Bloat and gastric dilatation-volvulus (GDV) in dogs

Symptoms an owner can spot at home

• Unproductive retching: the dog tries repeatedly to vomit and brings up nothing, or only foam
• A visibly distended, drum-tight abdomen, most obvious just behind the ribs
• Restlessness and pacing, an inability to settle or lie down comfortably
• Excessive drooling
• Rapid shallow breathing, pale gums, weakness, or collapse as shock develops

When to see a vet

• Unproductive retching plus a swollen abdomen is an emergency now, drive to the nearest 24-hour hospital and call en route
• Any large-breed dog that is restless, drooling, and appears bloated after a meal
• Pale or grey gums, a weak pulse, or collapse, this is decompensated shock
• Do not wait to see whether it settles overnight; survival tracks tightly with time to decompression and surgery

What it is

Bloat (gastric dilatation) is gas accumulation that distends the stomach. Volvulus is rotation of that distended stomach around its long axis. Together, GDV creates a closed loop: gas cannot escape, the gastric wall loses perfusion and begins to die, and the enlarged stomach compresses the caudal vena cava so venous return to the heart falls. Cardiovascular collapse, cardiac arrhythmias, and endotoxaemia follow, which is why this kills quickly.

Risk is structural before it is behavioural. The American College of Veterinary Surgeons identifies increasing depth-to-width ratio of the chest, large and giant breed size, advancing age, being underweight, and a first-degree relative with a GDV history as the strongest risk factors. Great Danes carry the highest reported breed risk of any dog.

Feeding-management factors have been studied and reported as associated with increased risk in large-breed cohorts, notably eating rapidly and eating from a single large meal. Raised feeders have been reported as associated with increased risk in large and giant breeds, the opposite of the conventional advice that circulated for decades. None of these is a proven cause; they are associations, and no feeding routine substitutes for knowing the emergency signs.

How vets diagnose it

Diagnosis is clinical and radiographic. A right lateral abdominal radiograph shows the classic 'double bubble' or reverse-C compartmentalised stomach when volvulus is present, distinguishing GDV from simple dilatation. Stabilisation runs in parallel with imaging: intravenous fluid resuscitation for shock, gastric decompression by orogastric tube or trocarisation, ECG monitoring for ventricular arrhythmias, and bloodwork including lactate, which carries prognostic weight.

Treatment overview

This is editorial overview, not a treatment plan; your vet builds the plan. Confirmed GDV requires surgery: derotation of the stomach, assessment and resection of any devitalised gastric wall or spleen, and a right-sided gastropexy that tacks the stomach to the body wall to prevent recurrence. Without gastropexy, recurrence rates after simple derotation are high; with it, they fall dramatically.

Prophylactic gastropexy, often performed laparoscopically at the time of spay or neuter, is a discussion worth having with your vet if you own a Great Dane or another giant deep-chested breed, or a dog with an affected parent or sibling.

What owners can do

• Slow the meal down. A slow-feeder bowl or puzzle feeder directly targets rapid eating, one of the reported feeding associations, and costs less than a single emergency consultation.
• Split the daily ration into two or three meals rather than one large one.
• Feed on the floor unless your vet has advised otherwise for an unrelated reason. Elevated bowls have been reported as associated with increased risk in large and giant breeds.
• Keep vigorous exercise away from meals, before and after, as a practical precaution.
• Know the drive time to your nearest 24-hour emergency hospital and save the number in your phone today, not on the night it matters.
• If you own a giant breed, ask about prophylactic gastropexy before the dog is desexed, so it can be done under one anaesthetic.