"Bloat"

Welcome to PercyPods Pet Emergency blogs. This week we are going to focus on a specific emergency problem that occurs in dogs called “bloat” or more correctly “gastric dilation-volvulus syndrome” or “GDV”. This condition is one of the true emergencies that can affect dogs with the potential to become life-threatening very quickly, in a few hours or less. It is therefore very important that all dog carers, but especially carers of bigger dogs, are aware of this condition.

What is bloat and why is it a problem?

So let’s start this blog by explaining in a bit of detail what bloat is and why it can be such a severe problem. There is a little bit of variation in terms of exactly what happens when bloat occurs but in most cases the first stage is for the stomach to become very enlarged being filled with gas and fluid. The term ‘gastric dilation’ is what we use to describe a stomach that is enlarged in this way. In some but not all dogs, the enlarged stomach then twists on itself and this twisting, also known as ‘volvulus’, makes the situation even more severe as the gas and fluid cannot escape from the stomach now. So bloat is basically a condition in which the dog’s stomach enlarges and then may or may not twist on itself.

Now this enlargement and twisting of the stomach has a number of different consequences within the dog’s body that can happen very quickly and be very severe. Many affected dogs go into shock and collapse and some also develop difficulty breathing. Bloat can be rapidly fatal if urgent treatment is not provided.

This x-ray from a dog shows a stomach that is very large and filled with gas as well as some food and fluid. The stomach in this picture is not twisted.

Which dogs are affected by bloat and why does it occur?

Let’s now consider which dogs are affected by bloat and why it occurs. The vast majority of affected dogs are big or deep-chested, with commonly affected breeds including Great Danes, Bull Mastiffs, German shepherd dogs, Standard Poodles, Airedales and so on. Having said that it is possible although very rare for smaller dogs and even cats to develop a similar problem.

It is important to realise that we are still not clear why dogs develop bloat. Many theories or factors have been suggested and it is probable that the situation varies to some extent from dog-to-dog. Some of these factors relate to the dog’s body itself, or its ‘anatomy’, for example to do with the position of the stomach in bigger dogs. There is some suggestion also that dog’s with more fearful or anxious demeanours may be at greater risk of bloat. However other factors are more to do with how the dog is looked after in terms of his or her diet and feeding and exercise routines. The most common scenario that we as vets see in terms of cases presenting with bloat is for a dog to have had a relatively big meal, either a short while before or a short while after doing a fair amount of exercise, and to then go downhill within a couple of hours and most cases seem to occur in the evening.

One thing that we would like to mention at this point is something that we refer to as ‘food engorgement’. Some dogs, especially it seems Labrador retrievers, are very good at raiding food stores or gaining access to garbage bins and consuming a very large amount of the contents, i.e. gorging themselves. These dogs can develop similar problems to dogs with bloat but there is a distinction between the two conditions because dogs with bloat have not usually overeaten as such. This distinction is important to a degree and it can affect the treatment although it is also important to realise that some dogs with food engorgement can then go on to develop the more serious condition of bloat.

What symptoms does a dog with bloat show?

Okay so at this point you may well be thinking that’s all very well and good but how do I know when my dog might have bloat? Well one of the most consistent signs that dogs with bloat show is that they seem to retch; retching looks a bit like vomiting but these dogs do not actually produce anything out their mouth, or occasionally they may produce a little bit of froth or phlegm. Some dogs drool saliva as well. Dogs with bloat may appear restless and in fact sometimes the first thing you will notice is that your dog just doesn’t seem settled; they may be pacing or whining and unable to get into a comfortable position, and some dogs repeatedly turn and look at their stomach area. Depending on your dog, you may also notice that the tummy area looks bigger or swollen and can feel hard – a bit like a ball or balloon that has been pumped up with too much air. It is important to say though that this swelling of the tummy area is not obvious in every case.

You must contact your vet practice immediately if you notice any of the signs we have described here and this cannot be stressed enough.

How is bloat treated?

Bloat is a potentially life-threatening problem in dogs that requires immediate treatment and vets and nurses are well aware of this. Treatment usually starts with administering a fluid drip into one or two veins. Dogs with bloat are often in shock and this fluid drip is very important for stabilisation. The treatment can vary to some extent between individual dogs but may then include an x-ray being taken to confirm that the stomach is swollen and to try and see whether it is twisted or not. The swollen stomach needs to be made smaller – or what we call ‘decompressed’ – and this may be done in a couple of different ways including by placing a tube through your dog’s mouth and down into the stomach; gas can then escape out this tube.

Your vet will want to discuss performing an operation on your dog. There are a number of good reasons why dog’s with bloat should have surgery including to untwist the stomach, check how healthy it looks, and fix it into position so that it cannot twist again in the future. When the stomach swells and twists this can also have effects on other organs in your dog, such as the spleen, and performing surgery allows all of these to be examined as well. Most dogs recover well from this surgery but if you have reservations you should be sure to discuss these with your vet before consenting to the procedure.

After surgery your dog will need to stay hospitalised for maybe 2 or 3 days depending on how he or she recovers and then will also need to be looked after carefully for a while before they can return to life as normal. Your vet practice will go through the details of the post-operative care with you.

As mentioned before dogs with ‘food engorgement’ may be treated differently to those with bloat. Dogs with food engorgement are often starved and just given time for all the food to pass through their bowel. Sometimes a laxative may be given and some cases are kept in the practice to be monitored for a while. Sometimes rather than starving the dog we decide to make them vomit up the food instead. Remember though as we said before that some dogs with food engorgement can go on to develop bloat.

Can I stop my dog from getting bloat?

Okay so before we finish this blog let’s talk about whether it is possible to stop your doing from getting bloat. The honest answer is that you cannot stop your doing from ever getting bloat with 100% certainty. However you can do some things to try and make it much less likely.

The first thing is to recognise that your dog is one that is at an increased risk.

• As we said earlier bloat almost always happens in big or deep-chested breeds and it may also be more common in older dogs.
• There is some evidence that bloat may also be an inherited condition so that if one dog gets it, generations of dogs from within the same breeding line are also more likely to be affected.

The next thing is to manage your dog’s exercise and feeding routine:

• You should feed your dog two or three smaller meals a day rather than one large meal, and most people recommend a good quality food that is very digestible with normal fibre levels.
• You should also try to make sure that your dog does not eat straight after doing a lot of exercise and similarly that they do not exercise straight after eating. There are no hard and fast rules but you should try and leave at least one hour, if possible two hours, between exercise and eating.
• If your dog has a fearful or anxious demeanour, try and feed him or her in a quiet peaceful environment and some dogs prefer to be fed on their own away from other dogs in the house.
• The other important thing is to not let your dog gulp a large amount of water straight after exercise, before eating or after eating. Again, small amounts of water more frequently are best.

Another thing to mention is that as we said earlier bloat is a condition that most often seems to happen in the evening or late at night. You should therefore bear this in mind because if you fed your dog and then when out for the evening, you may return home to find them very sick. Ideally you should be able to keep an eye on your dog for as long as possible after they have eaten. And of course if your dog starts to show any of the signs that we mentioned earlier on then you must realise that this is not a ‘wait and see’ moment but a time for consulting your vet practice urgently.

Okay so that brings us to the end of this blog on bloat in dogs. It is one of the most well-known emergency problems affecting dogs and can be life-threatening. However increased awareness amongst pet carers and veterinary staff as well as improvements in emergency veterinary care has meant that many cases go on to recover fine. The next blog will be in approximately 2 weeks time when we will talk about a condition in male cats known as urethral obstruction which means that these cats cannot pass urine; they are often referred to as ‘blocked cats’.

Before we sign off just to remind you that you can contact us in various ways. Via email on percypods@gmail.com; via the PercyPods Facebook page; or via Twitter on @PercyPods. We would really love to hear your comments on this podcast as well as suggestions for future topics. Also don’t forget to subscribe for future episodes via the RSS feed or iTunes. So thank you for listening and until next time, may you and your pets be safe.