Bloat, the Mother of All Dog Emergencies

What you need to know about this life-threatening condition for dogs
By Shea Cox DVM, November 2011, Updated September 2020
Doberman Dog Breed Susceptible to Bloat in Dogs

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

First, some vocabulary: Bloat is a condition when a dog's stomach fills with air, gas or fluid causing the stomach to expand and distend. In some cases, this can progress to a twisting of the dog's stomach, called gastric dilatation volvulus (GDV). The term bloat is often used to describe GDV, but there is a vast medical difference between the two.

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 is GDV in dogs?

Gastric dilatation volvulus (GDV) is the twisting and bloating of the dog's stomach. Think of a balloon being twisted in half, like when a clown makes an animal figure.The enlarged 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 dog's 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.

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Symptoms of GDV or bloat

For each hour that goes by, there is a greater risk for complications.

  • Anxiousness
  • Agitation
  • Restlessness
  • Pacing
  • Drooling
  • Depressed attitude
  • Swollen or distended stomach
  • Hard or tense stomach
  • Vomiting, highly nauseated but little comes up.

The biggest sign of bloat is the vomiting. A dog with bloat appears highly nauseated and retches but little comes up. It is important to recognize the signs of bloat and below you’ll find an educational video of an Akita, named Roscoe, experiencing bloat with GDV (don’t worry, he survived!). No one present at the time they recorded the video had ever seen signs of bloat before. As soon as they realized Roscoe was suffering from bloat, they rushed him to the emergency vet where he received life-saving treatment.

What dogs are at risk?

There are many theories regarding what triggers bloat in dogs, 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 bloat have been identified over the years and include:

  • Having closely related family members with a history of GDV.
  • Feeding only one meal a day.
  • Eating rapidly.
  • Feeding from an elevated bowl.  
  • Restricting water before and after meals.
  • Being thin or underweight.
  • Moistening dry foods (particularly if citric acid is listed as a preservative in the dry food).
  • 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.
  • Large dogs with deep chests are at a much higher risk.

Bloat 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.

Reducing the risk of Bloat:

  • 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.
  • Surgical prevention

Preventative Surgery: Gastropexy

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. 

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

Treatment

The treatment for dogs with bloat depend on the severity of their condition. Seek veterinary care ASAP! You should not attempt to treat your dog at home.

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

Medications like Gas X 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.  Reminder, the problem with GDV is not the gas bloating, but the actual twisting of the stomach. 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.

prognosis

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

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 of bloat 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. From personal experience, nearly all dogs return home (95 percent or greater) with early and appropriate veterinary medical treatment.

Please be sure to raise awareness of this all-too-common condition.

Image by Petra Bensted

Shea Cox earned a veterinary medical degree from Michigan State University in 2001 and has been practicing emergency and critical care medicine since. In 2006, she joined PETS Referral Center. In her spare time, she loves to paint, wield her green thumb and cook up a storm. She shares her days with the three loves of her life: her husband Scott and their two Doberman.