What causes twisted stomach in dogs

Understanding Gastric Dilatation-Volvulus (GDV) in Dogs

A twisted stomach in dogs, medically termed Gastric Dilatation-Volvulus (GDV), is one of the most serious and rapidly progressing emergencies a dog owner can face. It’s crucial to understand what GDV is, its causes, risk factors, symptoms, and what to do if you suspect your dog is suffering from it.

What Happens During GDV?

GDV occurs in two distinct phases: dilatation and volvulus.

Dilatation:

The stomach first becomes excessively distended with gas, fluid, or food. This build-up can happen for several reasons, including rapid eating, swallowing air, or a blockage in the stomach or intestines. The stomach expands significantly, putting pressure on surrounding organs and the diaphragm, which can make breathing difficult.

Volvulus:

Following dilatation, the stomach twists abnormally on its axis. This twisting is the 'volvulus' part. The pylorus (the lower part of the stomach that connects to the small intestine) and the greater curvature of the stomach rotate, often 180 degrees or more. This twist has dire consequences:

• Blood Supply Compromised: The twisting cuts off the blood supply to the stomach wall, leading to tissue damage and potential necrosis (death of tissue).
• Venous Return Blocked: Blood cannot drain from the stomach and spleen, leading to a buildup of blood in the abdomen.
• Pressure on Diaphragm: The enlarged stomach presses against the diaphragm, severely impairing the dog's ability to breathe.
• Cardiovascular Shock: The compromised blood flow and internal pressure can lead to a rapid drop in blood pressure and cardiovascular shock, which can be fatal within hours.

What Causes a Twisted Stomach in Dogs?

The exact cause of GDV is not fully understood, but a combination of factors is believed to contribute. It's not a single event but rather a cascade of physiological events.

Primary Causes and Contributing Factors:

• Rapid Eating (Aerophagia): Dogs that eat very quickly tend to swallow a lot of air along with their food. This excess air can contribute to stomach distension.
• Dietary Factors: While not definitively proven, some theories suggest that certain types of food or the way food is fed might play a role. Feeding one large meal per day, as opposed to multiple smaller meals, is considered a risk factor. The type of food (e.g., kibble that expands significantly) has also been investigated, but results are inconclusive.
• Genetics and Breed Predisposition: Certain breeds are far more susceptible to GDV than others. This strongly suggests a genetic component. Large and giant breeds with deep, narrow chests are at the highest risk because their stomach has more room to move and twist.
• Anatomical Factors: The shape of a dog's abdomen and the way the stomach is anchored within the body contribute to susceptibility.
• Stress and Excitement: High levels of stress or excitement, especially around meal times, can lead to rapid eating and swallowing air.
• Bloating (Gastric Dilatation): GDV is often preceded by simple gastric dilatation, where the stomach fills with gas but does not twist. If the dilatation is severe, the risk of subsequent torsion (twisting) increases significantly.
• Reduced Stomach Motility: Conditions that slow down the emptying of the stomach can lead to a build-up of gas and food.
• Raised Feeding Bowls: Counterintuitively, feeding from raised bowls has been linked to an increased risk of GDV in some studies, possibly due to changes in eating posture that encourage more air swallowing.

Risk Factors for GDV

Understanding who is most at risk can help owners take preventative measures:

• Breed: Great Danes, Weimaraners, German Shepherds, Doberman Pinschers, Saint Bernards, Irish Setters, and other large or giant breeds are at the highest risk.
• Age: Older dogs are generally at higher risk than younger dogs.
• Sex: Male dogs appear to be at a slightly higher risk than female dogs.
• Temperament: Anxious or nervous dogs may be more prone to GDV.
• Family History: Dogs with a first-degree relative that has had GDV are at increased risk.
• Previous Gastric Surgery: Dogs that have undergone gastropexy (a surgery to tack the stomach in place) have a significantly reduced risk of GDV.

Recognizing the Symptoms

Prompt recognition of GDV symptoms is critical for survival. If you notice any of these signs, contact your veterinarian IMMEDIATELY:

• Restlessness and Pacing: The dog may seem uncomfortable, unable to settle down.
• Unproductive Retching or Vomiting: The dog may try to vomit but only bring up foam or clear liquid, or nothing at all.
• Distended or Swollen Abdomen: The belly may look visibly larger, tight, or hard to the touch.
• Excessive Drooling: Salivation may increase significantly.
• Pain: The dog may whine, yelp, or become aggressive when their abdomen is touched.
• Weakness and Collapse: As the condition progresses, the dog may become weak, pant heavily, and eventually collapse.

What to Do If You Suspect GDV

GDV is a life-threatening emergency. Time is of the essence.

1. Contact Your Veterinarian IMMEDIATELY: Call your vet or the nearest emergency veterinary hospital as soon as you suspect GDV. Let them know you are on your way.
2. Do Not Induce Vomiting: Attempting to make the dog vomit can be dangerous and ineffective in cases of GDV.
3. Do Not Give Food or Water: This can worsen the situation.
4. Transport Quickly and Safely: Get your dog to the veterinary clinic as quickly as possible.

Treatment and Prevention

Treatment for GDV typically involves aggressive fluid therapy, pain management, emergency surgery to untwist the stomach and perform a gastropexy (securing the stomach to the abdominal wall to prevent future twisting), and intensive post-operative care. Survival rates depend heavily on how quickly treatment is initiated.

Preventative measures include feeding multiple small meals per day, avoiding strenuous exercise for at least an hour before and after meals, and considering a prophylactic gastropexy surgery, especially for high-risk breeds.