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Gastric Dilatation/Volvulus Syndrome

Randy Walker DVM

About Gastric Dilatation/Volvulus syndrome...

Gastric Dilatation/Volvulus syndrome (abbreviated GDV) is a serious, life threatening condition of dogs whereby the stomach bloats (meaning "to fill with gas") and twists upon itself. Synonyms for GDV are "gastric torsion" and ''twisted stomach''. When broken down into their root meanings, the words Gastric Dilatation/Volvulus Syndrome describe this disease. "Gastric'' refers to the stomach. "Dilatation" means "to swell" or "to become over distended". "Volvulus" means "to rotate''. So, looking at the root meanings, Gastric Dilatation/Volvulus Syndrome means "A syndrome in which the stomach over distends and twists upon itself".

What Is GDV?

The normal dog's stomach is a muscular pouch with an entrance to receive food from the esophagus (throat) and an exit leading to the small intestine. In a case of Gastric Dilatation/Volvulus the stomach has become over distended with gas and has twisted upon itself (called volvulus) so that both the entrance (from the esophagus) and the exit (leading to the small intestine) have become twisted so that nothing can enter or leave the stomach. When this occurs the stomach begins to swell (called dilatation) due to gas accumulation from bacterial and digestive processes. This condition rapidly leads to serious fluid losses, mineral imbalances in tile bloodstream, shock, adverse effects on the heart, and usually death if not treated on an emergency basis.

What Causes Gastric Dilatation/Volvulus Syndrome?

In deep chested dogs (such as German shepherds, Great Danes, etc.) the stomach literally hangs in the abdominal cavity, suspended by ligaments. As the stomach (which is a muscular organ) functions, its always trying to twist upon itself but is normally held in place by these ligaments. Sometimes the ligaments become weak and break down, allowing the stomach to twist upon itself, thereby leading to the GDV.

What Factors Make GDV More Likely To Occur In A Given Individual?

Breed is a primary factor with large, deep chested breeds being most commonly affected. These breeds include the German shepherd, Great Dane, Saint Bernard, Doberman Pincher, Rottweiler, and Weimeraner among others. Dachshunds also can experience GDV due to their exceptionally deep chested anatomy. Repeated overeating and rapidly eating huge meals only once a day have both been shown to contribute to GDV. Age is also a factor with most affected dogs being mature to senior animals.

What Are The Clinical Symptoms Of GDV?

Dogs with GDV will often have some degree of swelling in the front part of the abdomen and this swelling will worsen as the disease progresses. Retching with an inability to vomit is also commonly seen. If the condition is allowed to progress before diagnosis and treatment, the dog will begin to show signs of shock (weak pulse, poor circulation, rapid heart rate) weakness, coma and death. Without emergency treatment these patients will die within a short time (hours to 1-2 days).

How Is Gastric Dilatation/Volvulus Diagnosed?

Radiographs (x-rays) are used to diagnose this condition. Any dog with a swollen abdomen and non-productive retching should have an x-ray to rule out GDV.

How Is Gastric Dilatation/Volvulus Treated?

Treatment will vary with the severity of the condition. In some cases the stomach has swollen but has not yet twisted upon itself and in these cases relief can sometimes be obtained by simply passing a soft plastic tube down the esophagus (throat) to the stomach and using this tube to remove the gas, fluid and food from the stomach. In many cases, however, the stomach has already twisted upon itself to the point that a tube will not pass into it (and this won't correct the problem even if it does pass) and we have to use a needle (called a trochar) to pass through the body wall into the stomach and relieve the gas. Of course this is only of temporary benefit and, after the patient is stabilized with fluids and medications to lessen shock, an emergency surgery is performed to replace the stomach in its normal position in the abdominal cavity. During treatment of GDV, as much emphasis has to be placed on treating the complications of the disease as upon surgically correcting the condition itself. The patient with GDV not only receives surgery but also medication and fluids to combat shock, dehydration, blood mineral imbalances, heart problems which may develop, secondary bacterial infection and gastritis (inflammation of the stomach). Successful treatment of GDV requires major surgery and several days in the hospital under intensive.

What Is The Prognosis For GDV Post-op?

The prognosis for GDV is always guarded immediately after surgery due to the risk of secondary bacterial infection, shock, mineral imbalances in the bloodstream leading to heart problems (arrhythmias) etc. In those patients who pass these hurdles, recovery is usually complete.

How Can GDV Be Prevented?

Several things can be done to lessen the chances of GDV: (1) Try to obtain a pet from a breed line that has no established history of GDV. (2) Large dogs should have their total daily ration divided into several small meals fed throughout the day (so as not to overload and stress the stomach). These are the main two measures which have been shown to be effective. Other things which have been theorized to be of some positive effect are (l) moistening dry foods and (2) decreasing exercise and excitement immediately after eating. Soybean based dog foods have been shown not to cause an increased incidence of GDV ( soybean products are OK, in other words). Fat content of the diet doesn't seem to be significant, either. Antifoaming antacids (used for bloat in cows) are not useful for GDV since this condition does not cause a frothy bloat.

What Can I Do To Increase My Dog's Chances Of Survival In Case Of GDV?

The main factor is to get the patient to the veterinarian immediately. Of the patients who are lost to GDV, most of them are the ones that sat around for a day or two before being seen by the veterinarian.

- Randy Walker DVM
Sun Lakes Animal Clinic
May 16,2004

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