Gastric dilatation volvulus (GDV - Stomach dilatation-torsion syndrome) is an acute disease characterized by severe distension of the stomach followed by a change in position of the stomach. The stomach twists around its axis which prevents the evacuation of air or liquid which remain trapped and accumulate.
The stomach expands more and more and takes up so much space in the abdomen that it compresses the vessels that transfer blood back to the heart. This leads to a state of shock which puts the dog's life in danger and requires urgent treatment.
Large breed and giant breed dogs (Great Dane, Saint Bernard, Labrador Retriever, Irish Setter, Bernese Mountain Dog, German Shepherd, Rottweiler, etc.) are predisposed to this syndrome even though all dogs can suffer from it, including those of small size. Various risk factors have been identified: a deep chest, eating only one large meal a day, advanced age, foods high in fat or poorly digestible, stomach motility disorders, anxiety and stress, physical effort after taking the meal…
The dog tries to vomit but nothing comes out. We are talking about unproductive vomiting. The dog may also present excessive salivation, dilation of the abdomen, dejection, discomfort (the dog does not know how to get on and does not stay in place), weakness, …
In the most severe cases the dog is no longer able to stand up, breathes rapidly and has pale mucous membranes. It is necessary to intervene quickly otherwise this syndrome leads to the death of the dog.
The clinical presentation of a large dog that makes unproductive vomiting efforts with a marked dilation of the abdomen already allows to suspect this syndrome. Abdominal X-rays, on which a severely dilated and abnormally positioned stomach is observed, confirm this.
As soon as the dog arrives at the clinic, it is taken care of in order to be stabilized. Stabilization is mainly based on the administration of an intravenous infusion (administration of fluids directly into the vessels) and decompression of the stomach through a small tube introduced through the skin into the stomach in order to empty the stomach of the air that has accumulated there.
As soon as the animal is stabilized, surgery is performed to put the stomach back in its place and untwist it. During this intervention, the stomach is fixed, that is to say sutured with surgical stitches to the internal wall of the abdomen in order to avoid a new episode of dilation-torsion. Sometimes part of the stomach wall has suffered too much and shows necrosis; in such a case it is necessary to remove it (gastrectomy). If the spleen twists along with the stomach, it also needs to be removed (splenectomy).
If the dog is taken care of quickly, the prognosis is good. Unfortunately, if too much of the stomach has suffered or the state of shock cannot be stabilized, some dogs may die before, during or after surgery.
In breeds at risk, gastropexy, a surgery which consists in fixing the stomach to the internal part of the abdominal cavity, can be carried out as a preventive measure.
Dr Emilie Vangrinsven
Diplomate from European college of veterinary internal medicine | PhD U-Liège
Assistant at the Liege University in the university clinic for PETs | Author and co-author of numerous scientific publications
