Dog: Gastric Dilatation-Volvulus

General information

Other common/scientific names: bloat, GDV, gastric torsion, twisted stomach

Gastric dilatation (bloat) and volvulus (twisted) is a life-threatening condition that typically occurs in large and giant breed dogs. There are no home remedies for bloat. Therefore, if you suspect your dog is bloated, call your veterinarian immediately.

The normal stomach is located high in the abdomen and contains a small amount of gas, mucous and any food being digested. After receiving food from the esophagus, it undergoes a normal pattern of muscular contractions to grind food while moving this food into the small intestine.

In the dilated stomach, gas and/or food stretches the stomach to many times its normal size causing abdominal pain. The bloated stomach has a tendency to rotate or twist which occludes (shuts off) its blood supply resulting in stomach damage and preventing inflow and outflow of food. Since the spleen is attached to the stomach, it may also rotate compromising its blood supply. This is referred to as splenic torsion. Not all bloated stomachs will twist.

Damage is not limited to the stomach and spleen. The large, dilated stomach impedes on blood returning from the lower half of the body to the heart. If not treated and corrected quickly, this prevents the heart from pumping adequate amounts of blood to the body resulting in heart arrhythmias, multi-organ damage and systemic shock.

Abb. GS9Z3Q7J
Abb. GS9Z3Q7J: Schematic illustration of the canine gastrointestinal system showing the position of the stomach.


The exact cause of GDV is unknown and appears to occur as a result of a combination of factors. These factors include:

  • Dogs with deep, narrow chests such as Great Danes, St. Bernards, Weimaraners and Irish Setters. There may also be a genetic link to this condition.
  • Male dogs over seven years of age.
  • Dogs that swallow air and do not release this air by burping.
  • Dogs that are fed once a day as opposed to twice a day.
  • Dogs that eat rapidly or exercise soon after a meal.
  • Dogs that are more nervous, anxious or fearful.

Cardinal symptom

  • Retching
  • Abdominal distention


Clinical signs of GDV include retching or non-productive vomiting, abdominal distention (swollen belly), abdominal pain, restlessness and shortness of breath. If the stomach twists, the dog’s condition can deteriorate rapidly. These dogs soon become pale, develop a weak pulse and rapid heart rate, go into shock and collapse.


GDV is usually diagnosed by history and physical examination. At this point, treatment should be instituted immediately. Radiographs can be obtained to confirm diagnosis after treatment has been started.

Abb. GG20DTJ2
Abb. GG20DTJ2: Gastric Dilatation-Volvulus.
This is a radiograph showing a large, gas filled stomach which has most likely twisted.


For treatment to be successful, dogs with GDV must be treated immediately at a veterinary facility equipped and experienced with bloat. Treatment for shock with intravenous fluids, antibiotics and pain medication is administered initially. A cardiovascular monitor with an ECG (electrocardiogram) reading is used to monitor the dog’s cardiovascular status. Abnormal heart rhythms may need intravenous medications. The stomach is decompressed by passing a tube into the stomach or inserting a large needle into the stomach to remove the air. Once the dog has stabilized, abdominal surgery must be performed to properly reposition the stomach. Once the stomach is repositioned, it is sutured in place to prevent a recurrence. This procedure is called a gastropexy. The stomach, spleen and surrounding organs are assessed for damage. If the spleen is irreversibly damaged, it may need to be removed. Multi-organ damage may warrant euthanasia.

Post operative complications include heart abnormalities, infection, stomach ulceration or perforation and damage to the liver and pancreas. These dogs will need hospitalization and intensive monitoring for several days.


Early intervention is essential and can drastically improve a dog’s prognosis. If GDV is treated aggressively within a couple hours of developing and no complications are encountered, the prognosis is good. Survival rates can approach 80%. Delayed treatment, organ damage and post operative complications carry a grave prognosis.


Owners of susceptible breeds should be educated about GDV and able to recognize the early signs of bloat. Dogs that survive bloat are more likely to bloat in the future; therefore prevention and medical management must be discussed. Large breed dogs should be fed two to three times daily. Exercise, excitement and stress should be avoided an hour before and two hours after feeding. Diet changes should be made gradually.

A gastropexy can be performed as a preventative procedure in high risk dogs. This is commonly performed at the time of spaying or castrating.


After surgery, it is very important that the dog does not lick or pull at the sutures. A second surgery can be necessary if the dog removes the sutures too soon. A special collar (E-collar or Elizabethan collar) is worn by the dog to prevent this. While this collar may seem uncomfortable, most dogs tolerate it well. It may need to be removed to allow the dog to eat.


Because GDV is a veterinary emergency, it is vital that owners with susceptible breeds have a good relationship with a veterinarian capable of treating bloat. Life-threatening complications and death are not uncommon with this condition.

Update version: 4/24/2014, © Copyright by
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