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Oliver's Twist — a New Year's tale

1/15/2004

Oliver was a 5-year-old Golden Retriever— or is, I should say, thanks to a quick thinking owner and a well trained veterinarian.

Oliver's problem began after a lengthy run in the woods. Tired, hungry, and overheated, he returned to his home for a nice big bowl of chow and a bucket of water, which he inhaled with his usual speed and grace. A few hours later, the owner noticed Oliver lying about listlessly, with a very large belly.

What began as a full stomach from a big meal had suddenly become a life threatening condition — gastric dilatation and volvulus, or GDV.

GDV, or stomach torsion, usually occurs in large breed, deep-chested dogs. With excessive activity or intake of food, water, or air, the stomach bloats and then twists around its upper inlet — the esophagus.

The small intestines also swivel around, kinking off the outlet of the stomach as well. This creates a one-way valve effect, where air or fluids can enter the stomach from the esophagus but they can't exit from either end.

Setters and retrievers, because of their body shape, are predisposed to this condition, along with German shepherds and Great Danes. Affected dogs may first show signs of discomfort, belching and salivating and trying unsuccessfully to vomit. As the stomach enlarges, it cuts off critical blood flow returning from the abdomen to the heart, leading to shock, collapse, and eventual death of the animal.

Once a dog has a GDV, emergency treatment is needed to save its life. The veterinarian must give large volumes of intravenous fluids to fight the shock and will usually administer antibiotics to prevent infection.

The stomach will need to be decompressed — either by passing a tube down the throat into the stomach or, if a tube won't pass, by inserting a large needle through the dog's side into the stomach to relieve the bloating. Surgery is then performed to untwist the stomach, remove any dying tissue, and tack the stomach permanently to the dog's inner body wall to prevent reoccurrence. Without surgery, over 70% of affected dogs will develop GDV again. Even when surgery is performed quickly, up to a third of dogs with this condition may die from the effects of shock.

After surgery, the dog must be monitored carefully for irregular heart rhythm, which frequently occurs with this disease and can be fatal. Gradually, the dog will be weaned off of medications and fluids, and will hopefully return to full function within 2-3 weeks.

Fortunately for Oliver, he reached his veterinarian soon after the symptoms started, and within 2 hours his problem had been surgically corrected. Because of rapid treatment, Oliver did not require removal of any stomach tissue, dramatically decreasing his risk of postoperative complications.

Studies have shown that several factors can predispose dogs to GDV, including rapid ingestion of large meals (i.e. feeding a single meal each day), fearful temperaments, and feeding from elevated food bowls.

Many veterinary specialists now offer "prophylactic gastropexy" — tacking of the stomach to the inside body wall — to prevent GDV from occurring in healthy dogs. The technique can be performed through a standard surgical approach — e.g. during a spaying procedure — or by laparoscopy at a few select practices.

If your dog has a close relative that has had this condition, it is at greater risk for developing GDV, and a prophylactic gastropexy should be considered. The preventative surgery has few side effects; if your dog is at risk because of genetics or temperament, the procedure may be the best investment you could make for his future health.