If you suspect that your dog has bloat or has any of the clinical signs mentioned above, then it is important to bring him to your veterinarian immediately! This is a true emergency and should not be postponed until the following day. Make sure to keep your dog comfortable while transporting him, and do not allow him to roll over on his back at any time because this can increase the risk of aspirating some of his stomach contents, causing pneumonia.
A physical examination may reveal a distended stomach and possibly an enlarged spleen because it can be caught up in the stomach and blood vessels during volvulus. Gentle tapping on the belly may yield a sound that “pings” like a basketball. Weak pulses and a heart arrhythmia may be detected when your vet listens to your dog’s heart and lungs. They might also notice that your dog is having trouble breathing and start him on supplemental oxygen therapy right away. Dogs that are in shock need a rapid dose of a large volume of fluids to help stabilize them before testing, and blood work and x-rays are always recommended in order to confirm GDV and rule out other causes of illness.
In cases of mild bloat (without volvulus) and few clinical signs, you may be okay to have your dog hospitalized and focus on medical management with supportive care. However, if your dog has severe clinical signs and/or volvulus is confirmed, then surgical intervention will be necessary.
Surgical preparation starts with decompressing the stomach under light sedation. This can be done through a tube placed down your dog’s throat to release gas from the stomach, but if this is not possible, then your veterinarian will use a long needle to puncture the stomach through the skin. This is a slow but safe way to release air from inside of the stomach.
Once your dog is under anesthesia, the stomach is evaluated, emptied of its contents, and then sometimes surgically anchored to the abdominal wall in order to prevent future bloat reoccurrences. This procedure is called a gastropexy. If there is any part of the stomach wall that is necrosed (blackened and non-vital tissue), then that portion will need to be surgically removed (resection). Also, if there is similar damage to the spleen, then it, too, will need to be removed. Dogs who need to have their stomach resected, their spleen removed, or have any signs of a tumor that caused the GDV in the first place, then there is a higher risk for complications after surgery, including death.
Careful monitoring in the hospital after the first 48 to 72 hours is crucial. Your veterinarian will make sure to check your dog’s blood pressure and heart rhythm often. If he is still having heart arrhythmias, then a medication called lidocaine is administered. Your vet will recommend continued fluid therapy and may need to give medications to prevent vomiting and nausea. If a gastropexy was performed and there are no post-surgical complications, then most dogs have a great long-term outcome.