There is no cause of abdominal distention that is not a medical emergency, although some causes are more "emergent" than others. The most emergent of these causes results when the stomach distends with gas and twists on itself - referred to as Gastric Dilatation and Volvulous or GDV. While many causes of abdominal swelling develop over the course of days, GDV develops over the course of hours.
This terrible condition typically affects large breed, deep chested dogs like the Great Dane, German Shepherd, Boxer, Doberman, and Rottweiler. The cause of this devastating disease is often multi focal and, in and of itself, is a bit difficult to get a good handle on.
There are many predisposing factors to the problem which include, but are not limited to: Breed anatomy (deep chested large breeds); heritable tendency (occurrence in close family members); diet; behavior/stress level; eating habits (voracious, aggressive eater or drinkers); and maybe exercise/activity levels after meals.
Typically, the event begins around 2 hours after a meal (usually the evening meal). The stomach fills with gas, (often swallowed while eating - especially in voracious eaters), and starts to distend, (bloat). As it inflates, the lower most part of the stomach rises, until it is above the top of the stomach, (where the esophagus empties in ). It then continues rolling across the midline to the right side of the body. This twist, (volvulus) closes off the esophagus and the intestine leaving the stomach like two ends of a balloon - nothing goes in, nothing goes out.
Because of the bacteria and food already present in the stomach at the time of the twist, gas starts being produced, (as with any digestive process). The gas builds with no outlet and continues to distend the stomach, eventually cutting off vital blood supply to the stomach itself as well as putting pressure on other major vessels in the abdomen and pressure on the diaphragm making it difficult to breath.
Treating the problem is just as complicated as its development. Once the stomach is returned to normal position, and the blood supply returns, it will flood with toxins from the bacteria that have been brewing in this closed system for several hours. So, first, the body must be prepared for the impending and developing shock. Fluids are starting in large volumes along with antibiotics, oxygen, and pain medication. Very early on, a stomach tube may be successfully passed through the twist, but often a trocar (large needle) will have to be inserted into the stomach through the skin to let the gas out and the pressure off the twisted esophagus. Once deflated, a stomach tube can be passed and the contents of the stomach washed out to prevent further bacterial toxin absorption.
After decompression, the patient must be stabilized and a surgical plan developed. Some patients will need surgery right away, (if tubes can’t be passed, or if there is a lot of bleeding in the stomach once the tube is passed). Some patients can take a few hours to stabilize, and some a few days. Ultimately, surgery should be done to evaluate the extent of damage to the stomach from blood supply loss and to tack the stomach down to the inner abdominal wall to help reduce the risk of the problem occurring again.
Treating this disease process can be extensive, can have prolonged recovery period, and should not be undertaken lightly. The costs and prognosis associated with this disease is enough to “make your stomach turn”. If your pet is exibiting any evidence of abdominal distention, don't hesitate to call our office immediately.