Ozzy, a 7 year old Doberman pinscher presented to Pet Emergency Center for a distended abdomen and drooling that developed that morning. On Ozzys physical exam, he was quiet, hypersalivating, tachycardic and had a large distended abdomen. His clinical signs were concerning for bloat. Abdominal x-rays confirmed a gastric dilatation with volvulus (in other words, the stomach was dilated with gas and fluid and twisted on itself.) Decompression and emergency surgery was indicated. Ozzy was stabilized with IV fluids and gastric decompression. Trocharization (catheters aseptically introduced into his bloated abdomen) and passing of a stomach tube were used to help expel air and fluid in the stomach. While Ozzy had become more stable with the decompression, emergency surgery was indicated in order to completely de-rotate the stomach and then tack the stomach to the body wall to prevent future rotations. Ozzys preanesthetic blood work, including blood clotting times were stable prior to surgery. During surgery, Ozzys stomach was gas filled but no longer in torsion. Most often, a dogs stomach remains in torsion until manually de-rotated by the surgeon intra-operatively. An incisional gastropexy was performed which involved tacking a portion of the stomach wall to the body wall to help prevent further torsion in the future. However, pets are still at risk for bloat. During his recovery at PEC, Ozzy continued to receive intravenous fluids, antibiotics, anti-nausea medications and analgesia for pain control. A continuous EKG was used to monitor Ozzys heart rate and rhythm which revealed an arrhythmia called premature ventricular contractions. These can result from injury to the heart muscle from the initial shock seen with bloat. Ozzy was treated with a morphine, lidocaine, and ketamine (continuous rate infusions) drip to help the arrhythmia and treat pain. Ozzy remained in the hospital for intensive care and monitoring for 2 days and then was discharged home on antibiotics and tramadol for pain. Today, Ozzys owners report that Ozzy is doing well. Initially, he had some episodes of bloating which they found were caused by Ozzy drinking from an automatic water-spigot as he was swallowing excess air along with his water.They have been able to control this by providing him more controlled access to water via water bowels. The exact cause as to why some dogs bloat and others do not is not completely known. Possible causes of bloat/GDV include: breed predisposition (especially Great Danes, standard poodles, setters, St. Bernards.); deep chested dogs; dogs who have a first degree relative with a history of GDV; overeating; older dogs and dogs that exercise after eating. Possible ways to try to prevent bloat and torsion include: not feeding your dog from a raised food bowl, eating more slowly (separate household pets during meal times to stop competition; supervising your pet when eating.) Prophylactic gastropexy have been done in high risk breeds. Clinical signs of gastric dilatation with volvulus typically appear as: hypersalivating, retching, vomiting, apparent discomfort, restlessness, panting, fast heart rate, weakness, depression, and abdominal distention (which may or may not be evident to a pet owner.) It is important to get your pet to a veterinarian immediately if any of these symptoms are experienced by your pet. The longer a stomach is in torsion and bloated, the greater risk for tissue necrosis/death of the stomach, splenic rupture, shock and death.
lateral view showing marked gas filled stomach
V/D view of extreme gas distension
Ozzy getting prepared for surgery
Atlantic Street Veterinary Hospital Pet Emergency Center 1100 Atlantic Street Roseville, Ca 95678
