GDV Surgery in Dogs: Bloat Signs, Treatment and Recovery

Gastric dilatation-volvulus (GDV) is the twisted-stomach form of bloat. The stomach fills with gas and then rotates on itself, and the only fix is emergency stabilization followed by surgery. Every hour counts, and the first sign is usually retching with nothing coming up.

Go to an emergency vet now if your dog has any of these, especially a large, deep-chested dog:

- Retching or trying to vomit again and again with little or nothing coming up

- A swollen, tight or painful belly

- Restlessness or pacing, can't get comfortable, keeps looking at the belly

- Heavy drooling

- Panting, pale gums, weakness or collapse

Call the hospital on the way so the team can get ready. Don't wait to see if it settles, and don't give food, water, medicine or home remedies. A twisted stomach does not untwist on its own.

What Is GDV? Dilatation vs Volvulus

GDV has two parts, and the name lists both. Gastric dilatation means the stomach swells with gas, food or fluid. Volvulus means the swollen stomach rotates on itself, which closes off the way in and the way out. The gas is trapped, and the stomach keeps expanding.

Either part can come first. The University of Illinois emergency team says that by the time these dogs reach the ER, they usually have both.

That swollen, twisted stomach does damage fast:

• It presses on the large veins that return blood to the heart, so the dog goes into shock.
• Blood flow to the stomach wall drops, and parts of it can die. The wall can even tear.
• The spleen sits next to the stomach and can lose its blood supply too.
• The stomach pushes up against the diaphragm, so breathing gets harder.

Without treatment, GDV is fatal, and Illinois notes it can kill in as little as a few hours.

You can't tell the two apart at home, and simple bloat is also an emergency. Treat any of the signs above as GDV until a vet says otherwise.

Signs and Symptoms of GDV

Early GDV can look like an ordinary upset stomach, and that is how dogs lose time at home. The sign to know by heart is unproductive retching: your dog takes the vomiting posture, makes the noise and heaves, but little or nothing comes out. Our guide to dry heaving in dogs explains how to tell retching from coughing and gagging.

Early signs:

• Retching without producing anything
• Drooling
• Restlessness, pacing, an anxious look, turning to look at the belly
• A belly that starts to look full or swollen

Later signs, as shock sets in:

• Panting
• A clearly bloated, tight or painful belly
• Pale gums
• Weakness, lying down and not getting up, collapse

Don't wait for a huge, drum-tight belly. Retching with nothing coming up, in an at-risk dog, is reason enough to go.

Which Dogs Are at Risk?

GDV has been reported in nearly all breeds, but it is far more common in large and giant dogs with a deep, narrow chest (tall from top to bottom, narrow side to side). Our guide to deep-chested dog breeds shows what that build looks like.

Breeds named most often by ACVS, Merck and Cornell: Great Dane, Weimaraner, Saint Bernard, Irish Setter, Gordon Setter, German Shepherd Dog, Standard Poodle, Doberman Pinscher and Basset Hound. In a study of nearly 2,000 GDV cases from US veterinary hospitals, Great Danes had the highest risk of any breed, and purebred dogs had about 2.5 times the odds of mixed breeds.

Other things that raise the risk (Merck, ACVS, Cornell and a study that followed 1,637 large and giant dogs):

• A parent, sibling or littermate who had GDV
• Older age (risk keeps rising as dogs get older)
• A nervous, fearful or aggressive temperament, and stress
• A lean body condition
• Eating fast, eating one big meal a day, or eating only dry kibble
• A raised food bowl

• A spleen removed in the past

Merck states there is no difference between males and females, so you can drop older advice that says male dogs are at higher risk.

Basset Hounds are much smaller than most at-risk breeds, yet Cornell lists them among the breeds most often affected.

What Happens at the Emergency Vet

Here is the usual order. Your vet will adapt it to your dog.

1. Stabilize first. Your dog gets IV fluids and oxygen to fight shock. Some dogs also need a blood transfusion.
2. Let the gas out. The vet passes a tube down the throat into the stomach, or places a needle or catheter through the skin into the stomach. Merck says both work.
3. Confirm it and check the damage. Abdominal X-rays confirm GDV and separate it from simple bloat. Bloodwork, including lactate (a marker of poor blood flow to the tissues), and an ECG (a heart rhythm tracing) show how sick the dog is.
4. Surgery as soon as your dog is stable enough. Letting the gas out buys time but doesn't fix the twist. Merck reports that dogs decompressed without surgery have an extremely high chance of it happening again.

This is when the team will talk with you about the plan and the outlook. Ask what they saw on the X-ray and bloodwork, and what could change once they are in surgery.

GDV Surgery: What the Surgeon Does

GDV surgery is done under general anesthesia through an incision in the belly. In plain words, the surgeon does four things:

1. Untwists the stomach and puts it back in its normal position, emptying out the remaining gas and contents.
2. Checks the stomach wall. Any part that has died from lack of blood flow is removed (a partial gastrectomy).
3. Checks the spleen and the other organs. A badly damaged spleen is removed (a splenectomy).
4. Tacks the stomach to the body wall (a gastropexy). As the two surfaces heal together, they form a permanent attachment that stops the stomach from twisting again.

The gastropexy is not optional extra work. A 2022 specialist review calls it essential for every dog treated for GDV, and the Illinois team describes dogs without one as "repeat offenders."

Complications of Bloat Surgery

Most of the hospital stay is about watching for these:

• Irregular heartbeat (arrhythmias). Common after GDV and usually temporary. Many need no treatment, but the heart is monitored for the first days.
• Reperfusion injury. When blood flow returns to damaged tissue, it can trigger arrhythmias and injure the kidneys and liver.
• Stomach irritation and vomiting, which your vet treats.
• Peritonitis or sepsis. Less common but serious infections, usually linked to badly damaged stomach tissue.
• Bloating again. A gastropexy holds the stomach in place but can't stop it filling with gas. Some dogs still bloat later, usually after a very big meal, and still need a vet.

GDV Prognosis: Survival Odds

The odds are better than many owners fear when treatment starts early. Cornell puts survival with treatment at more than 80%, and ACVS reports that roughly 15% of dogs with GDV die. Without treatment, GDV is fatal.

The outlook gets worse when:

• Signs have been going on for more than 6 hours before treatment
• The heart rhythm is abnormal before surgery
• Part of the stomach has to be removed, or the spleen does
• Lactate stays high despite fluids, or the stomach has torn

After surgery with a gastropexy, the twist rarely comes back: Cornell says gastropexy cuts the risk of recurrence to as low as 3-5%.

Aftercare: Recovery at Home

Most dogs stay in the hospital for several days after GDV surgery, with fluids, supportive medicines and heart monitoring. When your dog comes home, your vet will give you a plan for that dog. It usually covers:

• Rest. Exercise is restricted for a few weeks while the incisions heal: no running, jumping, rough play or off-leash time until your vet says it's OK.
• The incision. Look at it every day, and use the cone if your vet sends one home.
• Meals. Your vet will tell you what to feed and how to split it. For the long term, ACVS advises 2-3 smaller meals a day over one large meal.
• Medicines and rechecks. Give only what your vet prescribed, exactly as labeled, and keep the follow-up visits.

Call your vet if the incision is red, swollen, leaking or opening, or your dog vomits, won't eat, seems weak or in pain. Go back now if you see retching, a swelling belly or collapse: a dog with a gastropexy can still bloat.

Preventive Gastropexy: Should Your Dog Have One?

The same stomach tack can be done before GDV ever happens. That is a prophylactic (preventive) gastropexy, and ACVS notes that many veterinary surgeons now recommend it for at-risk breeds and for dogs with a parent or sibling who had GDV.

• It can often be done during the spay or neuter, under the same anesthesia. If neutering is delayed, the Illinois team suggests a separate gastropexy around one year of age. Your vet will advise on timing.
• It can be done through a standard incision, or with less invasive options such as laparoscopic-assisted gastropexy (small incisions and a camera). Ask your vet which approach they offer or where they refer.
• It stops the twist, not the bloat. A dog with a gastropexy can still swell with gas and still needs a vet if signs appear, but it should not get the life-threatening volvulus.

Is it worth it? A 2003 modeling study estimated a lifetime GDV risk of about 37% for Great Danes and about 4% for Rottweilers. It found preventive gastropexy lowered the expected risk of dying from GDV in every breed studied, by about 2-fold in Rottweilers and about 30-fold in Great Danes. If you own one of the breeds above, it's a fair question for your next vet visit.

Feeding and Daily Habits That May Lower the Risk

Nothing at home removes the risk, and the evidence on habits is weaker than the evidence on breed and family history. These are the steps ACVS, Cornell and Merck suggest:

• Feed two or three smaller meals instead of one big one.
• Slow down a fast eater, for example with a slow-feeder bowl.
• Skip the raised bowl. In the large-breed study, raised bowls were linked to about 20% of GDV cases in large breeds and 52% in giant breeds.
• Keep things calm around meals. Cornell advises limiting activity after eating.

ACVS also lists dry foods with oils or animal fat among the first four label ingredients as a risk factor. If you have an at-risk dog, ask your vet whether the food needs a change.

Frequently Asked Questions

Can a dog survive GDV without surgery? No. Letting the gas out relieves the pressure for a while, but the twisted stomach needs surgery, and without it GDV is fatal.

How long does a dog have with GDV? There is no safe waiting time. It can kill in a few hours, and the odds drop the longer signs go on. Leave as soon as you suspect it.

Can GDV happen again after surgery? The twist is rare after a gastropexy, but bloat without a twist can still happen. Any retching or swelling still means a vet visit.

Can small dogs get GDV? Yes. It is far more common in large, deep-chested dogs, but it has been reported in nearly all breeds. A small dog with these signs still goes to the vet now.

Originally written by Dr. Catharina Hjorth. Updated by the I Love Veterinary editorial team.

Sources

• American College of Veterinary Surgeons: Gastric Dilatation-Volvulus
• Merck Veterinary Manual: Gastric Dilation and Volvulus in Small Animals
• Cornell Riney Canine Health Center: Gastric dilatation-volvulus (GDV) or bloat
• University of Illinois College of Veterinary Medicine: A Twist of Fate: Gastric Dilatation-Volvulus (GDV) in Dogs
• Glickman et al., 1994, JAVMA: Analysis of risk factors for gastric dilatation and dilatation-volvulus in dogs
• Glickman et al., 2000, JAVMA: Non-dietary risk factors for gastric dilatation-volvulus in large and giant breed dogs
• Ward, Patronek and Glickman, 2003, Preventive Veterinary Medicine: Benefits of prophylactic gastropexy for dogs at risk of gastric dilatation-volvulus
• Rosselli, 2022, Veterinary Clinics of North America: Updated Information on Gastric Dilatation and Volvulus and Gastropexy in Dogs

This article is for general information and is not a substitute for advice from your veterinarian.