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28 February 2010

Bloat - A Killer - Be Aware

This is one of many dog ownership tips I'd like to share with you under the name 'Paws for Thought' written by a friend at work, posted here with her permission. Please note that these posts are written by a dog lover learning more every day and happy to share. They are intended to give you options and ideas to think about. They do not replace the help of a professional (such as a vet, behaviourist, trainer or lawyer). Posts can be shared with others as long as you make sure that any references contained within the post remain with the post and please do not take chunks out of context. Preference is definitely for the whole post to be shared rather than pieces.

This is a very personal topic for me having come within minutes of losing my beloved Merlin to bloat in June 2008. Thankfully I was home with him when it started. Thankfully our vet is just 10 minutes away. Thankfully it was before they closed for the night (just). Thankfully they are a vet hospital and thankfully they decided to operate on him right there and then rather than transport him to the after hours emergency centre.

Given recent posts and questions I thought I’d review what we appear to know about bloat. What is presented here is based on publicly available information only. It really all just confirms for me the need to talk to your vet about this killer and what you can do to reduce the risks with your dogs.

What is bloat?

Bloat is a life-threatening condition. A large number of dogs die of it every year in a painful and horrible death. Some stats indicate that even with immediate treatment 15% to 60% of dogs will die. The Purdue study indicated a mortality rate of approximately 30%.

My personal experience though is out of ten or more dogs that I have known or heard of having GDV my boy is the only one I know of who has survived.

Bloat is the most commonly known name for a condition also known as gastric dilation, gastric torsion and twisted stomach. The correct medical term is Gastric Dilatation-Volvulus (GDV) -sometimes referred to as Gastric Dilation-Volvulus . It happens when an accumulation of gases, air, fluid or food in the stomach causes it to first dilate and then to twist, sealing off the entry and exit to the stomach, causing the spleen to swell an placing pressure (if not cutting off) the major vein that brings blood from the lower body back to the heart. Toxins are then released from the dying stomach lining and heart dysfunction can occur. All of this happens quickly over just minutes to hours so timely treatment is critical.

Unfortunately I have known a number of people lose their dogs while down the shops, while dogs were home alone during the day or when sleeping in runs and kennels outdoors overnight.

What causes bloat?

The exact cause or causes of bloat remain unknown. Be aware though that bloat can affect any dog of any age, size, weight or breed.

A number of risk factors have been identified including:

Shape

Deep and narrow chests or abdomen.

Breed (although it is actually about their conformation – deep chests)

Risk factors are higher for dogs whose chests are long (from backbone to sternum) rather than wide – including mixed breed dogs.

Research by the University of Purdue, which of course did not cover all breeds, showed:

The highest average lifetime risk of an occurrence of GDV appears to be the Great Dane at 41.4% more likely than a mixed breed dog.

The rest of the list looks like:
·         Saint Bernard – 21.8%
·         Weimaraner – 19.3%
·         Irish Setter – 14.2%
·         Gordon Setter – 12.3%
·         Standard Poodle 8.8%
·         Basset Hound 5.9%
·         Doberman Pinscher – 5.5%
·         Old English Sheepdog – 4.8%
·         German Shorthaired Pointer – 4.6%
·         Newfoundland – 4.4%
·         German Shepherd Dog – 4.2%
·         Airedale Terrier – 4.1%
·         Alaskan Malamute - 4.1%
·         Chesapeake Bay Retriever – 3.7%
·         Boxer – 3.7%
·         Collie – 2.8%
·         Labrador Retriever – 2%
·         English Springer Spaniel – 2%
·         Samoyed – 1.6%
·         Dachshund – 1.6%
·         Golden Retriever – 1.2%
·         Rottweiler – 1.1%
·         Mixed breed – 1.0%
·         Miniature Poodle – 0.3%

Genetic predisposition

Having a first-degree (generation) relative with a history of GDV increases risk by 63%. So if you are a breeder of a susceptible breed (or mixed breed) then please consider not breeding from any dog that has suffered a GDV incident.

Sex

Males are more at risk than females (some say a slightly higher risk others indicate double the risk for males).

Age

More often seen in middle age to older dogs – some even report that few dogs under 1 year of age appear to be effected; others indicate that they have had youngsters suffer from GDV.

Research indicates that large breeds risks increase by 20% each year after the age of 5 while giant breeds risks increase by 20% each year after the age of 3.

Weight

Thin dogs are more at risk than overweight dogs (but of course overweight dogs are not healthy in other ways).

Health problems

Experiencing a major health problem before age 1

Temperament

Fearful temperament

Nervous temperament

Aggressive temperament

Feeding

Eating only one meal a day

Feeding only dry dog food, particularly if:

- Fat was listed amongst the first four ingredients (some research indicates a 170% increase in risk others question the research)

- More than one corn ingredient is listed among the first four ingredients (although only a minor risk increase
for this one)

- Foods with citric acid are moistened (some research indicates a 320% increase in risk – others question the research).

Feeding food with only small particles

Feeding a large volume of food per meal

Moistening dry food before feeding (something that is widely thought to reduce risk but which Purdue’s research shows increases it)

Eating rapidly (some research say increases risks by 15% which it is proposed may be linked to increased swallowing of air)

Eating from a raised feeding bowl (also something that is widely thought to reduce risk but with Purdue showed increases it by 110%)

Water intake

Restricting a dog’s water intake before and after eating (identified by Purdue)

Over drinking (identified by others)

Purdue indicated that giving water from a raised bowl also increased risks by up to 110%

Exercise

Increased physical activity before and after eating

Stress

May include recent kenneling or a recent long car ride

Trauma


Abnormal gastric motility


Hormone secretion.


Atmospheric pressure and changes.


What are some of the symptoms of bloat?

If your dog develops bloat you may see:

·         Pacing and restlessness

·         Head turning to look at the abdomen

·         A distended abdomen (looking something like your dog is pregnant or being pumped up with air) – often starting with the left side of the abdomen first

·         Stiff legged stance with arched back

·         Unsuccessful belching or vomiting or vomiting up white froth

·         Retching

·         Weakness

·         Excessive salivation (drooling)

·         Shortness of breath

·         Pale gums

·         Rapid shallow breathing

·         Rapid heartbeat

·         Acting uncomfortable, unwilling to move around

·         Collapse.

What should I do?

If you even suspect that your dog has bloat get your dog to a vet immediately. Time is critical with this condition – so it is far better to be wrong and cop a vet bill then to be right but too late (and possibly copping an even larger vet bill for surgery and critical care).

How is it treated?

Treatment will depend on your dog’s condition but often includes:

·         Trying to pass a gastric tube into the stomach to release gas etc. This is sometimes also used as part of the confirmation (or other) that the dog is suffering from GDV. If they can’t get a gastric tube in then something is almost certainly wrong and further investigation is warranted.

·         Using a large gauge needle to release gases from the stomach.

·         Taking an x-ray of the abdomen to check the stomach’s position – Note: This is highly recommended even if a gastric tube or needle have been successfully used to release gas etc.

·         Intravenous fluids to reduce shock.

·         Blood work to check for abnormalities.

·         Heart monitoring.

·         Emergency surgery to relieve the pressure and untwist the stomach. In some cases damaged parts of the stomach and spleen will have to be removed.

Intensive (and costly) post-operative monitoring for several days is routine.

As you can see this is a serious condition and surgery is highly risky – but often the only alternative to certain death.

Unfortunately research has shown that it is possible for vets to miss or misdiagnose GDV. So if you suspect your dog has GDV, but the veterinarian dismisses it as a minor problem, inquire about radiographs to rule out GDV or at the very least keep an eye on your dog and if the symptoms increase or do not reduce be persistent and return to your vets or seek another opinion. Don’t mean to scare you – but the research shows it happens.

Many vets will recommend permanently attaching the stomach to the side of the abdomen with stitches in an attempt to prevent future episodes, either during the emergency surgery or even if the situation is resolved before emergency surgery is required.

Some sources quote stats of 75% - 100% of dogs who survive GDV having recurrences unless this surgery is conducted, after which recurrence is drastically reduced (to less than 5% according to the Purdue study).

Can it be prevented?

Unfortunately you cannot guarantee that a dog will not suffer GDV. There are however a number of things that it appears can be done to lower the risks. Some are management and care issues, others are medical. Research primarily at Purdue University by Dr. Larry Glickman, VMD, Ph.D, (an AKC Excellence in Canine Research Award winner), and Dr. Malathi Raghavan, DVM, Ph.D. have particularly contributed to this list.

Meals

o        Feed several small meals rather than one or two large meals throughout the day

o        Feed no more than one cup per 33 pounds of body weight per meal when feeding two meals a day

o        Feed an energy-dense diet, to reduce volume, but avoid a diet where a high amount of calories are from fats.

o        Feed a food with larger particles, and include larger pieces of meat to the diet.

o        Avoid moistening dry foods

o        Feed products with protein ingredients of animal origin, including beef, poultry, lamb and fish amongst the first four ingredients (the more of these listed among the first four ingredients the better). The Purdue University research indicated that this decreased risk by 53%

o        Feed a variety of different food types regularly. The inclusion of human foods in a primarily dry dog food diet was associated with a 59% decreased risk of GDV while inclusion of canned pet foods was associated with a 28% decreased risk

Feeding bowls

o        Avoid feeding from a raised bowl unless advised to do so by your vet

Speed of Feeding

o        If your dog eats rapidly, find ways to try to reduce his speed of eating. These might include:

- Feeding on a baking tray or other flat surface

- Use of specially designed bowls or adding a largish ball, rock or block into a standard bowl

- Feeding dogs separately (to avoid them gulping down their food)

Drinking

o        Encourage normal water consumption – have water available at all times. Note though that some question the correlation between intake of water and incidence of GDV

Weight

o        Maintain an appropriate weight

Exercise

o        Avoid rigorous exercise before and after meals – up to 1 hour before and 2 hours after. Again some question the correlation.

Stress

o        Try to minimize stress for your dog. Stressful events have been reported to be precipitating factors in GDV occurrence. Some stressful events particularly mentioned are boarding, traveling, showing, breeding, and trialing.

o        Avoid vigorous, excitement and stress up to 1 hour before and 2 hours after eating.

Monitoring

o        For high risk dogs or when risk factors are increased (such as stress) consider using a baby monitor to alert you if your dog is in distress.

Preparation

o        Have vet contact numbers and know the way there for 24 hour coverage. This means you might need to have after hours numbers or alternative vet hospital or emergency care centre details handy.

A few of the key areas where there is contradictory advice appear to be:

·         Feeding in a raised bowl or on a raised feed station

·         Amount of water that the dog should be allowed to drink immediately before or after eating

·         Making changes in diet slowly, over a period of a week or more or feeding a varied diet at all times.

·         Anti-flatulence treatments – some recommend it and others believe that it increases the risks of GDV.

So this merely reinforces the importance of talking to your vet!

A recent discussion with my vet reinforced that we really don’t yet know the specific causes and that it can even happen from just gulping down too much air. A friend then lost a dog that bloated on water. We have a long way to go in really understanding GDV – so all we dog owners (and vets) can do is work with the information we do have and be willing to change (or at least consider changing) as new information comes to light.

If you have a high-risk breed then you might want to talk to your vet about performing a gastropexy during de-sexing or at another time. A gastropexy is where they attach the stomach to the abdomen making it harder (if not impossible) for the stomach to twist.

References:

http://www.aspca.org/pet-care/dog-care/dog-care-bloat.html

http://www.petalia.com.au/Templates/StoryTemplate_Process.cfm?Story_No=1648&specie=1

http://www.in-memory-of-pets.com/phpbb2/viewtopic.php?t=998&sid=515772b9020a20bd1bb488f9a7fe7bbd

http://personal.uncc.edu/jvanoate/k9/bloatfaq.htm

http://personal.uncc.edu/jvanoate/k9/bloatfaq.htm

http://petdoc.com/story/bloat-and-torsion-gdv-dogs

http://www.kifka.com/Elektrik/Bloat.htm

http://www.thepetcenter.com/article.aspx?id=3453

http://www.crittersitextra.com/pettips/NEW_Purdue_Bloat_Study.pdf

http://www.thewagway.com/Behviour%20Tip%20Sheets/gastric_dilatation.htm

http://webcanine.com/2007/rottweiler-bloat-risk/#more-128

http://webcanine.com/2007/med-surg-treatment-for-bloat/#more-107

http://webcanine.com/2007/breed-related-risks-for-bloat/#more-20

http://webcanine.com/2007/diet-related-risks-for-bloat/#more-18

http://www.vin.com/proceedings/Proceedings.plx?CID=TUFTSBG2003&PID=5091&O=Generic

http://www.stat.purdue.edu/~mlevins/Articles/GDV_biometeor.pdf

http://www.vetsurgerycentral.com/gdv.htm

http://pethealthlibrary.purinacare.com/dogs/bloat-gastric-dilatation-volvulus/

http://www.dfordog.co.uk/didyouknow_bloat.htm

http://largedogbreedz.com/your-large-dogs-health/dog-health-conditions/dog-bloat-treatment/prevention.html

http://www.peteducation.com/article.cfm?c=2+1571&aid=402

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