When an owner sees signs that suggest bloat, she should take her dog to the hospital immediately. If the dog is suffering from gastric dilatation and volvulus and is not treated, it will die in almost every case. The goals of treating bloat are to:
- Resolve the shock caused by reduced circulating blood flow (hypovolemia)
- Decompress the bloated stomach
- Correct the position of the stomach surgically if it has torsed
- Surgically remove devitalized or dying stomach, spleen or intestinal tissue
- “Tack” the stomach to the abdominal wall through a procedure called “gastropexy,” to reduce the chances of recurrence of this dangerous condition
When a dog comes into a veterinary hospital showing signs of bloat, the medical team will unite to prepare for emergency surgery to save the dog’s life. Typically, intravenous catheters will be placed immediately, to provide fluids for the dog to resolve dehydration and try to correct hypovolemic shock. Antibiotics may also be given intravenously. The distended stomach sometimes can be decompressed by putting a tube through the dog’s mouth, down its throat and esophagus and into the stomach, to provide an escape route for the accumulating gas. This is called orogastric intubation. If this is not possible or is unsuccessful, the veterinarian may attempt to relieve the stomach bloating by a procedure called percutaneous trocarization. Basically, this involves clipping, cleaning and otherwise preparing an abdominal entry site on the left side of the dog’s belly, just behind the last rib, and then inserting a large needle through all layers of the body wall directly into the stomach. If successful, there will be an immediate hissing sound, and foul-smelling gas will come out through the large-bore needle, much like popping a balloon.
When the stomach has actually rotated, surgery is necessary to return it to a normal position. It may be necessary to remove the spleen, if it is involved, which it often is. When abdominal surgery is performed to correct the consequences of bloat, most veterinarians recommend suturing or tacking the stomach to the abdominal wall using a procedure called gastropexy. This can greatly reduce the chances of recurrent torsion. Many owners of at-risk breeds have a gastropexy performed preventively at 2 or 3 years of age, to prevent their beloved pets from bloating/torsing later on in life.
Heart arrhythmias often occur within the first 36 hours after bloat surgery. Most veterinarians will keep the dog in the hospital for at least that period of time post-operatively, to monitor its heart function.
Dogs that bloat and torsion, even if they are treated promptly and surgically, still often die from their condition. If the stomach lining has already started to necrose by the time the dog goes to surgery, survival rates are even worse. However, if caught early enough and if a gastropexy is successfully performed, the chances of recurrence are slim.