health care
Wellness: Health Care
The Science of Flatulence
There’s more to it than meets the nose!

As much as we might hate to admit it, flatulence is a normal biological function. A surprising amount of air is swallowed just with the simple act of eating, and if this is not burped out, it must exit through the other end. The amount of air swallowed tends to be increased when dogs feel they must eat quickly or in brachycephalic breeds (dogs with a compressed upper jaw and a short muzzle) that tend to breathe more by mouth than by nose.

Flatulence comes from an excess of gases in the intestinal tract. These gases may represent air that has been swallowed, gas produced in the biochemical process of digestion, gas diffusion from the bloodstream or gases produced by the bacteria that populate the intestinal tract. Contrary to popular belief, more than 99 percent of the gases that pass from the intestinal tract are odorless (whew!).

Dietary fiber in pet food is not easily digested by the pet’s own enzyme systems, but it is, however, readily digested by the gas-producing bacteria that live in the colon. As fiber is broken down here, hydrogen sulfide is produced, which is the cause of the really stinky gases. Therefore, a diet that is heavy in fiber further promotes a “happy environment” as well as “food” for the bacteria, ultimately producing more gas.   

Helping clear the air

Offering your pet a highly digestible, low-residue diet is one of the major ways to combat flatulence. A low-residue diet is designed to reduce the frequency and volume of stools, while prolonging transit time through the intestine. It is similar to a low-fiber diet, but includes restrictions on foods that increase bowel activity. Changing to a low-residue diet means that most of the nutrients of the food are digested and absorbed by the pet before they reach the colon, where the gas-forming bacteria live. Less food for the bacteria equals less bacteria, which equals less gas formed.

Sometimes just going through a case and/or bag of such a low-residue diet solves the problem and the pet can return to a regular food afterwards. If necessary, the therapeutic diet can become the pet’s regular food. Low-residue diets are available through your veterinarian, pet supply stores or can be cooked at home (boiled white rice, skinned chicken, cottage cheese and balanced with vitamins and minerals constitute low-residue ingredients).

Other easy changes that can help include:

  • Feeding smaller meals several times daily instead of one larger daily meal
  • Feeding a mixture of dry and canned foods
  • Discouraging rapid eating by placing an overturned small bowl inside the pet’s regular food bowl, preventing them from taking large mouthfuls
  • Avoiding soy, beans and peas in the diet
  • Avoiding any treats containing milk, cheese or other forms of lactose
  • Avoiding fresh or dried fruit treats
  • Avoiding canned foods containing the texturing ingredient carrageenan
  • Increasing activity: A sedentary lifestyle can increase the amount of gases produced as well as how long they “hang out” in the digestive tract. Activity increases gastrointestinal motility, which in turn expels gas and increases regularity of bowel movements.

Are there some medical conditions that can increase flatulence?

Changing the diet and ruling out actual intestinal disease are of primary importance in addressing flatulence. Some disease processes that can cause an increase in flatulence include:

  • Inflammatory bowel disease
  • Irritable bowel syndrome
  • Antibiotic-responsive intestinal disorders
  • Cancer
  • Parasites, viral or bacterial inflammation of the intestines
  • Food allergy or intolerance
  • Inadequate production of digestive enzymes by the pancreas

Medications and herbal and botanical supplements

Sometimes medication can help. Although there are many products available, most are unfortunately not as helpful as they are touted to be, or not labeled for animal use. There are more than 30 herbal and botanical preparations available to reduce gas in the stomach and intestines; however, the dosage, safety and efficacy are unknown.

If further therapy is needed, the following products have some basis and support that they may be of help for flatulence:

  • Yucca shidigera supplementation:
 Currently, this extract is labeled as a flavoring agent for pet food but it is also available as an oral supplement. Several studies have shown that it helps decrease the odor in flatulence.
  • Zinc acetate supplementation:
 Zinc binds to sulfhydryl compounds in flatulence ultimately serving to deodorize the gas.
  • Non-absorbable antibiotics: Such antibiotics kill the gas-forming bacteria of the colon and may be helpful as long as their use is not ongoing.

Some popular, but more questionable, products with regards to treating excessive flatulence include:

  • Probiotics: There are many ineffective probiotics being marketed and so it is important to use one that has been shown to contain live cultures that withstand stomach digestion. It is unknown if this type of product will really help in flatulence, as it is asking a great deal for these bacteria to survive the acid environment of the stomach, travel through the many feet of small intestines, and finally reach the colon in the attempt to displace the gas-forming resident bacteria. Still, these are unlikely to be harmful, and can be beneficial in other ways outside of the realm of flatulence, such as helping to stabilize the intestinal microenvironment.
  • Activated charcoal tablets: These tablets are not likely to be effective because the charcoal-binding sites are filled on the journey from mouth to colon, so by the time the tablet gets to the gas-forming large bowel bacteria, it has essentially already been used up!
  • Simethicone: This product may control the volume of gas produced, but not the odor. It is an antifoaming agent that reduces gas bubbles. This may be helpful at reducing our doggy’s gas discomfort, but not our nose discomfort.
  • Pancreatic enzyme supplementation: It is unlikely that these extra digestive enzymes would help a pet in the absence of actual exocrine pancreatic insufficiency. Furthermore, this treatment is relatively expensive for something that may only be slightly helpful.

While flatulence is a normal part of everyday life, if the problem persists or seems severe, it is recommended that you consult with your veterinarian. Even our pets sometimes need a smog check!

Wellness: Health Care
Be Prepared: Four Emergency Room Essentials
Lay the groundwork for quick, low-stress treatment

Working in the ER, I see a full range of preventable predicaments that complicate addressing a pet’s immediate health crisis. I’d like to highlight four simple measures you can take as a pet parent to prevent distress and concern should an emergency arise while you are away or if you need to seek care outside of your normal veterinary relationship.

Records!! Keep a copy of every medical record, radiograph and diagnostic test in a file. It allows a new veterinarian to quickly understand your pet’s health status. This is especially important if your pet has a history of illness such as kidney failure, cancer or multiple/ongoing disease processes.

Your pet file should also include a copy of vaccination records. I often get last-minute calls to fill out a health certificate for airline travel, but am unable to do so because owners do not have proof of their pet’s rabies vaccination. As is the case with most emergency hospitals, I am unable to administer another vaccine because we don’t keep any in stock (this is an area of health care that is left to general practitioners).

Advanced directive: I strongly recommend that every pet owner have in place an advanced directive with regards to their pet’s continued care in the event of physical decline in their absence. [Here’s a copy of an advanced directive form we provide that you can download and print.] This is especially important if you share your life with a geriatric pet or one who has ongoing medical issues or failing health. Discuss with your pet sitter, family members and your veterinarian your wishes and have a clear understanding of treatment limits in the event you cannot be reached.

I cannot tell you how many times I have seen family members or caretakers struggling to make the difficult decision of euthanasia in the event a pet is suffering and the owners are out of contact.

Pre-arrangement for payment in case of an emergency: Along the same lines as an advanced directive, pre-authorization for treatment is strongly recommended. It is not uncommon for owners to leave their pets in the care of a boarding facility, an in-home pet sitter or a family member during vacation, and then something goes wrong. It is heart-wrenching to navigate a situation where the temporary guardian brings in a pet and has no means of payment or way of contacting the owner to obtain approval for a treatment plan. We try to work as best as we can with these situations, but you can only imagine how heavy these decisions can be for everyone involved.

A common example is a pet who has been hit by a car. Although severe trauma can have an excellent outcome with treatment, the cost of stabilization and management can quickly reach thousands of dollars. Financial responsibility and decision to pay for this level of treatment is a big burden to place upon your sitter. I would give anything for this to be a world without financial concerns, but the hard reality is that emergency hospitals generally will not extend credit on good faith, especially if you have no previous relationship with them.

So before leaving town, stop by your local emergency clinic and your regular veterinarian to sign a release of payment in case of emergency. Your credit card number can be kept on file with your signature authorizing treatment in event of an emergency; you can also set the parameters of care at that time.

Plan ahead and anticipate medication shortages: I get many calls from owners asking to refill a pet’s medication because they are leaving town the next day and their regular vet is closed. What many people are not aware of is that legally we are not able to provide this service unless we perform a full physical examination on the pet, and with that, comes the cost of an emergency exam fee.

Although it can be understandably frustrating to have to pay an exam fee for an otherwise healthy pet for a “simple refill” of a medication, legally, hospitals cannot serve the role of a dispensing pharmacy. By law (and risk of our veterinary license) we cannot OK a refill of a medication without examining your pet, no matter how benign or common the drug. Because of this, I recommend keeping an extra bottle on hand, or getting in the habit of refilling your pet’s prescriptions when the bottle is approaching three-quarters empty.

Another tip: If you fill your medication at a human pharmacy, and it is a drug and dose that stays constant for a well-controlled disease state (such as medicated drops for eye disease or phenobarbital for seizures), ask your veterinarian to write an additional refill on the written prescription.

I hope these four simple proactive steps help raise awareness of potential situations that can arise while you are away, and help you to formulate a plan well in advance should any situation unexpectedly arise.

Wellness: Health Care
A Vet’s Top 10 New Year’s Resolutions
Make 2012 happier and healthier for you and your pup

Veterinarians love putting together a plan of care for their patients—so why should New Year’s be an exception? Here are my suggestions for ten (I think fairly reasonable) resolutions that can make a big improvement for your dogs and you. For those who’ve already embraced many of these good habits, this list can serve as a chance to pat yourself on the back.

  • Take your dog for more walks and exercise—after all, it is good for both of you!
  • Take your dog for a yearly physical examination.
  • Put your pet on a weight-reduction program, especially if he or she has enjoyed the holiday season as much as I have! (See: Weight Management Made Simple).
  • Make sure your pet’s microchip information is current and registered, and that he or she wears other forms of identification at all times.
  • Brush your my dog’s coat and teeth regularly. If more help is needed with teeth or your dog is middle-aged or older, maybe schedule a cleaning.
  • Practice effective flea and heartworm control all year long to keep your pet safe from preventable disease.
  • Start training again or resolve to take him or her to a class. Even if your pet isn’t unruly, training keeps you both sharp and engaged.
  • Reassess your home, making sure the environment is safe for pets. Cover electrical cords, remove potential toxins (such as Gorilla Glue) and plants, and know the location and telephone number of your closest emergency hospital.
  • Buckle up your dog in the car. Unrestrained pets are dangerous to both to you and your dog. Use a pet harness, doggy-designed car seat or travel crate to keep them safe.
  • Take the time daily to appreciate your pups; they do so much for you and ask little in return.
  • A few habits to encourage your dog to consider

    • Find your soul mate on Petfinder.com.
    • Work on not drooling when you hear the can opener—it’s a dead giveaway and gross.
    • Take time from your busy schedule of naps, snacks and adventures to stop and smell some behinds.
    • Work on understanding that cats are from Venus and dogs are from Mars—but peace can be found on Earth.
    • Be grateful for the toys that are currently in your bin.
    • Strive to only get into mischief during normal business hours, not during nights and weekends when your normal veterinarian is away.
    • Resist chasing that stick unless you see it leave the hand!!

    Do you make New Year’s resolutions? What new behaviors are on your list?

    Wellness: Health Care
    Christmas in the ER
    A different kind of giving and receiving

    While many people wake Christmas morning to open gifts and gather with family, we ER types begin and end our day with a slightly different routine. For me, my husband Scott, who is also an emergency veterinarian, and our two Dobie kids, Christmas Day begins with opening presents at 4 am, ends with eating a turkey dinner at 10 pm—with “challengingly good” chaos during the hours in between.  

    Working the ER over the holiday is one of those fasten-your-seatbelt types of experiences. Emergency clinics are typically very busy by nature, but over the holidays, the shifts seem to be on steroids.  The normal veterinary world has closed up shop, leaving us to be the first line of care for the patients of nearly 40 area practices. I also think the fact that people are home all day to observe their pets becoming ill or getting into mischief adds to the bustle. Combine these two factors and you have the makings for one action-packed day.

    My 8 am shift begins with morning “rounds” and the concurrent consumption of as much coffee as I can down in that hour. Transfer of care of the hospitalized patients then passes to me, and it is not uncommon to have 15 to 20 ailing critters, many of whom require intensive care. I begin by giving each pet his or her morning physical exam (with some added kisses and rubs) and make a continued plan for the day, adjusting medications and ordering up diagnostics as indicated. 

    The exams are followed by writing up medical records, interpreting the diagnostics as they are returned to me and making phone calls to the worried owners who have left their pets in our care. Adding to the ride, between the hours of 8 am and noon, I also treat each new patient that walks through our doors. Our skilled nursing staff triages each pet, meaning the most critical are seen first. As you can imagine, it is a constant balance of “who needs it most.”

    An amazing phenomenon on this day is that peoples’ patience grows exponentially. Having to wait for sometimes several hours to be seen due to more critical patients becomes a forgiven byproduct of the holiday mayhem, and for this I am grateful. Knowing people have to wait while I treat more critical patients is always a source of anxiety for me. I know worried parents are in the waiting room, equally as worried about their babies. Those are the times when I most wish that I could split myself into many.

    Noon is the magic hour for me—the clock strikes 12:00 and another doctor comes on duty allowing me to take a deep breath and play catch up. I swear I see golden rays of light when the swing shift doctor walks through the door, my knight in shining armor—irrespective of gender.

    Two o’clock comes around in what feels like a picosecond and with it the tummy starts letting you know you’ve neglected it. After all, a continuous oral infusion of caffeine can only get you so many miles.  And just when I think I’m going to hit the proverbial “E” on my body’s fuel gauge, the ordered-in holiday feast from Andronico’s arrives. I am literally stuffing mouthfuls of stuffing while on the run, but ever grateful to have the calories to catapult me through the second half of the day.

    My shift ends at 6 pm, but in ER reality, 9 pm is closer to the mark by the time all the i’s are dotted and the t’s are crossed. Then, coming full circle, I round my patients to the overnight doctor.  In the words of Sonny and Cher, the beat goes on.

    As crazy as the ER can be, I wouldn’t change it for the world. I just adjust my seatbelt, according to the peaks of exhilaration and the valleys of exhaustion, because there is no other ride I’d rather be on. It is an indescribable experience knowing that you have forever become a part of some person’s life by saving their beloved family member or by sharing tears when you give the gift of a peaceful death, allowing a pet to pass with quiet dignity in an owner’s arms.

    I’d like to share a portion of a card I recently received.  It reinforces why I work these crazy hours, upstream from the rest of the world. It reads:

    When you have those days, or weeks or months, when you question what you’re doing in this life, proceed with the questions but please remember the family whose pain and fear you eased and—most of all—the dear dog whose last months you made not only tolerable, but joyful.

    Reading this still brings tears to my eyes.

    So, at the end of my crazy, draining, exhausting day, I leave with a smile both on my face and in my heart because there is no better feeling than knowing you were the one to make a difference. I love my job, I can’t imagine doing anything else, and being able to help others and their pets on Christmas Day is truly the best gift of all.


    Wellness: Health Care
    Dough Is A Don’t
    Risks for dogs include obstruction and alcohol poisoning

    My husband has recently taken up the delicious hobby of artisan bread baking. Although this is a pursuit my belly fully supports, it has reminded me of the dangers that raw bread dough poses for our pets. The risks are twofold. The first problem is that dough rapidly rises after ingestion and can cause life-threatening stomach distention and obstruction. The second—and potentially more serious—risk comes from the fermentation of the yeast, which can lead to alcohol poisoning.

    Any species can be susceptible, but dogs are most commonly involved due to their often indiscriminate eating habits. Given the opportunity, many dogs will readily ingest bread dough during the process of rising, and because they snarf all that is available, they usually consume 1 to 2 loaves or a pan of rolls. They don’t think, “Hmm, I’ll just save this one loaf for later,” so they generally present with large amounts in their stomachs.

    A common scenario is that the soon-to-be bread is placed on a counter to rise overnight, and the next morning the owner wakes to find missing dough and a symptomatic dog. I treated a Labrador for alcohol poisoning just this past weekend after he ate two pizza dough rounds. He stumbled into the hospital with his worried parents but went on to make a full recovery with treatment.

    How does it happen?

    The warm, moist environment of the stomach serves as an efficient incubator for the replication of yeast within the dough. The expanding dough mass causes distention of the stomach, which compromises blood circulation in the body. The continued distention of the stomach can also make breathing more difficult.

    Yeast fermentation also produces ethanol (alcohol) as a byproduct, which is absorbed into the bloodstream, resulting in inebriation and potentially life-threatening disturbances to a pet’s system.

    What are the clinical signs?

    Early signs can include unproductive attempts at vomiting, visible belly distention and increasing depression. As ethanol intoxication develops, the pet can stagger and become disoriented. Eventually, profound neurological depression, weakness, coma, low body temperature and/or seizures can be seen. Death is usually due to the effects of alcohol rather than from the stomach distention, however, the potential for the dough to trigger life-threatening Gastric Dilatation and Volvulus (GDV or “bloat”) or intestinal obstruction should not be overlooked. [See: Bloat, the Mother of All Emergencies]

    How is it diagnosed?

    Blood alcohol levels can be obtained through a laboratory, but are generally not used in a veterinary setting; a presumptive diagnosis is usually made based on history of exposure and presenting clinical signs. Other disease processes that can present in a similar way include GDV, other intestinal foreign bodies, ethylene glycol ingestion (antifreeze) and ingestion of antidepressants.

    How is it treated?

    Vomiting may be induced with recent ingestion in animals not showing clinical signs, although the glutinous nature of bread dough may make removal by this method difficult. In animals where vomiting has been unsuccessful, gastric lavage may be attempted (“flushing” the dog’s stomach with water while he is under anesthesia).

    Cold water introduced into the stomach through a stomach tube during lavage may slow the rate of yeast fermentation and aid in removal of the dough. Surgical removal of the dough mass may also be required if a large enough amount has been ingested.

    Pets that present with the additional signs of alcohol toxicity first need to be stabilized and have any life-threatening conditions corrected before attempts are made to remove the dough. Alcohol toxicity is managed by correcting metabolic problems, managing heart abnormalities and helping the pet maintain his normal body temperature. Fluid therapy is administered to help enhance elimination of the alcohol from the blood stream. 

    Luckily, the dog I treated this past weekend did not require surgery. We supported him with IV fluids and took serial X-rays to monitor the passage of the dough, ensuring no complications developed. Aside from a pizza dough hangover, he made a full recovery in 36 hours.

    As always, prevention is the best treatment: If you have a fabulous baker boy (or girl) in your home, be extra conscientious during the rise!

    Wellness: Health Care
    Holiday Hazards for Pets
    Tips for keeping your pet merry this season
    O Christmas Tree! O Christmas Tree! You are beautiful, but you can hurt me!

    As the holiday season gears up, have you noticed that with the increase in fun and festivities comes a simultaneous increase in the level pet mischief? There just seems to be no way for our curious pups to resist the allure of all that holiday paraphernalia. 

    Below is a list (all naughty, no nice!) of the common problems I treat on an emergency basis:

    Decorative lights on the tree can pose a serious electrocution hazard when chewed. Signs of electric shock range from a dazed and confused behavior to difficulty breathing, burn injuries in the mouth, seizures and potentially sudden death. Immediate evaluation by a veterinarian is recommended if you suspect electrocution. Take appropriate precautions to ensure lights are hung out of reach and the cord is adequately protected. Use grounded three-prong extension cords and strictly follow manufacturer's guidelines for light usage.

    Tinsel and ribbon can potentially cause an obstruction in the intestines when ingested. In medical terms, we refer to these items as “linear foreign bodies,” and they have significant potential to get bound up within the intestinal tract causing a blockage, and in some cases, cutting through the intestines.

    Most often, these linear foreign bodies get “hung up” in the intestines, causing deadly “bunching” and can only be removed by surgical means. If you notice a bit of ribbon, tinsel or string, whether from the mouth or the other end (see photo), it is important to remember never cut the ribbon or attempt to remove it yourself! Seek veterinary care immediately.

    Vomiting, diarrhea, loss of appetite and depression will be the most common abnormalities seen when an intestinal obstruction is developing, and early surgical care is essential. Exercise extreme caution and never leave pets unattended around string, tinsel and ribbon. 

    Ornaments may be ingested and have potential to cause an obstruction leading to the need for surgery. Ornaments made of glass can fall and break, leading to cuts and other injuries. Adequately secure ornaments and place them above the reach of wandering paws and curious noses.

    Tree-stand water contains preservatives and sap that may cause vomiting and diarrhea.

    Festive plants are often displayed during the holidays and precautions should be taken to avoid ingestion of any plant. Even “nontoxic” plant material, such as pine needles, may cause stomach upset.

    Common holiday plants to take particular note of include:

    • Lilies are extremely toxic to cats. Ingestion of any part of the plant, even in small amounts, can cause life-threatening toxicity. Early signs include lethargy and vomiting. Without prompt treatment, most cats will become extremely ill and develop kidney failure within 36 to 48 hours of ingestion.
    • Amaryllis, also known as Belladonna lily, often causes vomiting, diarrhea and belly pain in cats and dogs. It can cause more serous problems including low blood pressure and liver damage.
    • Poinsettia plants are considered to be mildly toxic, often only causing mild stomach upset and/or skin irritation. Treatment is recommended only if any clinical signs develop.
    • Mistletoe and holly species contain a variety of potentially toxic constituents, but serious poisonings are infrequent. Clinical signs are usually limited to salivation, vomiting and diarrhea.

    Potpourri is often used around the house to put us in the holiday mood. The plant material and some additives are very irritating to the skin, mouth and intestinal tract. If skin exposure is suspected, then bathing with a mild soap is recommended and medical care may be needed to treat irritation and pain that follow exposure. Ingestion often results in signs that may include drooling, loss of appetite, vomiting, and in some cases, disorientation. 

    Treats are a common source of holiday emergencies. While it can be hard to resist your pleading pet’s eyes, it is important to recognize the dangers of particular foods and treats:

    • Fatty foods such as meat trimmings are common culprits for causing stomach upset, vomiting, diarrhea and pancreatitis.
    • Bones expose your pets to many unnecessary risks, including the potential for choking or developing an obstruction in their intestinal tract. Cooked bones when chewed can fragment into small slivers that can cause severe irritation to the intestinal tract as they pass.
    • Rawhides and bully sticks have potential to cause choking and intestinal obstruction.

    “People foods” that we take for granted as being safe for us are not always safe for our pets. Raisins and grapes have been implicated in causing kidney failure in dogs. Onion ingestion can cause blood cell damage in both dogs and cats. Chocolate contains caffeine and a caffeine-like substance (theobromine) that dogs and cats are highly sensitive to causing stomach upset, tremors, seizures and irregular heartbeat. Macadamia nuts cause dogs to show a variety of strange neurological signs that can include weakness, apparent pain, disorientation and tremors.  

    I hope this information helps you and your four-legged family members avoid any “bah-humbugs” this holiday season!

    News: Guest Posts
    Questions About Dog Breeding Won’t Go Away
    New York Times Bulldog story exposes serious health issues, deep denial

    In 2008, the BBC documentary “Pedigree Dogs Exposed”—which revealed high levels of disability, deformity and disease among purebred dogs—dropped like a bomb on the world of dog shows and breeding in the United Kingdom. A year-and-a-half later, the UK’s Kennel Club initiated steps to reform its practices and standards.

    Three years later, questions and calls for reform are finally gaining traction here. In April, the Humane Society of the United States convened “The Purebred Paradox” conference to explore issues like those being debated across the pond, and featuring some of those key players. In September, John Woestendiek presented the state of the debate in a feature for Bark (“Breeding Paradox: Can dog-breeding practices be changed?”)

    And last Sunday, Benoit Denizet-Lewis added The New York Times’s high profile voice to the conversation with a Magazine cover story on the poor benighted Bulldog (“Can the Bulldog Be Saved?”). The mascot for the Marines and many college sports programs just might become the most enduring example of breeding gone wrong.

    Is this a topic near and dear to your heart? Read up on the recent coverage and check back, we’ll be hosting an online conversation with experts soon. 

    Wellness: Health Care
    Bloat, the Mother of All Dog Emergencies
    What you need to know about this life-threatening condition for dogs
    Doberman Dog Breed Susceptible to Bloat

    There is no quicker way to jump to the front of the ER line than if you walk into the hospital with a distended dog. Bloat is a life-threatening condition that I treat frequently, and a good outcome is time-dependent.

    Last week, JoAnna Lou wrote about recognizing the signs of bloat and included an educational video of an Akita experiencing GDV (don’t worry, he survived!). This topic elicited excellent comments and questions, prompting me to want to expand upon it further. I hope to answer some of the questions put forth by readers as well as dispel misconceptions that could potentially harm your pet.

    First, some vocabulary: Bloat is a condition when the stomach fills with air and/or fluid (dilatation). This can progress to a twisting of the stomach upon itself, called GDV (gastric dilatation volvulus). Bloat is often used to describe GDV, but there is a vast medical difference. We’ll get to the details of GDV in a moment, but let’s start with the most important take-home message:

    If you even remotely suspect bloat or GDV, take your dog to a veterinary hospital IMMEDIATELY!

    What NOT to do:

    • Do not give anything by mouth.
    • Do not attempt to relieve gas from the stomach with medications or by other means.

    A note about the use of Gas X:  This medication may help to reduce the amount of stomach gas in the case of “simple” bloat, but it will do nothing to help your pet in the case of GDV.  The problem with GDV is not the gas, but the actual twisting of the stomach (think of a balloon being twisted in half, like when a clown makes an animal figure). It is the twist that kills, and a medication will not undo the deadly rotation of the stomach. Please do not waste valuable life-saving moments waiting to see if the medication helps! Taking an x-ray of your pet’s abdomen is the only way to tell the difference between bloat and GDV, allowing for appropriate intervention.

    What is GDV and why is it so serious?

    The twisted and bloated stomach presses on the major blood vessels that carry blood back to the heart, stopping normal circulation and sending the dog into shock. Making matters worse, the stomach tissue is literally dying because it is stretched tightly and blood cannot circulate through it. Intense pain is associated with this disease, causing the heart to race at such a high rate that heart failure will result.

    There can be no recovery until the stomach is surgically untwisted and the gas is released. A dog with GDV will die in a matter of hours unless surgery is performed. For each hour that goes by, there is a greater risk for complications during surgery as well as during the recovery period.

    What are the signs of GDV or bloat?

    • The biggest clue is the vomiting: A dog with GDV appears highly nauseated and retches but little comes up.

    • Drooling.
    • There is usually an obviously distended stomach, especially near the ribs, but this is not always evident depending on body configuration.
    • Anxiousness, agitation, restlessness and pacing.
    • Depressed attitude.

    View some of these bloat symptoms in the video we posted last week.

    What dogs are at risk?

    Classically, this condition affects deep-chested breeds, and dogs with deep chests that weigh more than 99 pounds have a 20 percent risk of bloat. Although a rare occurrence, I have also treated three small-breed dogs for this condition in my ten-year career.

    There are many theories regarding what triggers GDV, but truly, no one really knows—it remains a veterinary medical mystery. Risk factors, lifestyle and personality profiles that may increase a dog’s potential for developing GDV have been identified over the years and include:

    • Feeding only one meal a day.
    • Having closely related family members with a history of GDV.
    • Eating rapidly.
    • Being thin or underweight.
    • Moistening dry foods (particularly if citric acid is listed as a preservative in the dry food).
    • Feeding from an elevated bowl.  
    • Restricting water before and after meals.
    • Feeding a dry diet with animal fat listed in the first four ingredients. (Contrary to popular belief, cereal ingredients such as soy, wheat or corn, in the first four ingredients do not increase the risk.)
    • Fearful or anxious temperament.
    • History of aggression toward people or other dogs.
    • Male dogs are more likely to bloat than females.
    • Older dogs (7–12 years) are the highest risk group.

    On the flip side, the following factors may decrease the risk of GDV:

    • Inclusion of canned dog food in the diet.
    • Inclusion of table scraps in the diet.
    • Happy or easygoing temperament.
    • Feeding a dry food containing a calcium-rich meat meal listed in the first four ingredients.
    • Eating two or more meals per day as well as feeding a smaller kibble size.
    • Not breeding animals with a history of GDV in their lineage.

    One day after treating Bauer for bloat, veterinarian Shea Cox scheduled him for surgery to prevent the more serious GDV.


    What else can I do?

    For breeds with a high risk of bloat, a preventive surgery called prophylactic gastropexy can be performed at the time of spay or neuter. Gastropexy involves surgically “tacking down” the stomach to the inside of the abdomen to prevent rotation. If your dog has already been spayed or neutered, the same procedure can be done laparoscopically, and is minimally invasive. I had this procedure performed on my own Dobie, Bauer. I saw him bloat (and thankfully not twist!) one day at the park, and treated him at work. The next day, I scheduled the laparoscopic procedure.

    This is a same-day surgery with a quick and comfortable recovery. In the Bay Area, the cost is generally $1,500–$2,000, which is far cheaper than emergency surgery, and worth its weight in gold for peace of mind. One of my biggest fears was to have Bauer bloat while I was away for the day, only to return home to find I was too late.

    It should be noted that gastropexy does not prevent future bloat, but it does prevent future twisting, which is the deadly component of the condition.

    What is the prognosis?

    Decades ago, a diagnosis of bloat was almost always a death sentence, and only 25 percent of pets with bloat survived. Today, the survival rate is better than 80 percent! Part of the reason for this is increased owner awareness (go, pet parents!) leading to rapid intervention and treatment. The earlier the veterinarian gets started with treatment, the better chance for survival. Extremely aggressive medical and surgical intervention early in the course of the disease has the most dramatic impact on overall success.

    This is a condition I see much too frequently, but I have to say from personal experience, nearly all dogs return home (95 percent or greater) with early and appropriate treatment.

    Being the doting mom of two Dobies, this is a subject that hits close to home, and one I have experienced personally. Thank you to JoAnna for helping raise awareness of this all-too-common condition in our large-breed babies. Feel free to ask questions; I am happy to further elaborate on any area. For now, I’m off to hug my boy, being especially thankful that he is with me today.

    News: Guest Posts
    How Many Raisins in Raisin Bran?
    A veterinarian with a potentially sick dog needed to know

    Thanks to everyone who replied to my post, A Death in the Pack. Your stories and advice were both comforting and enlightening. Happily, Renzo dodged any long-term ill effects of his raisin binge and was back on stride within a few days.

    But there was one aspect of Raisingate that was not satisfactory. When I first brought Renzo in, my veterinarian tried to assess how many raisins he may have ingested by eating approximately a half a box of Kellogg’s Raisin Bran. She called Kellogg’s to ask and was told it was proprietary information the company couldn’t release.

    She was trying to figure out if he’d consumed more than three ounces, which would make a big difference in toxicity and treatment strategy—essentially, one day of fluids versus three days.

    Thanks to the Internet and a skeptical engineering student, my vet was able to crack this carefully guarded secret with a few strikes of the keyboard! Aspiring Polymath: Adrian Corscadden decided to challenge Kellogg’s two scoops claim and actually separated out the raisins and weighed them. (His judgment: Barely a cup, or 150 grams in the 475 gram box.)

    While Adrian was bothered by the vague “2 scoops” claim, I was peeved by Kellogg’s disregard for my dog. My business-savvy friends tell me it’s the way business is done. Sick dog be damned! Companies need to protect their intellectual property. I get that. I understand why they might not want to reveal a secret recipe. But anyone—including Corscadden, spikebythesea and Chow.com—can eventually separate out and weigh the raisins, so it’s hardly top secret.

    So thanks to all of you out there who like to count and measure and record your discoveries. I’m not the only dog mom who’s grateful you did (at least one commenter on Adrian’s blog mentioned needing the information for this same reason). As for Kellogg’s, count me unhappy.

    Dog's Life: Lifestyle
    Recognizing the Signs of Bloat [Video]
    See what the symptoms look like in real life

    Everyone with a large, deep chested dog is always worried about bloat (any breed can get bloat, but this demographic is disproportionally affected). Bloat is particularly scary because of how fast the condition becomes serious.

    When bloat occurs, the dog’s stomach fills with air, fluid and/or food. The enlarged stomach puts pressure on other organs and can cause difficulty breathing and even damage to vital organs.

    According to the ASPCA, even with immediate treatment, approximately 25 to 40 percent of dogs die from this condition. But certainly the odds are much better the sooner the dog can get emergency treatment.

    I'm familiar with the signs of bloat, but the video below helped me learn what the symptoms look like in real life.

    Roscoe, the dog in the clip, was adopted from Akita Rescue Mid-Atlantic Coast. The video was taken when he first got to his new home. No one present had ever seen bloat before. As soon as they realized Roscoe was sick, they rushed him to the emergency vet where he received life-saving treatment.

    Thanks to this video, I feel much more confident that I could identify the symptoms of bloat.