# Bloat



## Connie Sutherland (Mar 27, 2006)

from http://www.WorkingDogForum.com/vBulletin/f23/bloat-caught-tape-22298/






rick smith said:


> i posted that this was a great video, but it has made me think :
> 
> since access to 24hr ER for canines is limited here, if you were unlucky enuff to have a dog bloat while you were watching, what could/should you do to prevent it from getting worse and dying other than get access to a vet clinic ?
> 
> ...


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## Maren Bell Jones (Jun 7, 2006)

Rick, in the US, we as vets are obligated to either be available for our patients for an emergency after hours or direct them to a facility like an emergency center. If you call my cell phone and reach my voice mail, I have directions to call the University of Missouri veterinary teaching hospital in a medical emergency since as a house call practitioner, I can definitely not do a whole heck of a lot for a GDV. I have the same instructions on my website. Not sure about Japan, but assume it would be pretty similar to what's in the States. Most practices, if they don't have a nearby 24 hour emergency facility, have the doctors be on call for such an emergency.

The emergency & critical care specialists no longer recommend to us general practitioners to try passing a stomach tube before surgery because of the high risk of rupturing the esophagus, particularly when the stomach and esophagus can become quickly necrotic. So *definitely* NOT worth wasting your time on. As far as decompression with a needle, this is something they also don't recommend a lay person do because the spleen is often involved engorged with blood and laying right on the stomach, so if you don't know what you are doing, you can stab the dog in the spleen and it could bleed out and die. 

So don't dink around. Bring the dog in ASAP. Cannot stress this strongly enough. Even if they aren't having a full on volvulus, you need to know so they can decompress the dog, monitor, and schedule a gastropexy because they very commonly happen again and there's definitely no guarantee the stomach will play nicely a second time.


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## Laura Bollschweiler (Apr 25, 2008)

I had a conversation a long time ago with a woman whose dog bloated and she swore that the dog lived because as soon as she saw the signs, she poured Pepto Bismol down its throat on the way to the emergency vet. I did a little reading back then and I did find that you could give Gas X or something similar on the way to the ER. 

Is this an old wives' tale? Would it be harmful? I'd like to do everything I could in the event a dog bloated. 

Laura


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## Maren Bell Jones (Jun 7, 2006)

I have not asked specifically about Pepto, but I have asked several surgeons and ECC specialists about Gas X. They told me that if the dog is already to the stage of non-productive retching, you're not likely to get much down into the stomach anyways because they already cannot vomit due to dilation and subsequent torsion (also why passing the stomach tube can rupture the stomach or esophagus). So I would be very hesitant to introduce anything down the throat of a dog that is non-productively retching (like the Akita in the video) or one that cannot swallow well anyways because they're obtunded. Aspiration pneumonia plus a GDV would be very bad indeed...


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## Nicole Stark (Jul 22, 2009)

Maren, do you know of anyone whose ever used a bloat kit? 

Also, I would be interested in knowing what the bloat stats are with un or minimally vaccinated dogs. I still have a sneaking suspicion that there may be some correlation to the Vagus nerve damage that could be attributed to vaccinations.


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## Maren Bell Jones (Jun 7, 2006)

Before I was in vet school, our Dog Scout troop actually made bloat kits before I knew better. I now know there is nothing so important as time. I'd venture that most of us live within 20 minutes or less of the closest vet. Again, I know everyone wants to do right by their dog, so I emphatically say the best thing to do is call your vet absolutely right away to let them know and come ASAP.

That's a new one to me. I do not believe there to be any correlation between vaccines, the vagus nerve, and GDV. Otherwise vaccinated dogs of all conformations would get it with equal regularity, which is definitely not the case. The only thing I could find on the vagus and vaccination was claims by a chiropractor that vaccination stimulates the vagus. Well, that would actually promote digestion instead of the stasis of the gut because it's responsible for parasympathetic innervation (rest and digest).


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## Nicole Stark (Jul 22, 2009)

Maren Bell Jones said:


> That's a new one to me. I do not believe there to be any correlation between vaccines, the vagus nerve, and GDV. Otherwise vaccinated dogs of all conformations would get it with equal regularity, which is definitely not the case. The only thing I could find on the vagus and vaccination was claims by a chiropractor that vaccination stimulates the vagus. Well, that would actually promote digestion instead of the stasis of the gut because it's responsible for parasympathetic innervation (rest and digest).


I developed that suspicion from a slightly different vantage point. If there is a genetic predisposition to something such as seizures and you compromise that further by damaging a component that is know to be critical in digestion and simulation there does appear to be some merit to the possible relationship between the two. There's a fair bit of literature out there on this subject (specific to humans and idiopathic epilepsy). 

I did find an article on this topic relating to dogs a few years ago. I think the publication was by someone from of the UK. As a matter of fact I might still have the reference someplace if you want me to track it down.


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## Maren Bell Jones (Jun 7, 2006)

One problem with a comparison to epilepsy is that by definition, epilepsy is not a condition as GDV is a condition. This may sound strange, but seizures and epilepsy are signs or symptoms, like a cough is a sign or symptom. Unless it's because of toxicity, brain tumor, or hypoglycemia, we often don't know why dogs have seizures in many cases (often because owners can't afford advanced imaging diagnostics and other testing). We do know what the risk factors are for GDV though.

As I said, the only website I found claims that vaccines stimulate the vagus nerve, not damages it. 



> Some experiments demonstrated the increase of plasma Serotonin almost one hundred fold after vaccination. Serotonin is associated with deep sleep. It stimulates the Vagus Nerve to slow and even stop the heart. If death occurs early in the course of this syndrome, it is due primarily to Serotonin effect. Thimerosal in the vaccine may also play a role.


http://www.vaccinetruth.org/page_9.htm

Then again, I'd need to see peer reviewed articles on the matter and not the conspiracy theories and leaps of logic that these websites promote (keeping in mind I'm a judicious vaccinator myself, but I don't throw the baby out with the bathwater). 

Just a thought, but my problem even as a holistic vet with some of those anti-vaccine sites is they blame every single thing under the sun on vaccines and call the vets who give them money grubbing, but then they turn around wanting to hock the latest homeopathy snake oil (or an infantessimally small dilution of snake oil in water) or chiropractic or whatever "natural treatment" instead, which is typically completely unproven just as many of their ideas. Which is convenient, since homeopathic "remedies" and repeated visits to the chiropractor are not cheap. Sad thing for me again as the holistic vet is because I intentionally order thimersol free rabies vaccines for dogs or recombinant rabies vaccines without adjuvant for cats, which cost me significantly more than the standard ones. But then no one wants to pay the price for the more expensive but safer vaccine when they price shop. Argh... :roll:](*,)

Okay, sorry for the side rant, back to GDV...


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## Nicole Stark (Jul 22, 2009)

Sure, no problem.


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## Jackie Lockard (Oct 20, 2009)

Laura Bollschweiler said:


> I had a conversation a long time ago with a woman whose dog bloated and she swore that the dog lived because as soon as she saw the signs, she poured Pepto Bismol down its throat on the way to the emergency vet. I did a little reading back then and I did find that you could give Gas X or something similar on the way to the ER.
> 
> Is this an old wives' tale? Would it be harmful? I'd like to do everything I could in the event a dog bloated.
> 
> Laura


I worked with an extremely educated/experienced Dane breeder a couple years ago. She runs a boarding kennel. If any bloat-prone dog so much as barfed a leaf or farted it was absolutely *mandatory* that the dog was given a gas-x. I'm not sure what bloat cases she ever dealt with, growing up with GSDs in Germany and then breeding Danes in the US for thirty or whatever years, but she was pretty adamant about the gas-x.


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## Maren Bell Jones (Jun 7, 2006)

Sorry, didn't mean to get all preachy on the vaccine thing. I just get annoyed with those sites because I am in the middle of buying vaccines and trying to get the best for clients, including:

-thimerosol free rabies for dogs
-recombinant for cats (no adjuvant)
-single dose tanks instead of multi dose tanks
-offering titers for distemper and parvo
-offering the option of spacing out vaccines (i.e.-given distemper/parvo and rabies at least two weeks apart instead of the same day)
-offering the four way lepto only for dogs who really need it, not just everybody

I try to price them within just a few dollars of the typical multi dose tanks with thimersol adjuvant in them that are used at many other clinics, so I take a hit on bottom line and I have people hang up on me when they price shop vaccines. And no one wants to space them out because that's an extra house call and therefore more money. Just very frustrated right now trying to do the best and no one cares cause it's all about saving a few bucks... ](*,) 

Snake oil homeopathic remedy anyone? :-({|=


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## Bob Scott (Mar 30, 2006)

Jackie Lockard said:


> I worked with an extremely educated/experienced Dane breeder a couple years ago. She runs a boarding kennel. If any bloat-prone dog so much as barfed a leaf or farted it was absolutely *mandatory* that the dog was given a gas-x. I'm not sure what bloat cases she ever dealt with, growing up with GSDs in Germany and then breeding Danes in the US for thirty or whatever years, but she was pretty adamant about the gas-x.


Danes have one of the highest rates of bloat in the dog world.


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## Jackie Lockard (Oct 20, 2009)

Bob Scott said:


> Danes have one of the highest rates of bloat in the dog world.


Really?:roll::lol:

I just never heard her reference any cases, while I heard about specific dogs with nearly every other health issue out there. You can decide if that's for or against the gasx.


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## Nicole Stark (Jul 22, 2009)

Jackie Lockard said:


> I worked with an extremely educated/experienced Dane breeder a couple years ago. She runs a boarding kennel. If any bloat-prone dog so much as barfed a leaf or farted it was absolutely *mandatory* that the dog was given a gas-x. I'm not sure what bloat cases she ever dealt with, growing up with GSDs in Germany and then breeding Danes in the US for thirty or whatever years, but she was pretty adamant about the gas-x.


Same here. Actually, I added a pill to each meal for years.

Oh and Maren, don't worry about it. I generally am able to read a situation well enough to know when people are projecting about a particular topic/issue.


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## Bob Scott (Mar 30, 2006)

Jackie Lockard said:


> Really?:roll::lol:
> 
> I just never heard her reference any cases, while I heard about specific dogs with nearly every other health issue out there. You can decide if that's for or against the gasx.



I don't have any opinion on the gasx but this is from their site. I also have a friend who lost two Danes with it. He still went for a third and got lucky with that one...it died at 6 with bone cancer. 
http://www.gdca.org/healthandwelfare.htm


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## Maren Bell Jones (Jun 7, 2006)

Hubby wants one at some point (I like them too, even though they are walking health disasters), but if we had a Dane, I'd pexy that sucker before it even walked through the front door.


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## Jackie Lockard (Oct 20, 2009)

Nicole Stark said:


> Same here. Actually, I added a pill to each meal for years.


Huh. Wonder if that would have saved my Dutchie. I had a hard time putting weight on him, he just ate so damn much every day. I didn't like feeding him huge meals, but he was a really hard keeper. When it happened he was about 60-65 pounds, eating three cups a meal. Wonder if I added gasx to the meals if he'd still be here...

Maybe in the future when I have dogs that eat a lot for their size I'll have to do that.


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## Nicole Stark (Jul 22, 2009)

Jackie Lockard said:


> Huh. Wonder if that would have saved my Dutchie. I had a hard time putting weight on him, he just ate so damn much every day.


Hard to say. It sure wouldn't have hurt. I'm sorry you lost your dog. Whether it's caught on time or not it's never an easy event/loss to process.


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## rick smith (Dec 31, 2010)

maybe what i've heard and read is wrong, but my assumption was that a dog bloating will DIE if it can't get emergency treatment, and that treatment is VERY time critical
- and i am well aware a vet handling it is the best way, and even with vet care, there is no guarantee of 100% recovery

but my Q was if there was anything you could do when a vet ISN'T available...sounds like that answer is no :-(

Maren : - re: "Not sure about Japan, but assume it would be pretty similar to what's in the States. Most practices, if they don't have a nearby 24 hour emergency facility, have the doctors be on call for such an emergency.
..... i'm SURE about Japan; not similar. i live in a city of 250,00 and the nearest 24hr ER is 2hrs drive if traffic is light, which it rarely is :-( 
lived here two decades and small animal ER medicine is vastly different that the states as you mentioned it....that's why i said if i saw a dog bloating with no vet quickly available, i could either watch it die or try and do something myself even if that meant "dinking around" as you call it 
i assumed (maybe incorrectly) in the wide open spaces of the rural parts of the US this could happen without being able to find a vet in 20-30 minutes at odd hours....if they are available great, but what you seem to be saying is if you can't get to a vet all you can do is watch it fade away

- but i still think it would be wise for someone with a breed prone to bloat to "maybe" have some idea of how to get a tube down without ripping the esophagus if it would save the dog
...since, as i understand it, it is a painful way to die :-(

of course we all agree on the BEST way, no debate there, but imo, not always realistic to plan on always having a vet available for a life threatening emergency such as this

- i look at it as a risk analysis, and if doing nothing means better than 90% chance of death, why not try the slim percentage to do "something" and maybe save it, given you can recognize the symptoms and have some prior knowledge of what you could try ?

i'd rather put a dog down then watch it suffer and die in front of me......never had to do it for a dog but did for two cats :-(


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## Maren Bell Jones (Jun 7, 2006)

Rick, what city in Japan do you live in that's 250K with no emergency vets and no vets that share on call after hours? I can ask our vet school's neurosurgery resident, who is from Japan, or I can post on VIN and can find out for you. Unless you live in extremely remote parts of this country, you can likely find a vet even out in the country within 20-30 minutes. If you are that concerned that your dog will tors with no vet care, get them gastropexied. 

I respect cultural differences, but I find it exceptionally difficult to believe that not a single vet works or is on call after 5 PM in a city that size. Before the rise of 24 hour facilities in the larger cities and suburbs, just about all vets both urban and rural took on all the on call or shared it because you are obligated to care for your patients or refer them if an emergency arises after hours. It's actually a requirement when I applied for a facility permit as a house call vet that I would state where to send clients for after hours emergencies should I not be able to handle them myself. Trust me, as a house call vet, I couldn't since all I'd be able to do is start two IVs (fluid therapy is critically important with GDVs) and pain management. If *my* own dog looked like they were bloating, I would rush them in right away. So an untrained lay person definitely is going to do more harm than good by not going right away.


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## Connie Sutherland (Mar 27, 2006)

Bob Scott said:


> Danes have one of the highest rates of bloat in the dog world.


I believe, in fact, with a rate of well over 30% lifetime risk of experiencing bloat. I'll look for that.





ETA
Here we go:


*Analysis of risk factors for gastric dilatation and dilatation-volvulus in dogs:*

_.... the highest risk of GDV were Great Dane .... Weimaraner .... Saint Bernard .... Gordon Setter .... and Irish Setter._

at http://www.ncbi.nlm.nih.gov/pubmed/8050972

and

*Benefits of prophylactic gastropexy for dogs at risk of gastric dilatation-volvulus.*

_Lifetime risk (95% CI) of GDV in these breeds ranged from 3.9% (0-11.2%) for Rottweiler to *36.7%* (25.2-44.6%) *for Great Dane.*_

at http://www.ncbi.nlm.nih.gov/pubmed/12941556


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## Aaron Myracle (May 2, 2011)

Maren Bell Jones said:


> Then again, I'd need to see peer reviewed articles on the matter and not the conspiracy theories and leaps of logic that these websites promote (keeping in mind I'm a judicious vaccinator myself, but I don't throw the baby out with the bathwater).


Not directed at you so much Maren, but more of a general lament...
How are we supposed to GET these studies accomplished?

Studies need funding, researchers and research subjects. It's hard to accomplish that when the biggest money in Vet land comes from food manufacturers and pharmaceutical companies.

Hell, even the 7-year Rabies Challenge Fund study will be rejected out of hand by many, because it will be only ONE study, with a methodology that some will object to.

Diet studies are often completely rejected because they are conducted with similar methodology to the RCF study, or because they are cohort studies.
Ditto for S/N studies.


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## Connie Sutherland (Mar 27, 2006)

Aaron Myracle said:


> .... Hell, even the 7-year Rabies Challenge Fund study will be rejected out of hand by many, because it will be only ONE study, with a methodology that some will object to.



And look at how long it took and how hard it was to raise that funding. Some of that money came from such sources as small clubs (I know first hand) ..... the dog-world equivalent of holding bake sales to do a much-needed study.

I agree: _"Studies need funding, researchers and research subjects. It's hard to accomplish that when the biggest money in Vet land comes from food manufacturers and pharmaceutical companies."
_
And of course Maren knows this could not be further from being in any way personal.


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## Aaron Myracle (May 2, 2011)

It's definitely an on-going source of frustration.

We need studies to support ideas like grain-heavy foods being unnatural and potentially harmful to canids, or vaccinations having risks, but the people who control academic research make money off of grain-filled foods and vaccinations.

On the bright side, market demand for grain-free foods seems to be pushing many of the large food manufacturers to offer grain-free alternatives. Here's hoping that market demand continues to trend in that direction, and the companies gain additional financial incentive to seek different food ingredients and find a different way to dispose of production by-products.

Perhaps they'll develop a fuel based entirely on the grain waste and the manufacturers won't need pet food to make their refuse profitable anymore.

But now I'm just revealing my kumbaya hippie optimist leanings.


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## Connie Sutherland (Mar 27, 2006)

Aaron Myracle said:


> ... On the bright side, market demand for grain-free foods seems to be pushing many of the large food manufacturers to offer grain-free alternatives.


I'm not so happy when I see a load of starch (polysugars) filling up the food instead, flying under a banner that _seems_ to say "more meat" but doesn't.


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## Maren Bell Jones (Jun 7, 2006)

I don't feel a relatively small amount of grains are necessarily unnatural for dogs. And as I've said many times, my own dog does not do well on grain free diets (either kibble or raw). But there's a difference between including some whole grains, which include the most nutritious part of the seed, and making kibble with 60%+ low quality grain fractions and grain by-products. Just like with vaccines, there is a big, big spectrum in between no vaccines at all and yearly vaccines with lots of non-core products. 

I hope to do a residency in nutrition in a few years and while I was visiting the university whose program I'm interested in, one of their residents was working on a research project with raw diets in cats, so would be very interesting to follow up on something like that for another masters degree or PhD while I do a residency.


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