What is GDV?
GDV (gastric dilatation and volvulus) is a very sudden and serious condition seen in dogs where, due to range of factors, the stomach first dilates (bloats), and subsequently rotates (twists) on itself. This leads to the entrapment of fluid and gas in the bloated stomach. As the stomach becomes increasingly distended, pressure builds in the abdomen, choking blood vessels and leading to severe shock, damage to the spleen, stomach, and other organs, and ultimately death.
The mother of all emergencies, GDV is undoubtedly the most severe and acute life-threatening presentation seen in veterinary practices. It presents not only a medical challenge in terms of stabilisation of the patient before surgery and ongoing post-surgical care, but also a huge challenge with the need for urgent corrective surgical treatment.
The condition can certainly be treated successfully, and with rapid recognition by owners and prompt veterinary attention, many patients do survive. However, due to a range of factors including delays to presentation, complications arising from shock and widespread organ damage, post-surgical complications and the cost of treatment, the mortality rate can be quite high.
WHICH DOGS ARE AT RISK OF GDV?
GDV is very much a condition of large and giant breed dogs. While it has been reported in small breed dogs, this is rare. While any large or giant breed dog is at risk, it has been found that those that are “deep-chested” (having a deeper and narrower chest cavity) are at increased risk.
Having a relative who has suffered from GDV definitely increases the risk of GDV in your dog. The incidence across all large and giant breed dogs has been reported at 6%, however there are certainly breeds where the individual risk is higher than this.
Given that any large or giant breed of dog could develop GDV, it is not possible to present a definitive list of breeds in which the condition occurs, or conversely a list of breeds where it cannot occur. However, there are breeds in which we do certainly recognise an increased risk.
Great Danes have the highest incidence of GDV. Other breeds commonly affected include any of the Mastiff breeds, the German Shepherd, Rottweiler, Standard Poodle, Boxer, Doberman, Saint Bernard, Bernese Mountain Dog, Irish and Gordon Setter, Weimaraner, Irish Wolfhound, and Newfoundland.
HOW IS GDV TREATED?
As noted above, GDV represents a critical emergency with challenging medical and surgical aspects. Successful treatment requires early recognition of the problem by the owner, rapid attention by a veterinarian, and swift medical stabilisation and surgical intervention in a hospital setting.
Surgical correction of GDV requires the abdomen to be opened and the stomach de-rotated (untwisted) to allow decompression (removal of gas and fluid), which helps restore normal circulation around the body, and to vital organs. Sometimes, because of blood vessels being blocked off, severe damage to the spleen and stomach wall occurs, meaning that the spleen, and sometimes parts of the stomach may need to be removed.
Once the stomach is de-rotated, a procedure called gastropexy is performed, whereby the stomach wall is cut and sutured to the internal abdominal wall, thereby preventing the stomach from twisting out of its normal position ever again.
CAN GDV BE PREVENTED?
When a dog suffers from GDV, the stomach first dilates, and then twists. Dilation of the stomach results in discomfort, but once the twisting occurs, the consequences are immediately life threatening. Once a dog has had a gastropexy, the stomach is still able to dilate, but it cannot twist, and so life threatening GDV is prevented from developing.
To prevent GDV in the first place, we can perform what is called a prophylactic (preventative) gastropexy. When performed on a healthy dog, the operation is very similar in some respects to what is done on a dog suffering from GDV (after the stomach is de-rotated), without the emergency and potential for life threatening complications that go with GDV.
Before now, prophylactic gastropexy has been available to owners of at-risk dogs for some time and would often be recommended at the same time as desexing. However, because it was relatively involved and required a large incision into the abdomen, it was seldom performed.
Thanks to technological advances in the field of minimally invasive surgery and laparoscopy, we are now able to offer Laparoscopic Assisted Gastropexy. With this technique, using a laparoscopic view of the abdominal organs and stomach, a gastropexy can be performed via two small incisions. The procedure is far less invasive, in many cases faster, with far less pain during the recovery period.
Laparoscopic Assisted Gastropexy can be performed as a standalone procedure or at the same time as desexing in any at-risk dog. Once performed, this surgery will significantly reduce the risk of GDV, down to a negligible level. Please feel free to discuss whether a prophylactic gastropexy is appropriate for your dog, with any of our veterinarians.