Gastric Dilatation Volvulus: Which dogs are at high risk?

The short answer is Great Danes! In an article in the Preventative Veterinary Medicine Journal in 2003 the Great Dane was the most common breed of the ones studied, and they had a life time risk of developing GDV of 37%. Other most common breeds in that study were Irish Setter, Rottweiler, Standard Poodle and Weimaraner. Obviously large breed deep chested dogs are most commonly affected, although smaller breeds have been reported to have GDV.


Other factors that have been identified to predispose to GDV are:

• large or giant breeds, deep chested conformation
• parent or sibling that was affected by GDV
• large dogs that are fast eaters and prone to aerophagia
• dogs that have previously developed gastric dilatation without volvulus
• large dogs that are high strung, excitable, and not “happy”
• dogs undergoing splenectomy for splenic masses

GDV dogs also seem to have delayed gastric emptying and laxity of the gastric ligaments, particularly the hepatoduodenal ligament which maintains the position of the pylorus on the right side of the abdominal cavity. The gaseous distention of the stomach is due to aerophagia. Therefore, anything that causes dogs to ingest air, such as panting, will allow air accumulation in the stomach and may set the stage for GDV. Postprandial exercise has also historically been thought to contribute to episodes of GDV, although clinical studies have not proven this to be an important factor.

Feeding dogs from a muffin tin can significantly slow them down.

Critical to successful management of GDV is an appreciation of the anatomic changes that occur in the stomach and associated structures. A key aspect of the stomach rotation is that the pylorus moves from right to left. (See figure below).

It does this by rotating first ventrally, then dorsally and to the left. When viewing the dog from the rear, this is a clockwise rotation of the stomach. The stomach fundus moves to the right side, and the spleen may also move from left to right. Occlusion of the pylorus and cardia results from this malposition of the stomach.     

Understanding the malposition of the stomach makes it clear how a gastropexy between the pyloric antrum and interior of the right body wall can prevent further rotation of the stomach. Watch the following video, produced by VisioCare Consult, that clearly shows the anatomic changes in the stomach during a gastric dilatation volvulus. The stomach is viewed as you would see it during a ventral midline abdominal exploratory. 

Definitive diagnosis of a GDV is with plain film abdominal radiographs. On a right side down lateral projection, the stomach looks like a Smurf hat, with the pylorus and antrum seen cranial to the remainder of the stomach.

Typical appearance of the stomach in a dog with GDV.

In the next post we will continue to look at this disorder, including emergency treatment methods and surgical correction (which is the best part!)

References

Prev Vet Med. 2003 Sep 12;60(4):319-29.
Benefits of prophylactic gastropexy for dogs at risk of gastric dilatation-volvulus.
Ward MP, Patronek GJ, Glickman LT.