Gastric dilatation-volvulus (GDV) is a life-threatening situation that requires immediate veterinary intervention. Other commonly used terms for the condition are gastric torsion or bloat. Knowing the causes and the clinical signs can save your dog's life!

Understanding the Terms for Bloat and GDV

Food engorgement, bloat (gastric dilation), and gastric dilatation-volvulus (GDV) are distinct but related conditions that affect dogs' digestive systems, with varying degrees of severity. 

Food Engorgement, also known as overeating or simple bloat, occurs when a dog quickly consumes a large amount of food. This can lead to stomach distension due to the rapid intake of food and air. The stomach becomes stretched due to the excess food and air, causing discomfort and potentially leading to vomiting or regurgitation. However, it does not involve the twisting or rotation of the stomach, as seen in more severe conditions like GDV. While uncomfortable for the dog, food engorgement usually does not pose an immediate life-threatening risk like GDV.

Bloat is characterized by the stomach filling with gas or fluid, causing it to become distended, which can occur independently or as a precursor to GDV. Bloat is concerning as it can lead to stomach torsion or twisting (GDV) in some cases, which is a life-threatening emergency. Signs of bloat may include a distended abdomen, restlessness, pacing, unproductive attempts to vomit, excessive drooling, and signs of discomfort.

Gastric Dilatation-Volvulus, also known as stomach torsion or twisted stomach, is a severe and life-threatening condition where the stomach not only becomes distended with gas or fluid (as in bloat) but also twists on its axis, cutting off blood flow to the stomach and spleen. GDV is a medical emergency requiring immediate veterinary attention. It can lead to shock, damage to abdominal organs, tissue death, and death if not treated promptly.

The sequence of events in this syndrome involves the accumulation of gas in the stomach, causing the stomach to dilate (dilatation), followed by the rotation of the distended stomach, causing the stomach to twist (volvulus) from a 90-360° rotation. Ultimately, this causes both stomach ends to be closed off, trapping fluids, food, and gas inside. 

If you do not react to these signs quickly, the increased pressure within the abdominal cavity leads to the compression of gastric, cardiac, and other blood vessels. Blood cannot flow to the stomach and intestinal tract, leading to irreparable tissue damage. 

As the swollen stomach presses against the diaphragm, it interferes with the inflation of the lungs, leading to more distress for your dog as her breathing will become labored.

Death can occur if immediate action is not taken.

Although GDV can happen in any size or breed of dog, if you have a deep-chested large and giant breed dog, they have a high risk for gastric dilatation-volvulus. If your dog weighs over 100 pounds, there is a 20% higher risk for GDV.

Other conditions that have been shown to increase the risk of GDV are age, gender, and body condition of your dog.  Older, male, and very lean or underweight dogs are at a higher risk for GDV. 

Predisposed breeds for GDV include Great Danes, German Shepherds, Golden Retrievers, and Weimaraners. Saint Bernards, Standard Poodles, Irish Setters, Gordon Setters, Doberman Pinschers, Old English Sheep Dogs, Akitas, Boxers, and Basset Hounds. 

If you plan to buy a purebred dog predisposed to GDV, ask the breeder for the history of your puppy’s parents. GDV has a genetic component, so you want to know if any of the dogs in your new puppy’s family has had GDV.

Dogs known to swallow non-food items are at a greater risk of developing GDV. Gastric foreign bodies, non-food items stuck in the stomach, can block one or both openings of the stomach. Food, fluids, and gas will become trapped, causing the dilatation of the stomach, the first component of the GDV syndrome.

Several medications can cause a decrease in the motility of the gastrointestinal tract. If your dog is prescribed pain-relieving medications that contain narcotics or antidiarrheal drugs, watch closely for signs of GDV, as the decrease in gut motility is associated with GDV. 

Interestingly, your dog’s behavior may also put him at risk for GDV. Fearful and nervous dogs are known to have an increased incidence of GDV. Acute and sudden stress has also been implicated in the precipitation of a GDV episode

Studies have shown that dogs solely fed a kibble diet or a canned food diet are at greater risk of GDV due to the citric acid used as a preservative in the food. Citric acid can promote the creation of excess gas in the stomach.

Feeding indigestible fiber increases the transit time of food from the mouth to the colon by up to 900%! The increase in the transit times gives the bacteria more time to digest the soluble fiber within the food, increasing gas production in the intestinal tract.

One study found that Irish setters who consumed a single type of kibble were three times more likely to develop GDV than dogs who consumed various food types.

You have probably heard that placing feed bowls on an elevated platform and slowing down the eating pace will reduce the amount of gas your dog swallows, thus reducing his risk of GDV. 

The accepted theory has been that gas collecting in the stomach was ingested when your dog ate his food.  However, a study that measured the gas types within the stomach of dogs experiencing GDV showed that the level of CO2 was 13-20%, whereas the CO2 content in the air was less than 1%. 

This study demonstrated that gas produced in the intestines by the bacteria as they break down soluble fiber is actually moving up the intestinal tract and into the stomach.

Recent research demonstrated that using a raised bowl can increase your dog’s risk of bloat. Among the cases of bloat, 20% of the cases in large breed dogs and 52% in giant breed dogs correlated directly with the use of raised food bowls.

Another perpetuated myth about GDV is that exercising your dog too soon after eating will cause GDV. However, there has been no evidence to link the onset, duration, or intensity of GDV with the timing of feeding and exercise. One study showed that more than 80% of the incidence of GDV occurred more than an hour after feeding.

My Vet Wants to Attach My Dog's Stomach to the Abdominal Wall

Have you been told that your veterinarian can perform a surgical procedure to prevent GDV?  Gastropexy is a procedure that attaches the stomach to the abdominal wall. Veterinarians often encourage pet parents to do this when their dog is in for a spay or neutering procedure.

Despite gastropexy being deemed a way to prevent at-risk dogs from having a GDV episode,  it is not a simple or completely safe procedure! One study of gastropexy surgery revealed that 10% of the dogs had post-surgical complications while 30% had incision-related difficulties.

Gastropexy is not 100% preventative. Dogs can still have GDV, a twist still occurring in the stomach region or in a different area of the GI tract that is just as life-threatening.

Recognizing the typical clinical signs of GDV is crucial, as every minute counts if your dog has a complete torsion or twisting of the stomach.

Distension of the abdomen is the most common sign to be noticed. Your dog will be in pain if the area is touched. You will hear a hollow sound upon gently tapping the abdomen and gurgling sounds from the stomach.

Dogs in pain will become restless and pace as they cannot find a comfortable position. Your dog may stand hunched over or in a yoga down-dog position,  front legs stretched out with head down and tail in the air.

Other signs to watch for are dry heaving, unsuccessful attempts to vomit, excessive drooling, or pale gums and tongue. Breathing abnormalities such as labored breathing, panting, or rapid breathing result from the distended stomach pressing against the diaphragm, eventually leading to your dog collapsing from an inadequate oxygen supply.

Ultimately, shock can occur from the pressure on the heart and the cut-off of the return blood flow to the heart.

Immediate professional help is required to determine if your dog is experiencing GDV or just bloating caused by overeating.

Upon diagnosing GDV, emergency surgery must be performed within a few hours to save your dog’s life. Fatality rates of 15-60%, averaging 33%, have been reported due to irreparable damage or necrosis of the intestinal wall.

Your veterinarian will place an IV catheter in your dog’s vein to provide easy access to administration fluids and necessary medications, including the anesthesia for emergency surgery. 

A gastric tube will be passed into the stomach via the nose or mouth to relieve some of the pressure in the stomach.

Radiographs (x-rays) will be taken to determine the cause of the bloat, either a simple dilatation or an actual volvulus. A twisted stomach filled with air and fluids is easily seen on an x-ray.

The twist in the stomach will require immediate surgical intervention. 

Avoid feeding your dog any diet with a high level of indigestible fiber. Indigestible fiber slows down the transit time of the food passing through the GI tract, allowing more time for gas to be produced within the intestines.

Almost all commercially made dry dog foods contain highly starchy ingredients. Starch feeds the harmful bacteria that produce the gas that can back up into the stomach, causing it to bloat. Creating and maintaining a healthy gut microbiome in your dog through prebiotics and probiotics will drastically reduce the growth of the gas-producing harmful bacteria.

One study at Purdue University demonstrated that the fat content in dry food was more likely to cause bloating. If the dry food has fats listed among the first four ingredients, there is a 170% increase in GDV. 

If you feel kibble is the best option to feed your dog, add human-grade foods to his bowl. This adjustment can reduce the risk of bloat by 59% for large-breed dogs and 28% for giant-breed dogs.

Reducing your dog’s stress levels can also reduce his risk for GDV.  Be observant of what causes stress in your dog and minimize those situations.  Provide stress-relieving activities such as plenty of exercise and mentally stimulating activities.

Do not use raised platforms for your dog’s food bowls. Studies have shown that dogs eating from raised bowls have a higher incidence of GDV. 

Gastric dilatation volvulus (GDV), also known as gastric torsion, is a life-threatening condition that requires immediate veterinary care. 

Bloat is when the stomach fills with gas or fluid, causing it to become distended, which can occur independently or as a precursor to GDV.

Gastric dilatation–volvulus (GDV) is one of the most serious and rapidly progressive emergencies encountered in canine medicine. Often referred to as gastric torsion or simply “bloat,” GDV occurs when the stomach fills with gas and subsequently rotates within the abdominal cavity, obstructing normal outflow and compromising blood supply to vital organs. Without immediate veterinary intervention, GDV can progress to shock, organ failure, and death within hours.

Gastric Dilatation and Volvulus Syndrome in Dogs

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