a colloidal solution such as hetastarch, and emergency surgery. The stomach is initially decompressed by passing a stomach tube, or if that is not possible, multiple trocars can be passed through the skin into the stomach to remove the gas. During surgery, the stomach is placed back into its correct position, the abdomen is examined for any devitalized tissue (especially the stomach and spleen). A partial gastrectomy may be necessary if there is any necrosis of the stomach wall.