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– What is GDV? –
June 2, 2003 – This week's
DaDane is the third installment in a four-part series on a dangerous medical
condition known as Gastric
Dilatation and Volvulus (GDV) or, as many call it, BLOAT. We first heard
from Gaysie Mae, a five-year-old Great Dane who survived an episode of bloat and torsion.
She shared her story with us, enabling us to experience GDV from a Dane's point
of view. Last week we experienced a bloat crisis from an owner's perspective.
Paula Stebbins gave us a candid look at what she and her six-year-old Dane, Gambler,
went through together. We'll conclude the
series by taking a closer look at GDV – its symptoms, its treatment, and possible
causes and prevention.
Note: The information presented below is not intended to substitute for professional veterinary care. Please discuss GDV ahead of time with your veterinarian and seek his or her assistance in all actual or suspected emergencies.
What is
Gastric
Dilatation and Volvulus?
"Gastric Dilatation" is the technical name for an abnormal accumulation
of air, fluid, and/or foam in the stomach; we usually call this
BLOAT. "Volvulus" refers
to a dangerous twisting, rotation, or torsion of the stomach.
As the stomach swells with fluid and/or air, it can twist between its
two fixed anchors points, the esophagus and the duodenum. When
this happens, a devastating sequence of events starts to unfold. Once the esophagus
has been
clamped off, everything is trapped inside the stomach. An afflicted
dog cannot vomit or belch to relieve the internal pressure, so the problem intensifies.
As pressure continues to build within
the torsioned stomach, it enlarges and compresses the
veins
in
the
abdomen.
This restricts
blood flow back to the heart and leads to low blood pressure,
followed by dangerous cardiac problems and, often, shock. Meanwhile, the stomach's
lining
starts to
break down (die) due to the loss of circulation, creating toxic
by-products. In some cases, the stomach will actually rupture.
Not
only that,
but the dog's spleen, bowels, liver or pancreas may also be severely
damaged by this grisly cascade of events.
Obviously, GDV is a dangerous condition that
constitutes an extreme medical emergency. If left
untreated, or if treatment comes too late, your dog
will die a very painful death. The
speed with which you provide your
dog with competent medical attention can mean the difference
between life and death.
Is your Dane at Risk?
GDV occurs most often in large breed dogs with deep chests.
As a breed, the Great Dane is at high risk for
bloat. According to a 1998 study by Purdue University
School of Veterinary Medicine, Great
Danes are 40 times more likely to develop GDV
than a mixed breed dog. Danes topped the list
of vulnerable breeds with the highest incidence
of GDV – nearly double the risk compared to the second most
vulnerable breed, the Akita. In fact, the Purdue
report states: "Assuming that these Great Danes live to be 10
years of age, we conservatively estimate that
more than 50% will eventually suffer an episode
of GDV!! This is quite alarming given that nearly
25% of dogs can be expected to die during or
shortly after an episode of GDV and it is consistent
with previous findings that GDV is one of the
leading causes of death in many giant and large
breeds of dogs." While
I find these high numbers a bit questionable, the fact remains
that bloat is one of the leading causes of
death in the Great Dane. You should know the
symptoms and develop your own plan for handling
this life-threatening emergency.
A note about the Purdue Studies
The Purdue Bloat Studies have
been highly controversial in the Dane community. Some people
have claimed the research has not been "peer-reviewed" and they feel
it has little merit. I suspect the Journal of American Veterinary Medical
Association would beg to differ, having published two of the studies: Incidence
of and breed-related risk factors for gastric dilatation-volvulus in dogs (January
1, 2000) and Non-dietary
risk factors for gastric dilatation-volvulus in large and giant breed dogs (November
15, 2000).
That said,
my personal view is that some valid arguments can be made against certain assumptions
in these papers. I feel the research has merit, but it is not definitive by any means.
Perhaps the most vocal detractor of the Purdue research is Linda Arndt.
Please review the Purdue articles and then review Ms. Arndt's article, The
Purdue Bloat Study: On My Soapbox. She raises some good points. (For
example, I absolutely agree with her assertion that
feeding from elevated food dishes does NOT contribute
to bloat.)
In the end, it is up to each of us to look at the body of information that's been offered and decide for ourselves what we
will use and what we'll put aside.
What are the symptoms
of Bloat?
GDV begins with a variety of symptoms. If you see any of these symptoms in your dog, you should be alert to the possibility of bloat and take appropriate action:
- Gagging,
unproductive attempts to vomit
- Foamy/slimy
mucous around mouth and lips (or vomiting this substance)
- Distended
(hard) abdomen that sounds hollow when thumped
- Accelerated heartbeat and
a weakened pulse
- Anxiety
or restlessness, whining
- Pacing, refusal to lie down
- Heavy
panting, salivating or drooling
- Discolored gums (very
red in early stages, blue or white in late stages)
- Weakness and collapse
When it comes
to bloat, time is of the essence. Depending
on a number of factors – most of which
are out of your control – your dog could have as little as 30
to 45 minutes to live after you identify
the symptoms.
What are the causes of Bloat?
The short answer is that nobody
really knows what causes bloat. We used to hear that
GDV is caused by vigorous exercise
after a large meal. The rationale
was that running and jumping
causes an overly heavy, bulky stomach to twist around
in the abdomen. Although this was once a commonly accepted
explanation, there
has
been no scientific evidence to
support the theory. In fact, most bloat victims do
not have overly full stomachs,
nor have they recently engaged in strenuous activities.
More recent theories suggest that for reasons unknown,
the stomach's contractions
lose their regular rhythm. Food,
air and gas is then trapped in the stomach,
and this leads to torsion. But
the bottom line is this: No definitive cause of bloat
has yet
been
identified.
(Personally, I would still prevent
any dog from ingesting large
amounts of food or water and
I would restrict vigorous exercise
for an hour or two after eating.)
The
following factors may influence
whether or not your dog experiences
a bloat episode:
- Rapid eating, or ingesting a large
amount of food in one
session
– Instead, feed smaller meals 2 or 3 times a day
- Drinking too much water before or after eating
– Monitor or ration the amount of water
ingested before and after a meal
- Vigorous exercise before and after
eating
– Monitor and limit your dog's activities before and after meals
- Feeding a low quality dog food
– Feed a quality meat-based dog food with natural preservatives
– Consider adding probiotics or enzymes to your dog's diet
– Or feed a raw diet (B.A.R.F.)
- Feeding gas-producing foods
– Avoid soybean products, brewer's yeast
- Emotional Disposition (possessing an
anxious or fearful temperament)
– Know your dog; a "sensitive" dog may be more vulnerable to
bloat
- Stress (changes in normal routine, travel, boarding, etc.)
– If your dog seems prone to stress, minimize stressful situations
- Heredity (having a close relative that has bloated)
– Bloat seems more prevalent in some lines, indicating a genetic predisposition
- Physical Build (large dog, deep narrow chest)
– Keep your Dane at a healthy weight, neither overweight nor underweight
- Age
– Older dogs are more likely to bloat than younger ones
More to come
Next week we'll talk about what
you should do if your dog is bloating. We'll
discuss emergency bloat surgery and
post-operative pain management. We'll learn
why many Great Danes survive the operation but,
sadly, die during the post-op period. We'll talk
about gastropexy, and we'll explore whether or
not there is anything else you can do to increase
the chances that your dog will survive an episode
of bloat.
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