Stefanie asked a good question...
What is the recommendation for feeding and exercising a dog - especially for deep-chested breeds that are prone to bloat? Is it better to walk a dog first thing in the morning and then wait and hour and feed him/her or feed first, wait an hour and then exercise?
This is a condition that I have personal experience with. When I was 16 we had a German shepherd that had to be euthanized because he developed bloat. We had gotten him when I was three years old, so it was hard for me as that was my friend as I grew up.
For those who aren't aware, let me describe what is commonly called "bloat" in dogs. The proper medical name is gastric dilatation and volvulus, or GDV. In this condition the stomach twists, either rotating along it's axis or flipping 180 degrees. In either case, the inflow and outflow of the stomach are closed off resulting in gasses building up inside the stomach. This can cause difficulty breathing as the stomach balloons against the diaphragm, but more importantly pressure against the wall of the stomach can cut off the blood supply and lead to a rupture. As can be imagined, this is a critical condition and dogs can die quickly once it begins.
Dogs that bloat most commonly act and look like they swallowed a large beach ball. Their abdomen becomes large and tense, their gums can become pale, they will become suddenly lethargic, and will usually act like they are gagging or retching. If you see your dog act like this with a bloated belly, consider this a life-or-death emergency and see a vet immediately.
Though this can theoretically happen in any dog, there are definitely certain breeds that are more prone to GDV. These breeds include English bulldogs, Weimaraners, Rottweilers, German shepherds, Great Danes, and any other large, deep-chested breed. Though it seems like it's a genetic breed tendency, it's really more a factor of the anatomy of these breeds based on their size and shape. Studies have looked at how to prevent it, and there is really only one thing that has been shown to significantly increase the risk--exercise after filling the stomach with food or water. So take a dog of the right size and breed, fill their stomach with food or water, then let them run around a lot. That's a formula for bloat.
Here are precautions to take to help prevent this deadly condition:
* Wait at least one hour after eating or drinking before allowing exercise. This is the main factor shown to prevent bloat.
* Don't encourage your dog to roll over. Though a low risk, the twisting action has been shown to lead to bloat. In fact, some veterinarians do not rotate a dog over their back while anesthetized due to this risk.
* Feed 2-3 meals during the day rather than one large meal. However, be sure that you're taking the measured amount of daily food and dividing it into the meals rather than giving the once daily amount two or three times.
* Don't allow excessive water drinking immediately before or after a meal. Abnormal amounts of water have the potential to delay breakdown of food and lead to gas production.
* DO NOT raise the food bowl. While this was at one time thought to prevent bloat, a study in 2000 showed that this can actually increase the risk.
* Dogs who have had episodes of GDV are at risk for further occurrences. A surgery can be performed to attach the outside lining of the stomach to the body wall (gastropexy). While this doesn't completely prevent the stomach from rotating, it does lower the risk. Some advocate having this surgery performed routinely on high-risk breeds, but personally I disagree. Even in breeds that are prone to bloat most will never have this happen, and I don't think the benefits of the procedure (since it's not a guarantee that it will never happen) outweigh the risks. Remember, this is only in cases of preventative surgery. I certainly do think that it should be done in a dog who has bloated once since they show a personal tendency.
Stefanie, I hope this fully answers your question. This is a horrible thing to happen, and I hope it never happens to one of your dogs.
I have to disagree with the recommendation not to pexy. All Great Danes should be pexied (in my book). The current estimates/literature show that 1/4 Great Danes will develop a GDV. If my chances of winning the lottery were 25%, I sure as heck would play!
ReplyDeleteAlso, I think at risk breeds (Dobies, Weims, etc) that are female should definitely be pexied when they are spayed. You're already in there, why not?
I do agree that as many as 25% of Great Danes will bloat. But personally I'd rather bet on the 75% chance of them not bloating. Again, that's my personal opinion. Also, we're not dealing with spending a dollar on a lottery ticket. We're talking about surgery and all of the complications that can happen.
ReplyDeleteAlso, the incision you make for a spay is different than the one you make for a stomach surgery. Even with a relatively minor stomach surgery like a gastropexy, you'd have to extend the incision by a few inches (which is more than it may sound) and do surgery in a location pretty far from the area of a spay. All of that is going to extend your surgery time as well as take longer to close and have a longer incision. It's not as simple as "already being there" because the surgical locations are quite different.
I think you're going to get a variety of opinions on the necessity of the surgery. Keep in mind that a gastropexy doesn't eliminate the risk of bloat, as it can happen even when the surgery has been performed correctly. It does lower the risk, but I personally don't feel that it's enough to overcome the risks inherent in a surgery like this. And in almost 14 years of general practice I've never regretted this viewpoint.
As an ER veterinarian, I see the other side - the 25% that do bloat. The owners always ask me - could this have been prevented? I explain that while gastropexy doesn't always prevent a bloat, it is certainly a recommended surgery (again, in my opinion) for at risk breeds and helps prevent it from happening.
ReplyDeleteHaving done lots of pexies on bloated patients, I don't find the procedure to be particularly tricky (the pexy itself), and I can comfortably say it would probably add 15 minutes to my surgery time if I were already in for a spay (although I don't do GP, so I' probably way slower at a "normal" spay than you are).
I agree that the surgical incision is much longer - but as they say in vet school - incisions heal side-to-side, not end to end. Length doesn't really matter.
On that note, we can agree to disagree. I do think it should be offered to owners with at risk breeds (esp Great Danes) with everything you said explained - that the risk of GDV still exists and that it's a longer incision and surgery, etc.
Those are all good points. And I do agree that a long incision heals as quickly as a small one. But I get more concerned about total surgery time. It's interesting because I might be faster at a spay, but the pexy would probably add more than 15 minutes because I don't do as many of them.
ReplyDeleteOn a slightly different note, I think this brings up an interesting difference between specialists and generalists. ER doctors like yourself see a high concentration of the bad cases. GPs like me see the occasional bad case mixed in with the numerous good ones. So while my view may be skewed by the 1 case of bloat I see per year and the hundreds of normal patients I see weekly, yours is skewed by the weekly or monthly bloat cases you see. The real incidence is probably somewhere in the middle.
Hmmmm. And this discussion gives me a couple of good blog topics. Coming this week!
Great points from both of you. I agree with explaining the pros and cons and letting the owner decide.
ReplyDeletehaving witnessed Mr Rock J Dog go through a bloat I will now have every large breed dog I rescue pexied.
ReplyDeleteOnce a dog bloats there is such a high risk of death. Shock, toxins from blood build up, heart problems, stomach and spleen damage it is just not worth the risk for me to take with my dog. Although he may bloat again even with the stomach tacked I would rather have a better chance of saving my dog.
It is really hard to list what can lead to bloat, for instance even with the study of elevated bowls there are some that say the data is skewed. The reason being is one of the questions asked when a dog bloated was he eating from an elevated bowl. If yes it went into the cause of bloat column. It did not take into account the dogs that eat with elevated bowls and do not bloat.
To be on the safe side though I did take away elevated bowls.
On another point, stress can be a big factor in bloat. On an Irish wolf hound site they did a survey and 80 percent of the bloat cases all had a stress situation being the start of bloat.
We had a little dog yappy dog that was staying with us for a few days.
We had to keep him seperate from Rocky but he drove Rock crazy with that yappin.
I think the stress of all that yapping caused Rock to stress and bloat. ( of course being a bullmastiff puts him in the possible category and stress was the button)
Has anyone ever heard of a acupressure point that causes Peristalsis? Does anyone have any experience with this?
The acupressure point is on the hind leg. If you start at the hock, on the front of the leg (anterior) you can feel the tibia. Move your hand up the leg along the tibia’s sharp crest; what in humans would be called the shin. As your hand approaches the stifle, or the "knee" the crest becomes very pronounced and then curls around to the outside (laterally). Just inside this curve is a depression. The acupressure point is in this depression.
Thank you Dr. Bern. That did answers my question and I have to say I didn't know that raised bowls could actually contribute to bloat. Although what's the solution for a dog with severe arthritis? I was told by my vet the raised bowls help with that. Bloat sounds painful for the dog and I really hope I never have any fosters in my care that have that happen to them - but if they do at least I've been educated on what to do (seek vet help immediately!).
ReplyDeleteI've never heard of raised bowls helping with arthritis. I can imagine that if there is pain in the neck it would help not to bend the neck. But most arthritis pain is in the limb joints, and a raised bowl won't affect this at all.
ReplyDeleteIn fact, the only condition I know of where raised bowls absolutely DO help is with megaesophagus.
These comments are a great example of great communication among colleagues! I like the productive communication! I was wondering, I have heard that wetting the dog's food (if it is a dry food) also helps prevent bloat, do you know if there are any significant studies on this or have a personal opinion, my boyfriend and I have a German Shepard. Thanks!
ReplyDeleteI just adopted a 1/2 great dane 1/2 english mastiff... what are his odds of bloat and should he not have elevated food bowls? I thought that's something Danes needed. I'm confused now.
ReplyDeleteGo back and read the blog, as it answers your questions. Deep-chested dogs are at an increased risk of bloating, but it's hard to put a specific risk number on a given dog. Also, read my comments about elevated bowls. This is NOT currently recommended, and anyone still saying this isn't aware of current research.
ReplyDelete... okay, I went back and read the blog again. It just said there's a study in 2000 that says food bowls shouldn't be elevated. I'd like to know why.. is there somewhere I can see the study? I'd like to take it into my vet to read. Thanks.
ReplyDeleteI don't have the study and can't point you to a link, but the idea is that an elevated food bowl causes them to swallow more air. This fills up the stomach and can lead to an increased risk of bloating. Elevating the bowl doesn't slow down the feeding or otherwise lead to a change in the conditions of bloat. In fact, the only condition that elevated food bowls has been shown to help is megaesophagus.
ReplyDeleteThis is one of these things that gets passed around but has no real proof behind it, and it's not the only one. I challenge anyone to find an original source or study that says that elevated food bowls will help. Honestly, this is anecdotal and I doubt anyone can show definitive evidence.
What can be done to prevent a reoccurance of bloat? Do you advise the use of Gas-X or any similar product? What about grains in the food? Have read it is best to avoid all foods containing grains due to the fermation in the stomach.
ReplyDeleteIf bloat occurs, the best prevention is a gastropexy (tacking surgery), avoiding elevated bowls, and avoiding eating or drinking close to exercise. I haven't heard about avoiding grains, and would want to see some data. A dog's stomach contents empty in less than two hours after ingestion, which isn't typically enough time for fermentation. Gas prevention medications may help, but again I'd want to see a specialists opinion on this.
ReplyDeleteThis is the first I've heard of rolling on their back increasing the risk of bloat.
ReplyDeleteMy GSD (5 year old, plexied/spayed female with no history of bloat) sleeps on her back most nights. Is this something I should discourage her from doing?
Thank you.
I have read this whole page and find it very informative. Thank you so much. I do have some questions about bloat and Great Danes. Is there a certain age at which they become more at risk? And, do you know what the success rate of the pexy is? I have a 5 month old. Everyone I talk to tells me about Danes and bloat. I am thinking about having her stomach attached when I have her spayed.
ReplyDeleteJessica, the issue of rolling on the back is still debatable and I've not seen a lot of evidence for it one way or the other. It is, however, one of the things that is mentioned as a potential risk factor.
ReplyDeleteBrandon, I've not seen data on a age-related risk factor, though I do believe that adults are much more prone than puppies. I also don't know the success rate of the pexy surgery, as many of the dogs who have this done would never have bloated anyway. We also do know that dogs with a pexy can still bloat. Someone else may have hard numbers but I haven't seen them.