Gastric dilatation–volvulus in large-breed dogs: recognition, stabilisation and prevention

1. Clinical importance

GDV combines rapid gastric distension with rotation of the stomach. Venous return falls, tissue perfusion deteriorates and reperfusion injury can affect multiple organs. Sharp and Rozanski [2] describe cardiovascular effects that explain why apparently alert dogs may decline quickly. This article is educational and does not replace immediate veterinary assessment.

2. Recognition and triage

Typical signs include repeated unproductive retching, salivation, restlessness, abdominal enlargement and pain. Weak pulses, pale mucous membranes, tachycardia, altered mentation and collapse indicate shock. Deep-chested large and giant breeds carry higher risk, but signalment should never rule out disease. Glickman and colleagues quantified breed-related patterns [1].

3. Diagnosis

Treatment should not be delayed for an extensive work-up. Right lateral abdominal radiography commonly demonstrates compartmentalisation of the gas-filled stomach and helps distinguish volvulus from simple dilatation. Laboratory evaluation guides resuscitation; serial lactate can help assess response but should not be interpreted alone.

4. Stabilisation and decompression

Large-bore intravenous access, balanced fluid resuscitation, oxygen and analgesia are instituted promptly. Gastric decompression may be attempted by orogastric tube; percutaneous decompression is used when passage is not possible or would delay care. Reassessment is essential.

5. Surgery

Definitive treatment requires exploratory surgery. The stomach is returned to normal position and assessed for viability; clearly nonviable tissue is resected when necessary. Gastropexy fixes the stomach to the right body wall and is critical because correction without fixation carries high recurrence risk.

6. Postoperative priorities

Monitoring focuses on perfusion, pain, electrolytes, acid–base status and ventricular arrhythmias. Prognosis varies with disease duration, severity and the presence of gastric necrosis.

7. Prevention

Risk has a heritable component and is influenced by conformation, age and family history [3]. Prophylactic gastropexy may be discussed for high-risk dogs. Owners should understand that it aims to prevent volvulus, not every episode of distension, and that retching or distension remains an emergency.

8. Conclusions

Outcome depends on early recognition, simultaneous resuscitation and decompression, timely surgery and attentive postoperative care.