The "B" Word
When you share your life with dogs, there is a seemingly endless list of things to worry about. Among the most terrifying “what ifs?” are the ones that can’t be reasonably prevented; they tiptoe in when you least expect, like a stealthy home intruder who can breach any safe room.
And topping that list is bloat.
Gastric dilatation, informally called bloat, is a condition where a dog’s stomach rapidly fills with gas. In a lethal second step, called volvulus, or tortion, the stomach twists; without fast surgical intervention, the tissue will die, and the dog soon after. While no one knows exactly why bloat happens, a dog’s anatomy (deep-chested breeds seem most vulnerable), temperament (“nervous” types might gulp more air and trigger an episode) and heredity are all thought to play a role.
Bloat is diagnosed with an X-ray, like this one.
Tips for avoiding bloat are similarly infuriating in their lack of definitiveness. Dividing up food into small meals, avoiding exercise and water consumption before eating and administering over-the-counter medications that reduce gas, such as “De Gas” or PeptoBismol, are all recommended, but none are sure fire. Some advice even contradicts itself: While the conventional wisdom has long been that eating from floor-level bowls increased the risk of bloating, much-publicized research from Purdue University has concluded just the opposite. And even tacking the stomach to the body wall (a procedure called a gastropexy) isn’t a guarantee that the dog won’t bloat again (though it’s almost impossible for the stomach to twist, which is the really dangerous part).
Consider the case of “Bee” (Ironline Honey Bee), a Bullmastiff owned by David Salisbury of Ironline Bullmastiffs in New South Wales, Australia.
After 20 years in the breed – and after having lost Bee’s dam Clara to bloat at age nine – Salisbury knew the precautions to take. On a day like any other in October 2014, he fed Bee her usual dinner of a high-quality kibble soaked in hot water and cooled, chicken carcass and chicken necks in a semi-raised bowl with no vigorous activity leading up to dinner.
Soon after, the warning signs appeared. “After observing Bee’s distended abdomen, dry retching, excessive salivation and general discomfort, I knew to get her straight into the car, as she was bloating,” he remembers.
Bee’s regular vet was about 25 minutes away, but Salisbury knew there wasn’t time to spare. He called ahead to a closer practice, and as he pulled up to their office, so did the veterinary surgeon, “in his touch-football gear as he was playing a game in a local competition and was just around the corner.”
The vet inserted a stomach tube, which suctioned out some stomach contents and gas. That stabilized Bee so he could take X-rays, which confirmed there was gastric dilation with a partial torsion – the stomach had twisted 180 degrees.
A lucky Bee recovering after surgery for bloat.
Rushing Bee into surgery, the veterinarian deflated her stomach, corrected the twist and emptied out the large amount of food that was still in there. Finally, he performed a gastropexy, tacking one side of the stomach to the abdominal wall with a couple of anchoring sutures – the simplest version of this procedure, as Bee had been under anesthesia for quite a while.
After the emergency intervention – and a $3,000 bill – Bee survived her bout with bloat.
Teddy the Dogue de Bordeaux wasn’t as lucky. His owner, Vicky Brown of Manchester, United Kingdom, was also hyper-aware of the dangers of bloat. “I became obsessed with reading up on it!” she says. “I made sure everyone in my house knew all the signs … I even made them watch videos.”
But one evening, Teddy suddenly bloated. Brown rushed home and got him to the emergency vet in less than a half-hour. It looked like the vet had gotten things under control, but complications developed during surgery: Teddy’s spleen burst, and he lost nearly two-thirds of his blood supply. He defied expectations by making it through the night, but 10 minutes after Brown visited him, he had a massive heart attack.
“I read up on the signs and symptoms, but there were no signs whatsoever,” Brown laments. “Now I always make sure I have Gaviscon when I hear the bubbling noises from their tummy,” she adds, referring to the over-the-counter medicine for acid reflux and heartburn. “They hate it, but I give them a squirt!”
Teddy the Dogue de Bordeaux died from complications of surgery after he bloated. The mortality rate for bloat can be as high as 33 percent.
As these stories show, the greatest tool Molosser owners can have when dealing with bloat are well-honed powers of observation: When minutes count, knowing your dog can make the difference in whether he lives or dies.
There is another tool you can have in your bloat arsenal, and that is a bloat kit. Essentially, these do-it-yourself kits give you the equipment and instructions you need to insert a stomach tube, which can buy you more time and prevent the stomach from twisting.
The idea of inserting the tube yourself understandably may make you squeamish. But when your dog’s life is hanging in the balance, you’d be surprised at what you might be able to do rather than sit idly by.
Below, respected Bullmastiff breeder-vet Sandra Statter explains how to properly insert the tube, as well as other emergency measures that can help stop the progression of bloat as you seek veterinary intervention.
Please note that this story is not a substitute for medical advice, and you should review any emergency plants with your veterinarian. In the case of bloat, getting your dog access to professional veterinary care as quickly as possible is crucial.
Using a Bloat Kit
By Sandra Statter, DVM, Showdown Bullmastiffs
Bloat (technically, gastric dilation-volvulus, or GDV) is a word that strikes fear in owners of Molosser breeds, and with good reason. It is a true emergency that can come on quickly and progress to a state of shock or death if not treated. With prompt medical, and likely surgical, treatment, dogs can survive bloat. Being prepared is the key. If you are able to recognize the signs early and act, the odds for survival are good.
Bloat can occur in any dog, but large breeds with deep and narrow chests seem to be at higher risk. There may be a genetic component, as having a close relative will also increase risk.
It is important to be able to recognize the symptoms of bloat and to know what to do if it is suspected. This is an uncomfortable condition, so a bloating dog will often be restless. A classical symptom is non-productive vomiting and excessive drooling. Oftentimes the abdomen will be visibly distended and hard. Do not rely on this, though! As the condition progresses, shock will ensue. If you suspect a dog may be bloating, you must get him to a veterinary hospital immediately. Radiographs can confirm if it is indeed bloat. The treatment will involve decompression of the stomach, stabilization and then likely surgery.
Dr. Statter no longer sells her bloat kits, but a similar product is available from Nature's Farmacy.
Because time is critical, there is the concern of being in a situation where immediate veterinary assistance is not available. This is the reason I used to put together emergency bloat kits. This is in no way meant to replace a visit to the vet, but rather to slow the progression of the condition in extenuating circumstances. Become familiar with the kit and what each item can be used for. Unwind the tube and pre-measure it to your dog, marking with a Sharpie pen (see instructions below). Note how your dog reacts with restraint and gentle opening of his mouth. Know what normal abdominal shape and tone are on your dog. Gently press into the abdomen with flat hands to feel how soft it is. Become familiar with the normal gum color and capillary refill time (the time it takes for color to return after blanching the gums by pressing a finger on them). Read through the directions, and imagine yourself performing them in a calm manner. Make sure you know where the closest 24-hour emergency veterinary hospital is as well.
Passing a Bloat Tube
Measure the tube by holding it alongside the dog, with the blunt end at the level of the last rib.
Using a pen or tape, mark the tube where it reaches the nose or mouth opening. (This is a step that can be done ahead of time, when you get a bloat tube.)
Position the dog so that he is backed into a corner.
Lubricate the blunted end of the tube.
You need to find something to be used as a mouth gag (roll of surgical tape, a large hard toy, a strong stick, etc.) and wedge it in the mouth.
Slowly feed the tube into the center of the dog’s mouth. Do not force the tube at any point. Excessive force can cause damage to the esophagus or stomach. Stop if you meet resistance or if the marked area of the tube reaches the lips. Fluid or stomach content may flow out of the tube.
Prior to removing the tube, fold the exposed end of the tube onto itself. This will prevent bringing stomach content into the dog’s mouth, causing aspiration.
Emergency Decompression
In a case where the dog cannot be transported to a veterinary facility and a bloat tube cannot be passed, you may try to decompress the stomach by trocharization. This is where a large-bore needle is passed through the body wall to release the air accumulated in the stomach.
Lay the dog on his side, preferably left side down. (The spleen is usually on the left side, but with torsion it could be shifted to the right.)
Locate a hard area of the abdomen, usually the highest point.
Using a large bore (i.e., 18 gauge) sterile needle, quickly jab the needle into the abdomen. There is some risk of puncturing the spleen, but if the situation is grave enough this may be a risk to take.