Bloat: What We Know and Where We Are Going

Speaker: Elizabeth Rozanski, DVM, DACVIM (SA-IM), DACVECC, Tufts University

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Gastric dilatation, commonly known as "bloat", is a rapidly progressing and devastating condition that can develop in several different breeds of dogs. It can be life threatening. The condition is initiated when the stomach dilates and food and gas cannot be expelled. As the stomach dilates and expands, the pressure in the stomach begins to increase, causing (1) inadequate blood return to the heart from the abdomen, (2) loss of blood flow to the lining of the stomach, and (3) rupture of the stomach wall. In some cases the stomach can become dilated enough torotate [flip around] in the abdomen, a condition called "volvulus" (GDV). The rotation can lead to blockage of the blood supply to the spleen and the stomach wall, and without immediate surgical correction of volvulus and removal of the dead tissues the patient can die. It is more common in large and deep chested breeds.

Bloat is not common in PWDs, but it can occur. In any dog, it can develop unpredictably, and rapidly. The symptoms are primarily an enlarged tight abdomen with severe pain, salivation, attempts to vomit, and/or retching. The dog can go into shock and collapse.

Dr. Rozanski noted that GDV is considered a survivable disease, with 80-85% success in promptly treated cases. It can easily be seen on a regular abdominal X-ray. Surgery is required for correction, along with intravenous fluids and pain control. The surgery consists of rotating the stomach back into normal position, inspecting the other organs, and possible removing the spleen or dead stomach tissue. Most dogs do well after treatment and go home afterward, but there are some that continue on to develop more complications involving the other organs of the body.

While much research has focused on the risk factors for the development of bloat, it is unknown why some dogs do quite well with surgery and are home within a day or two, and other dogs have complications with severe morbidity or even death. For many years, severe cases were associated with splenectomy [removal of spleen] or gastric necrosis [death of the stomach tissues], requiring removal of the stomach.

However, the surgical procedures in themselves are relatively benign and don’t explain why a dog would have a profound clinical course. Her group has been investigating the concept of multiple organ failure (MOF) or multiple organ dysfunction syndrome (MODS) as a uniting theme for explaining the complications associated with bloat. When they occur, the complications are a result of deposition of small blood clots in numerous organs which blocks vital blood flow including in the kidneys, liver, intestines and lungs. Abnormal heart rhythms and heart damage can occur.

Dr. Rozanski’s research is focused on the specific clotting changes associated with MODS, and the early warning signs for the development of clotting abnormalities. One newer test that she uses is called, "thromboelastograph" and it is more accurate that using traditional clotting tests.

She does advocate for prophylactic gastropexy in high risk breeds, especially Great Danes. [PWDs are not considered at high risk.] Gastropexy is a procedure that tacks the stomach to the inside of the abdominal wall to prevent bloat from reoccurring.

Learn More about Bloat

Dr. Elizabeth Rozanski is a board-certified specialist in emergency medicine and critical care and professor at the Tufts University Cummings School of Veterinary Medicine. Since 1996, she has worked at Tufts Veterinary School, where she directs the critical care service.

 

 

 
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