Gastric dilatation and volvulus (GDV)

What is GDV?

Gastric dilatation and volvulus (GDV) is an emergency condition where the stomach fills with gas and rotates on itself. The gas becomes trapped and causes significant dilation of the stomach.

As the stomach continues to enlarge, the wall of the stomach becomes compromised and can die or rupture. The pressure of the dilated stomach can also obstruct blood flow to the heart, leading to life-threatening systemic shock. It also puts pressure on the diaphragm, making it harder for the animal to breathe. 

When the stomach twists it may also involve other organs such as the spleen, blocking blood flow and causing significant damage.

GDV is a critical condition, which requires an immediate diagnosis and emergency treatment. 

Which animals are at highest risk of GDV?

Dogs with a deep, narrow chest are the most prone to GDV. These breeds include Great Dane, German Shepherd, Irish Setter, Weimaraner, Saint Bernard, Standard Poodle, and Bassett Hounds. However, many other breeds, including small breeds, are also susceptible.

There is also evidence to suggest that stress or the rapid consumption of food, particularly followed by exercise, can precipitate the condition. Animals that have known relatives with a history of GDV are also at increased risk.

Signs of GDV 

·       Non-productive regurgitation or attempting to vomit

·       Distended abdomen (appearing “bloated”)

·       Drooling

·       Restlessness 

·       Panting

·       Collapse

If you believe that your pet is displaying any of the above signs, please contact the hospital immediately. 

How is GDV diagnosed?

Upon arriving at the hospital, if there is any suspicion that a patient may have GDV, it is important that the veterinary team acts fast.

In many cases, a distended abdomen will be immediately obvious. A physical examination can also identify signs that are suggestive of shock, such as a fast heart rate and weak pulses. There may be a characteristic tympany (hollow drum sound) when assessing the abdomen due to the trapped air. 

The best way to confirm a diagnosis of GDV is an abdominal X-ray. With one very specific X-ray view, a veterinarian can diagnose GDV from a characteristic “double bubble” appearance to the stomach – showing air dilation and a shelf of stomach wall from the twist in the stomach.

Treatment of GDV

Once the diagnosis of GDV has been made, prompt treatment is required. Stabilisation is key. Patients will be given intravenous fluids to help improve their blood pressure and pain relief to start. In most cases, the vet must try to decompress the stomach (i.e. remove the gas from the stomach) as quickly as possible to relieve the pressure and slow the secondary effects of the condition. This can be done by using a needle through the skin into the stomach, or by passing a tube through the animal’s mouth into their stomach.

After initial stabilisation, surgery is required. This surgery is done on an emergency basis as soon as the patient is stable enough to be anaesthetised. Our Surgery team is available 24/7 to treat these cases whenever they are needed.

Surgery is performed by opening the patient’s abdomen to allow the stomach to be manually untwisted and put back into a normal position. Once the stomach is untwisted, it must then be secured to the abdominal wall using stitches (a procedure called a gastropexy) to prevent it from re-twisting in the future. The other organs in the abdomen are also examined to see if any further damage has occurred. In some cases, animals will have significant damage to their spleen which may need to be removed at the same time. Patients may also require part of their stomach wall to be removed (partial gastrectomy) if the stomach has become too severely injured.

Intensive post-operative care is needed for all GDV patients until they are stable and ready to be discharge. Patients require 24-hour care, including monitoring their heart rate/rhythm and blood pressure as well as nutritional and gastrointestinal support. Recovery time can vary greatly depending on the severity of the GDV, organ damage and shock. 

Once discharged, patients should be kept rested at home and fed smaller, more frequent meals during their recovery period.

Prevention of GDV

There are a few simple environmental factors that can be altered to help decrease the risk of GDV including feeding small meals more frequently and avoiding exercising your pet after meals. 

However, the most successful way to prevent GDV is a gastropexy procedure. 

For more information, please see the “Laparoscopic Gastropexy” section.