canineammo

[canineammo]

Canine Bloat/GDV

PART 1 – Bloat/GDV PART 2 – My experience with Bloat PART 3 – Signs & Recognition PART 4 – Emergency Prehospital Care PART 5 – Emergency Plan PART 6 – Prevention PART 7 – Further Information PART 8 – Final Words .

PART 1 – Bloat/GDV

The one everyone fears.

This is my contribution to spreading awareness and education about bloat. There are still many that don’t know of it, or realise how serious it is, it is a life threatening condition that requires aggressive emergency medical stabilization, surgical intervention, and intensive post operative care.

Some of you reading this may have experienced it, some are lucky enough to have not. It’s not talked about much because many that have lost dogs to it find it too upsetting to talk about, which is perfectly understandable, and those that have not experienced it I don’t think can truly comprehend just how terrible it is. If you have experienced it you may or may not learn something, if you have not experienced it and don’t know much about it, you will learn something, something that could save your dog's life. I truly believe that any dog person that loves their dogs and considers them part of the family should be aware of it, and understand how to recognise it, and how to act, bloat kills many dogs around the world every year, it’s more common than you realise. Even if you have owned, bred dogs for many years without experiencing it, don’t be under the illusion that it will not happen to you, there is always a first time, and it’s highly likely that someone reading this will at some point in the future.

I grew up with dogs, they’ve been around all my life, I’ve had my own dogs for over 30 years but, I have only experienced or known people personally that have experienced bloat in their own dogs within the last few years, 15 dogs, 7 survived, 8 did not, the last was a Malamute this past Christmas Eve. I have spoken to many more owners who’s dogs did not survive.

The first I heard of it was 22 years ago when I was researching Malamutes, I read about it in breed books, you know the ones, most of them have a section on health issues that only briefly touches upon it which doesn’t come close, so there’s not much point in me briefly doing the same, that’s not really how people remember, it’s easily forgotten when presented like that, I will go into graphic detail here about this condition and my experience with it because I believe people are more likely to remember, so I have to warn anyone who has experienced it, you may find this upsetting.

Not long ago I was told by a friend “bloat is a horrific way to lose a dog", she was right, I can’t think of another word to describe it, “Horrific”.

What is Bloat?

Bloat is used as a slang term for GDV (gastric dilatation volvulus) or expansion and twisting of the stomach. Medical bloat (GD (gastric dilatation)) on it’s own is when the stomach fills with gas or food and distends without the twist, it can sometimes correct itself like if the dog burps, it can still be critical but, without an underlying medical cause it’s not as common. GDV, aka torsion, is when the stomach expands and twists on itself, it is one of the most serious non traumatic medical emergencies in dogs, without surgery is always fatal, as the stomach is twisted there is nowhere for the gas to escape so the stomach keeps expanding.

In both GD and GDV, dilatation of the stomach results in compression of major blood vessels in the abdomen with impaired venous return to the heart and results in shock.

I will use the term Bloat to describe GDV, as that is what everyone knows it as.

Bloat can build up slowly over a few hours or kill in a very short time. The stomach can bloat then twist, or it can twist first then bloat. They do not know what causes it and it is impossible to predict, there are risk factors and recommendations which are:

Don’t feed one large meal a day, split it into 2 or more smaller meals.

Restrict exercise for 2hrs before and after meals (of questionable benefit and research evidence is scant). One of the theories on this is when the stomach has some weight in it from food (or water) it can then act like a pendulum, as the dog runs about it can flip the stomach over.

They used to recommend feeding with raised bowls so the dog takes in less air when they eat, now they recommend not to feed with raised bowls.

They think dogs on the much slimmer/leaner side are more prone, theory behind this is those dogs have less fat in the abdominal cavity so there is more room inside the abdomen for the stomach to turn.

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The Facts:

• Dogs that eat kibble bloat • Dogs that eat raw bloat • Dogs with only water in their stomach bloat • Dogs with an empty stomach bloat • Dogs that exercise soon after eating bloat • Dogs that exercise hours after eating bloat • Dogs that eat from raised bowls bloat • Dogs that eat from a bowl on the floor bloat • Dogs that have bloated are at a much higher risk of bloating again • There is no specific diet which prevents bloat despite what you may be told.

It usually affects larger deep chested breeds (or those with a higher width to depth ratio of the chest) from around age 7 onwards, though it can affect any breed at any age, I’ve known of dogs 3 years old and younger to suffer bloat, even some smaller breeds.

Out of the many studies and research done nothing has proved a definitive cause, the only thing they are pretty sure of is that stress may be a major factor as its seen a lot in military working dogs, so much so that many US MWDs are given a prophylactic gastropexy.

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Signs and symptoms:

The first signs can be very subtle and hard to notice…

• your dog may just seem not his/her usual self • may become restless, they may try to lay down but can’t get comfortable • pacing about • excessive panting • drooling, excessive salivation • retching or trying to vomit but nothing comes up, sometimes just a white froth • enlarged abdomen, may look like a basketball behind the ribs • expansion of the rib cage • whining or vocalizing as bloat is extremely painful • weakness • difficulty breathing • dark red gums as shock starts to set in, pale gums as shock advances

your dog may have any combination of these signs or early on just one, this can all build up slowly or advance very fast, once it starts advancing your dog doesn’t have long, I cannot stress enough that you need to get to a vet fast, minutes count. If your vet is open ring them to tell them your dog is bloating and you’re on your way so they can get ready, don’t waste time discussing symptoms on the phone just go, if it’s out of hours you will obviously need to ring first so the vet can meet you at the surgery unless you're lucky enough to live close to a veterinary hospital where a vet is on site 24/7, no good vet will question you or judge you if you are wrong, they will understand, if they don’t, get a different vet, it’s better to get to the vet and be wrong than be right and waste time your dog doesn’t have.

If your dog is lucky enough to get to a vet in time and survive surgery, the next few days can be critical, bloat does not affect just the stomach, depending how advanced it gets and how long for can cause a massive amount of complications from tissue death and organ failure as the expanded stomach cuts of blood supply back to the heart and other organs, as the blood circulation stops, toxins start to build up in the blood stream, and then sepsis, it truly is horrific.

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Treatment:

Dogs will present to the vet in various degrees of stability, from critical to serious but stable, they will typically be in some degree of cardiovascular shock which will be treated with fluids and oxygen, they will be treated aggressively with pain medication, the vet may attempt to deflate the stomach via orogastric tube or needle decompression, x-rays and bloodwork taken then into surgery, part of the stomach may need to be removed and possibly the spleen. If there is too much damage then the dog will need to be pts. If the dog is able to be saved the stomach will be fixed to the abdominal wall to prevent recurrence, a procedure called gastropexy, but this does not stop a simple bloat or distention of the stomach.

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First Aid for bloat:

I am not a medical professional, I've just had some canine first aid training, learned from some great professionals and my own experience with bloat in my own dog.

It is important to minimize additional stress and unnecessary movement, avoid abdominal pressure as increased pressure on the distended stomach will lead to more pain and can increase the risk of it rupturing if severely compromised.

If your dog doesn’t have time to get to a vet there is something you can do to buy some time if you can get the training, I spoke to my vet after someone close to me lost her dog to bloat, as he didn’t even make it to the van, I asked if there was anything I could do in that situation, she said there is but there is a risk and she offered to show me, and I’m very grateful to her for that, it’s called a gastric needle decompression or gastric trocarization, it involves inserting a large bore hypodermic needle through your dog’s skin and into your dog’s stomach to release some of the gas and reduce pressure, it does carry risks and should be performed by a vet or other medical professional along with fluids to treat the shock but like my vet said to me, “if your're not going to make it to a vet in time you might as well try".

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Other options for First Aid:

• Orogastric tube, or tubing. I’ve heard that some carry these in a bloat kit for emergency, I wouldn’t even think about attempting it in an un-sedated dog, I have no experience with it so will say no more, even some vets will choose to trocarize first.

• Simethicone/Gas-X, this is the most common recommendation by pet owners which is quite worrying being as they never mention the risks involved, some will say it will save your dog like its a wonder treatment, some will say it saved their dog, you might possibly be able to give your dog something early on, you might not, never force it, however its not without risk and some don't even realise.

Whatever you are told, understand there is no wonder treatment you can give unfortunately, but most importantly don't let anything you read or learn from anyone give you a false sense of security in dealing with bloat, people do mean well, and want to help, some advice is good, some not so good but with the best intention, so before you do anything understand the bloat signs, they are not always obvious, understand how to read your dog, vital signs, shock signs etc, when it might be possible to do something, when you should absolutely not, if the dog is retching/dry heaving and so nothing is able to come up then nothing is able to go down, if you then give something it might go down but it won't reach the stomach where you want it, it will sit in the dog's esophagus, if they then bring it back up which they very likely will there is then a very real risk of aspiration which will make a really bad situation a whole lot worse, which can actually kill the dog in itself.

So I'm not telling anyone what they should do, just to understand the risks aswell as the possible benefits, so you can weigh up the situation at hand and ask yourself if the benefit outweighs the risk? Or would time better be spent getting to the vet? There is no easy answer because every emergency is different, just understand when to do something and when you should absolutely not do something. Whatever you do or don't do, you have to live with the outcome.

Not one of the emergency and critical care vets or field medics who have experience of addressing bloat in the field that I have spoken to recommend tubing or giving anything orally, the only recommendation by them if warranted and if you are trained is needle decompression (see part 4).

In any type of first aid whether canine or human, there is no substitute for professional training, first aid measures to address bloat are advanced and require decompression of the stomach and treatment for shock, sometimes treatment needs to be aggressive to save a life.

All these options are not without risk and should really only be performed by a medical professional but you still need to get the dog to the vet and give them a viable patient to save, you may be on your own and left with a tough choice only you can make armed with the knowledge you have. Just learn as much as you can so you are as prepared as you can be. If you are interested in learning needle decompression then speak to your vet for training, you really need hands on training with a vet to do this.

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PART 2 – My experience with Bloat

I will now describe my experience of bloat in my own dog Cooper, he was 10 years old, I’ll say up front Cooper didn’t actually die from bloat, he died from a blood clot on his lung caused by an infection, the bloat was secondary, but it wasn’t that simple, he was very unlucky in the fact he suffered two very serious conditions at the same time, both emergencies that on their own are often fatal so his chance of survival was slim to none, but I gave him the best chance I could, if you knew Cooper well you might not want to read this.

He started coughing one evening which got worse by the morning so I took him to the vet, I recorded him coughing on my phone to show the vet, she looked and said it looked like classic kennel cough, she gave him a thorough check over and everything was ok, she said there were other possible causes but we will try him on antibiotics and take it from there, he initially got worse but after a few days improved, after 9 days on the Friday he was pretty much back to normal, just a couple of slight coughs, he had about 4 vet visits in this time, Saturday morning he was symptom free and running around the garden, vet check up late morning and everything was good. I didn’t walk him for the entire 10 days as kennel cough affects the throat aswell and if he pulled on lead would make it worse, but I now thought I’d take him for a short walk, he got very excited and started pulling, I crossed the road outside my house and he started coughing so I took him straight back, wasn’t gone for more than 3mins. I kept a close eye on him but the cough was no different from the previous 10 days at this point so I thought he just irritated his throat, after an hour I gave him some food to see if that would settle him, this was probably the biggest mistake in hindsight, but at this point I had no idea he was suffering a blood clot on his lung, after a couple of hours the cough started getting worse and his gum colour was a bit off, slightly pale, his tongue was a little puffy, he was panting and he didn’t seem right so I called the emergency vet around 6pm and said I need to bring him down, while on the phone I was watching him, he tried to lay down but I could see he was uncomfortable and got back up, the vet said she’d meet me in 15 mins, at no point did I observe him retching which is one of the main signs of bloat, he walked up into the back of the van by himself no problem and sat down, I then left, by the time I was about 1 minute from the clinic he started crying (anyone who really knows dogs knows they can put up with a lot of pain before they cry about it, unlike us humans), we arrived at the clinic about 10 mins after leaving, I got him out of the van and my heart sank, I knew straight away he was in a full on serious bloat, his body was huge, he had a huge expansion of his rib cage, his mouth was clenched shut (obviously due to the severe pain he was in), he was drooling heavily, his gums were dark red as shock was starting to set in and he was struggling to breath through his nose (as the stomach expands it puts pressure on the diaphragm so the lungs can’t inflate), he was a mess, to top it off the vet wasn’t there yet, I rang her while we were standing about 10 feet from the door but the phone signal was rubbish and so kept getting cut off, after the 4th attempt I looked him closely in the face, now we all know what physical pain is, its something we feel, not many of us experience true unimaginable pain but when I looked my boy in the face I see what that pain looks like! So I grabbed a decompression needle from the first aid kit, found the landmarks, and pushed it into his stomach, once through his skin I could feel his stomach, it literally felt like a balloon so I pushed and he screamed, within a couple of mins he started to improve, his mouth was open and he was panting, then the vet arrived, I told her what I’d done and we got him in, she listened to his heart but couldn’t hear the right side, she said he’d thrown a blood clot to his lung which would have been caused by the kennel cough or whatever infection he'd been fighting and the bloat was secondary, he then collapsed and died.

I cannot begin to explain what I felt when I walked out leaving my boy lying on the floor. It is soul destroying. I can only assume the coughing, which got worse after feeding him caused his stomach to torsion.

I am not a writer, this is the best I can do to explain it, it is not easy to write, I describe bloat and my experience in graphic detail because it is much more likely for people to remember than simply reading a little about it in a breed book etc, I don’t mind talking about it now, if it means it may save another dog from a horrific death, then it is worth it.

Bloat is something to fear and many do, especially those with experience, but try not to let it scare you so much that you don’t learn about it, how to recognise it, and how to deal with it, because one day you may wake up not knowing what is about to unfold, and the knowledge you gain is ultimately what could save your dogs life.

Would Cooper have survived had he not suffered the blood clot?

I don’t know, but I gave him the best chance I could, all because I learnt about it before hand, and I’m so grateful to my vet for showing me what to do, as I couldn’t imagine watching my boy die in front of me without at least trying to help him, these dogs give us so much and we owe it to them to be there for them, when they are in pain and scared, it’s us they will look to when they need help.

Cooper 2008-2018 x

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PART 3 – Signs & Recognition

The most important part, the signs and recognising it!

There seems to be some confusion in posts I read about this so this is what I have learnt from professionals and my own experience….

We often hear "catch it early and get to a vet fast", which ofcourse is correct but, its not always so simple. In an ideal world we would catch it early but rarely is everyone so lucky. Many will know the common signs which are passed around to make everyone aware but, its very important to note the common signs are not always present early on, or even at all, one reason it can be easily missed and one reason which makes it so dangerous. The most common sign everyone knows as retching or unproductive vomiting which would clearly indicate bloat as a major possibility to many of us is not always present, so do not rely on it being present to indicate a bloat. Pale MMs and slow CRT are not always an early sign of shock, it can be the opposite, early (acute compensatory) shock can show as brick red gums (hyperemic) with a fast CRT, before progressing to the next (early decompensatory) stage of shock, which will then show as pale MMs and slow CRT, by then its very serious. The abdominal swelling behind the ribs is also not always present, that is a common sign in less fit dogs, well conditioned dogs such as sporting or working dogs, or if you do any fitness with your pet, can have a good strong abdominal core which can hold the stomach up under the rib cage, then when the stomach expands will show as distention in the rib cage with a more barrel like shape to the whole body. Tripod stance, legs apart to take pressure off the abdomen. A rapid thready pulse. Shallow, rapid breathing as the stomach puts pressure on the diaghram and lungs, preventing the lungs from inflating. The most common earliest sign is often your dog just not seeming himself, unable to get comfortable, just keep a close watch, palpate the abdomen, it should feel soft, you should be able to get your fingers partially up under the ribs, know what feels normal for YOUR dog. If you have any doubt at all at anytime, just go to a Vet, in some cases it can and does progress very fast, many think it builds up slowly over a few hours, it can, but not always, it can in some cases progress and kill in less than 30 mins, GDV kills in 2 ways, rapid or slow, rapid is due to obstructive shock and can progress fast!

Understand what is normal for YOUR dog, and the signs of GDV, the signs are not always clear, they are never the same for every dog.

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PART 4 – Emergency Prehospital Care

This is a serious, but important topic, and not something you will find in a typical canine first aid course for obvious reasons. Emergency Prehospital Care for GDV involves decompression of the stomach, fluid therapy and oxygen if you have that capability but that is beyond the scope of most of us, you can learn needle decompression, the challenge may be finding a professional to teach you, some will not agree with me sharing it here, some vets are not willing to teach it because its considered too invasive, some vets are willing, I have included it here just for information because the problem with not giving people information even though its well mean't, is they then turn to the internet or other sources, and I know some pet owners are teaching this and tubing in some breed club seminars, just be carefull where you learn anything from, there is nothing here I have learnt from a pet owner, only vets/medics.

Personally I believe if someone is responsible enough to seek training from a professional then it should be available in this case, but everyone’s experience is different so they will have differing opinions. Just ask those that have lost dogs to bloat without even making it to a vet.

I had to decompress my own dog (I had training from my vet) as stated earlier, I also got criticised by 2 people for doing it, one of them was a canine first aid instructor who's course I attended, funnily enough she admitted she'd never actually seen bloat in a dog, let alone had to deal with it. The other was a pet owner. Every veterinary professional I've spoken to since about it including my own vet, doesn't have a problem, why? Because they understand what it might take to save a life, though I do speak to the ones who teach this stuff. I had a good conversation about my experience with a vet I did some first aid training with, she teaches it to clients who want to learn, she did also say that some of her colleagues wouldn't feel comfortable teaching it to their clients, "it is a last resort" she said.

K9TCCC/TECC, First Aid, Prehospital Care, whatever you want to call it, is a hot topic at the moment, there are a few qualified individuals/companies running training, sharing their knowledge to help save lives, there are some great, experienced professionals in the US doing great things for Working Dogs at the moment, there are also those that don't have experience of what they are teaching, one thing those with experience say is seek knowledge and training from those that have experience, and have actually done what they teach. So if you do any type of training, don't be frightened to ask what experience the instructor has, and have they actually done what they teach? I have found those who have, who understand, are only too happy to share their knowledge, and answer questions, I've spoken to a few in the Working Dog community and learned a lot from them and the information they share, they are good people doing great things for dogs.

Understand you may never need to do this, many dogs do survive bloat, but many also do not, but if this article encourages people to learn more, may be speak to their vet about it, or even save one life, then it's worth it.

I am not a medical professional, this is just what I have learnt, some of the information comes from my own vet and I’ve shared other sources in part 7.

I had a conversation with my own vet a few months after someone close to me lost her dog to bloat, as he didn’t even make it to the van, let alone the vet. I asked my vet if there is anything I could do in that situation? If I couldn’t get to a vet in time? She said “well there is, but it does have risks". Then she said two things that stuck with me word for word, to quote her “I have clients with Great Danes that regularly bloat, I show them what to do and send them away with needles, I can show you if you like"…. “if you’re not going to make it to a vet in time, you might as well try".

In the US, VetCOT (Veterinary Committee on Trauma) published their “Best Practice Recommendations for Prehospital Veterinary Care of Dogs and Cats” in 2016, in each section of that paper on each condition it gives separate recommendations for responders with minimal to no medical training, and medics, in the section on GDV (bloat), it recommends for both medics and non medics (if trained) in the setting of delayed veterinary care to perform gastric needle decompression (trocarization).

To quote from that same section “Field or home decompression of bloat has been advised for many years, trocarization of the stomach is a reasonable intervention in the field in a dog in extremis".

These 3 quotes put into perspective just how serious bloat is.

All dog first aid courses cover bloat in the sense they teach you how to recognise it, signs and symptoms, risk factors, then once you realise or suspect your dog is bloating to take them straight to a vet, which is absolutely correct, the only problem with that is it assumes you catch it early and are able to get to a vet in time before the damage is done.

Unfortunately its not always that simple, many dogs do get to a vet in time and survive, many don’t, there are many factors involved, we can’t all be with our dogs every minute of the day, your dog may be kenneled or you may be out and come home to find your dog bloating, you may come downstairs in the middle of the night to find your dog bloating, get them out of the car after a trip out and they are bloating, then there is the trip to the vet, time of day, road/weather conditions, distance to vet, traffic, it can be a long drive, all can have an effect, plus bloat doesn’t always build up slowly over a few hours, it can kill very fast, then if you do get to the vet with your dog still alive that is no guarantee they will survive.

The biggest factor which determines whether a dog suffering bloat will survive is not getting to the vet, it's the quicker the dog receives treatment, that is someone actively treating the dog, by giving fluids to raise the blood pressure and decompression of the stomach to take the pressure off the vital blood vessels trying to carry blood back to the heart, whether the vet does it or someone else, the timing is critical, once blood flow is cut off to parts of the body tissues, and toxins start to build up, your dog only has minutes before irreversible damage is done. Circulatory shock is the immediate life threat. I also had a conversation with a veterinary technician regarding field treatment of bloat, and to quote her “Your first field treatment of a GDV is a gastric decompression to return blood flow back to the heart which returns oxygen to the vital organs including the brain. Time is tissue".

Decompression is not a cure, the dog will need surgery, but it can buy your dog valuable time, and it can be done as many times as you need to on the way to the vet. There are several cases of military dogs bloating hours from a vet, being repeatedly decompressed on their way to the vet.

There is an excellent paper written by Dr. Lee Palmer (a military veterinarian) who is also one of the leads of the K9TECC (tactical emergency casualty care) working group, titled “Prehospital Care of Canine Gastric Dilatation Volvulous”, to quote from his paper “Gastric Needle Decompression is a rather simple procedure easily learned by anyone. Despite its simplicity, GNDC does carry some inherent risks; therefore only those properly trained in the procedure should perform it".

Needle Decompression should ideally be performed along with IV fluid resuscitation to treat shock but that is not always available in the field and is beyond the scope of most of us, in that case needle decompression is still warranted.

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Training:

Learning how to do it. You need hands on training with a professional to do it.

In the US there are some very reputable companies teaching canine emergency field care such as www.vettacgroup.com , www.k9medic.com , www.dustoffk9.com , all of which cover GDV, they primarily teach to working dog handlers and emergency medicine providers but do run some training for active pet owners, contact them for more information, they are a great bunch of professionals doing great things for dogs.

In the UK you need to speak with your vet.

Needle Decompression can be done in a conscious or unconscious dog with a 14g 3¼ inch over the needle catheter.

Some say do it on the right side to avoid the spleen which naturally resides on the left side, if you hit the spleen it will bleed like crazy but it’s not usually life threatening, in reality when the stomach twists the spleen can be anywhere as its attached to the stomach, so you can do it on either side, to reduce the risk of hitting the spleen percuss, or tap the distended abdomen with your fingers while listening with a stethoscope or your ear against the abdomen, when the abdomen is distended and taut it will sound like a drum if the gas pocket is behind and loudest where it's closer to the abdominal wall, if it’s more of a dull sound its likely the spleen maybe there, so check the other side, this is usually just behind the last rib at the most distended point.

Don’t delay transport, transport immediately and treat en-route to the vet, pull over, do it, then get going, if it’s a long drive and you need to, pull over and do it again. If successful you should see a rapid Improvement.

When you get to the vet, make sure you tell them you’ve done it whether successful or not, how many times, and where, they need to know.

RISKS:

Hitting the spleen

It not being bloat and hitting the bowel. Both these injuries are usually well tolerated.

Reperfusion Injury

Releasing toxins if it's gone on for too long.

Complications with trocarizing are rare if performed by someone trained in the procedure. The benefits out way any risks if you're not going to make it to a vet in time.

IMPORTANT: you should only do this if you have hands-on training in distinguishing bloat from other medical conditions, proper anatomical landmarks, and handling the needle.

You could say it’s similar to a cardiac arrest and performing CPR, in the sense that time may not be on the patients side, and to quote one trauma vet “if it needs doing, then it needs doing”.

Bloat is a Killer…. “if you’re not going to make it to a vet in time, you might as well try".

It’s something to consider.

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PART 5 – Emergency Plan

Do you have an emergency plan for your dog?

I see posts on FB of dog owners asking if anyone knows of an emergency vet, and they are asking when its an emergency, I'm not criticising, some people don't realise or just don't think about this because they've never had a real emergency before, so….

You may know how to spot it, and act quickly, but do you have an emergency plan?

• Do you know your vet's out of hours emergency procedure? • Does your vet have their own out of hours emergency service or do they subscribe to an out of hours service elsewhere? • Do you have a backup vet if you can't get hold of your usual vet? That's happened to me once. • Not all vets and clinics are capable of dealing with a major condition or trauma, the closest may not be the best choice, check! • Even if your vet can deal with your emergency, are they willing and able to keep your sick dog in over night after treatment or do you need to transport your dog to another vet to stay in over night for monitoring? Yes, that does happen! • If you are on holiday with your dog do you know where the nearest suitable emergency vet is located?

Remember, time is against you, every minute counts, all too often I hear people say "catch it early, get to a vet fast"…. "you may have a couple of hours", you may, but not always, no matter how early you catch it! And not just in the case of bloat.

Something to think about, especially at this time with a shortage of vets.

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PART 6 – Prevention

The only prevention tactic with a very high success rate is a prophylactic Gastropexy, it does not prevent a simple bloat but stops the stomach rotating.

Some owners will tell you it doesn't work because they had their dog gastropexied and the dog still bloated, in some cases died, nothing is 100% guaranteed, however it does have a very high success rate in the prevention of GDV if it is performed correctly. It's more commonly done at the time of the emergency surgery when treating a dog suffering a GDV, it seems more popular as a preventative measure in the US than here in the UK, I don't know about other countries. Its commonly done in bitches at the same time as a spay.

The goal of a gastropexy is to create a permanent adhesion between the gastric wall and the abdominal wall. Ideally, a gastropexy should create a strong adherence, have minimal complications, not affect the stomach's natural orientation or markedly alter gastric outflow, and require minimal postoperative management. Gastropexy is usually performed by attaching the pyloric antrum to the right abdominal wall to prevent further gastric rotation.

There are several types of gastropexies, including incorporating, tube, circumcostal, belt-loop, laparoscopic-assisted, and incisional. No controlled studies have compared adhesion strength, clinical outcome, and physiologic impact of all the gastropexy techniques, so the choice of procedure is often based on the veterinarian's preference.

The US military gastropexy all DoD Working Dogs before they enter training and they have an extremely high success rate, they have gone from losing about 10% per year to GDV to losses of 0.1%.

Other prevention strategies such as limiting exercise before and after feeding, restricting water after feeding and feeding certain diets have no scientific evidence that they work. Some will tell you that raw fed dogs don’t bloat and that is simply not true, all the dogs I’ve known that bloated were all fed either kibble or raw. I can say that I’ve known people personaly who follow these strategies religiously and still have their dog bloat, some don’t have a dog bloat and so they think they work, I know people who limit exercise and don’t have a dog bloat and some do, I’ve known people who have for many years given their dogs light exercise such as a walk close after feeding and never had a dog bloat, you have to do what you think is right for your dog, just understand nothing is guaranteed to prevent bloat so don’t let anything you are told or read give you a false sense of security.

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PART 7 – Further Information:

Veterinary Tactical Group's GDV Webinar presented by Dr. Janice Baker, DVM. An excellent 1hr 30min presentation covering the facts, risk factors, signs & recognition, field treatment and prevention. https://veterinary-tactical-group.square.site/product/2020-gastric-dilation-volvulus-a-working-dog-dilemma/333?cs=true

Prehospital Care of Canine Gastric Dilatation and Volvulous by Dr. Lee Palmer, DVM. https://www.jsomonline.org/jsomstorefront/index.php?rt=product/product&keyword=Canine&category_id=0&product_id=2542

VetCOT's Best Practice Recommendations for Prehospital Veterinary Care of Dogs and Cats: The objective of these guidelines were to examine available evidence on prehospital care in human and veterinary trauma and emergency medicine and develop best practice guidelines for use by both paramedical and nonparamedical personnel in the approach to the prehospital care of dogs and cats. Section 12: GDV, is on page 213. http://users.neo.registeredsite.com/1/2/1/13151121/assets/Best_Recommendations_for_Prehospital_Veterinary_Care_of_Dogs_and_Cats.pdf

Clinical Management of Military Working Dogs by Joint Trauma System: There is a brief but informative 6min section on GDV in this video presentation from the Joint Trauma System's continuing education conference Clinical Management of Military Working Dog's Presentation for human HCP's. Presented by Dr. Michael Lagutchik, a civilian Veterinarian from the Military Working Dog centre at Lackland, USA. https://deployedmedicine.com/content/1265

Gastric Dilatation And Volvulus In Working Dogs: World Small Animal Veterinary Association World Congress Proceedings, 2013 Kate Hill Centre for Service and Working Dog Health, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand https://www.vin.com/apputil/content/defaultadv1.aspx?pId=11372&catId=35321&id=5709943

Bloat – What You Know Can Save Your Dog's Life by Dr. Alexis Newman, DVM https://issuu.com/workingdogmagazine/docs/vetcheck_1acd1b26c1c6ce

Bloating Akita A video showing a dog in the middle to late middle stages of bloat. Used by some as a training video, some may find it a difficult watch. This dog, Roscoe, was saved. https://m.youtube.com/watch?v=U1WrT2719yo&feature=youtu.be

Another video example of a dog bloating, it doesn't look as serious as the previous example but this dog is in a serious condition, apart from his stomach distension he looks pretty good in himself while at the vet waiting to go to the ER, those who might not have a good understanding of bloat may be tempted to wait and see. This video along with the previous shows the variation in how bloat can present, it is never the same for every dog, know what is normal for YOUR dog. https://m.youtube.com/watch?v=37Xs10PQEmk&feature=youtu.be

A good visual presentation of what GDV/Bloat is, and does, if you are not familiar, and may help you understand why it may present with some of the signs & symptoms which it sometimes does. https://m.youtube.com/watch?v=rf3bZUpMlN8&feature=youtu.be

Needle Decompression Here is a video of a vet demonstrating needle decompression, albeit in a clinic setting. https://www.atdove.org/video/gdv-gastric-trocarization

FREE Webinar – BLOAT: What Every Dog Owner Needs to Know. Published 2014 Presented by Dr. Elizabeth Rozanski DVM - a board-certified specialist in emergency and critical care medicine. http://www.vetvine.com/article/164/bl

FREE Webinar – GDV: What we know, and what we wish we knew. Published 2021 The 2nd Webinar Presented by Dr. Elizabeth Rozanski DVM In this webinar Dr. Rozanski provides updates on our current knowledge and understanding about GDV in dogs. Her discussion includes: •What is known about the genetic aspects of GDV •The pathophysiology and treatment of GDV •Why some dogs who develop GDV do poorly •Preventative measures including surgical gastropexy •Our current challenges with GDV in dogs, ongoing research efforts, and possible targets Running time: 57 minutes followed by 7 minutes of Q&A https://www.vetvine.com/article/704/gdv-what-we-know-and-what-we-wish-we-knew#global_content

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PART 8 – Final Words

Many have experienced bloat, many have lost dogs to bloat, some never even made it to the vet, some dogs died shortly after arriving at the vet.

Some dog owners and vet professionals may not agree with everything here, some vet professionals don’t even agree with each other.

There is a lot of misinformation out there on bloat, I have tried to give an honest picture of this condition with accurate information, a condition which takes the lives of many dogs in a horrific way, I am not a medical professional, this is just what I have learnt from my own experience and knowledgeable professionals who have real world experience with this.

With bloat I have learnt there are 2 types of people, those that can't or don't want to face it or even talk about (which is understandable), and those like me that want to learn everything they can incase they have to deal with it again and give their dog the best chance of survival, unfortunately for some, it happens more than once.

I was never satisfied with the only choice available to me being to put my dog in the car and drive to the vet, depending on the degree of bloat and distance/time to the vet that can be a roll of the dice, a 50/50 chance for the dog or less, to me that is not good enough, granted some wouldn't be able to put a needle in their own dog, I know I've done it and it's not easy, well not mentally, I had to look my dog in the face, see the pain in his face and watch him struggling to breath, there was no one else but me to help him and I wouldn't wish it on anyone. I'm afraid life can be cruel, and sometimes you need to take aggressive measures to save a life.

I can guarantee 3 things if you ever experience bloat in your own dog, you will be scared, you will pray you make it to a vet in time and, no matter what the outcome, you will never forget.

Many of the sources of information I mention in this article are professionals that have experience with bloat and prehospital care of bloat (clinical and prehospital care are not the same, a more clinical aspect of care doesn’t always work in emergency field care), they know what they are talking about.

If you are new to this hopefully this will help or at least give you a starting point but as they say “hope is not a good plan” and the last thing you will want to be in a bad situation with your dog is helpless, so don’t be, the knowledge you gain is ultimately what can save your dog's life, along with your Mindset and Training, staying calm so you can make good decisions quickly.

For the dogs 🐾