Gastric torsion (GDV) in pets - Emergency surgery in dogs

Gastric dilatation-volvulus (GDV), also known as gastric torsion, is a life-threatening condition that primarily affects large, deep-chested dog breeds. The stomach suddenly fills with gas and rotates on its axis, sealing off both the entrance and exit. This causes a rapid buildup of gas, constriction of blood vessels, and oxygen deprivation in the stomach wall and other organs. Without prompt surgical treatment, the animal dies within a few hours.

In this article, we discuss the causes, symptoms, diagnosis, treatment, and prevention of gastric torsion in dogs.

What is gastric torsion (GDV)?

GDV stands for Gastric Dilatation and Volvulus. It usually begins with a sudden swelling of the stomach (dilatation) caused by gas and air. The stomach then rotates (volvulus), cutting off the blood supply. This quickly leads to shock and organ failure.

Causes and risk factors

• Large, deep-chested breeds such as the Great Dane, Saint Bernard, and Irish Wolfhound
• Eating quickly and gulping down water
• Large meals eaten all at once
• Stress or exercise immediately after eating
• Familial predisposition (genetic factor)

Gastric torsion is extremely rare in cats and small dogs.

Symptoms of gastric torsion

• Heavy panting and restlessness
• Swollen, hard abdomen
• Unproductive retching (unable to vomit)
• Pain and whining when the abdomen is touched
• Lethargy and collapse
• Signs of shock: pale mucous membranes, rapid heart rate, low body temperature

Diagnosing GDV

The diagnosis is based on symptoms and further examination:

• Physical examination: swollen abdomen, pain, and shock
• X-rays: show the rotated stomach (the 'double bubble sign')
• Blood tests: reveal abnormalities in acid-base balance, electrolytes, and organ values

Treatment: emergency surgery

Treatment of gastric torsion always begins with emergency stabilization: administering IV fluids and pain relief to support circulation, followed by decompressing the stomach via a tube or percutaneous puncture. Once the patient is sufficiently stabilized, emergency surgery follows. During this operation, the rotated stomach is returned to its correct position and secured to the abdominal wall through a gastropexy. This prevents the stomach from twisting again in the future. If parts of the stomach wall (or spleen) have become necrotic due to oxygen deprivation, these must be surgically removed.

Without surgical intervention, the chance of survival is virtually zero.

Laparoscopic gastropexy is increasingly being chosen as the preferred approach. This is a minimally invasive technique performed through small incisions using a camera. The advantages include:

• Less postoperative pain
• Smaller wounds and faster recovery
• Less stress for the patient
• Long-lasting and reliable prevention of recurrence

Aftercare and recovery

Intensive care is needed after surgery:

• Monitoring of heart function and blood pressure
• IV fluids and medication for heart rhythm disturbances
• Antibiotics and pain relief
• Dietary advice: smaller, more frequent meals

The recovery period is usually 1–2 weeks, depending on the severity of the damage.

Preventing gastric torsion

• Several small meals per day instead of one large one
• Avoiding exercise after eating
• A calm eating environment and possibly the use of a slow-feed bowl
• For at-risk breeds: preventive gastropexy (often performed laparoscopically)

Prognosis

The prognosis for gastric torsion depends on how quickly treatment is provided. With prompt surgery, the survival rate is 70–80%. If necrotic stomach tissue or severe heart rhythm disturbances are already present, the chance of survival decreases significantly.

Want to know more?

Read more about our services in emergency surgery and gastrointestinal surgery. Our specialized surgeons at Nesto have extensive experience treating and preventing GDV and are happy to advise you on the best approach for your dog.

Frequently asked questions (FAQ)

What is gastric torsion?

A life-threatening condition in which the stomach fills with gas and rotates on its axis.

Which dogs are most at risk?

Mainly large, deep-chested breeds such as Great Danes, Saint Bernards, and Irish Wolfhounds.

How do I recognize gastric torsion?

Sudden abdominal swelling, unproductive retching, pain, and rapid deterioration in condition.

How is gastric torsion treated?

With emergency surgery in which the stomach is repositioned and secured to the abdominal wall (gastropexy).

Can gastric torsion be prevented?

Yes, through preventive gastropexy and through dietary and lifestyle adjustments.