Bloat Information You Need To Know From Dr. Katie   

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    Bloat (Gastric Dilation and Volvulus)   

This information, photos, and the following link's will help you better understand bloat and gastric dilation and volvulus.   Adapted from "Bloat in Large Dogs" Published by Univelt, Inc. 1983 (ISBN 0-912183-00-4)

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    Bloat First Aid   

Introduction:

A.   The procedures in this document should be used to provide first aid only to dogs in a bloat condition.  They are not intended to replace prompt, professional treatment by a qualified veterinarian.  Please read and understand these instructions completely before attempting the first aid procedures described herein.

B.   A bloat kit, which includes these instructions, was prepared for use on my Danes by people entrusted with their care and well-being.  Additionally, I provide a copy of these instructions to everyone getting a Great Dane from me.  Never assume that anyone already owning or purchasing a dane knows about bloat.  Please share these instructions with others that are concerned with bloat and what aid they can give to dogs in a bloat condition.  I strongly believe properly administered first aid will help to ensure a dog in a bloat condition has a good chance of survival once it gets to a veterinarian. Prompt, professional care is always required in bloat cases.

C.   Recommended Bloat Kit Contents:

• Instructions for use
• Stethoscope
• 3 Rolls of tape (1 in. x 10 yd)
• Stomach tube (2 different diameters). 5 ft. length beveled at one end, with two holes drilled in tube 2 & 3 inches up from the beveled end. Pre-measured and marked for each Great Dane in household
• 14 gauge or larger needles (2) (1 1/2" to 3" length)
• KY jelly
• Gas absorbent (Digel, GasEase, Phazyme etc)

D.   A bloat kit should be available wherever Great Danes are located (home, van, RV, etc).

2.   Bloat phases, symptoms and recommended actions:

A.   Canine Bloat (GASTRIC DILATION-VOLVULUS) is an acute disease or digestive problem believed to be caused by excessive swallowing of air while eating, gastrointestinal secretions, and gas for food fermenting in the stomach.

    Canine Bloat is a life threatening emergency.   

B.   Some symptoms may be anxiety, evidence of abdominal fullness after meals, heavy salivating, whining, pacing, getting up and lying down, stretching, looking at abdomen, unproductive attempts to vomit, labored breathing, disinterest in food, and stilted gait.  Severe symptoms, such as dark red, blue, grey or white gums, a rapid heartbeat and a weak pulse are normally followed by prostration and death.

3.   Determining Bloat Phases:

A.   Observing the dog's behavior and symptoms and comparing to those listed in TABLE 1 is the initial step in this process.

• Look at color of gums
• Determine dog's heartbeat/pulse rate
• Note the rate of abdomen distention

B.   Helpful hints in deciding the bloat phase of a dog (Practice the following actions on a well dog beforehand): (1) Look at the dog's gums.  If the gums are pink to red shade and you press the gum firmly with your finger and then let go, the color returns immediately, then the dog may be normal or may only be in phase 1.  If the gums are deep red, grey, blue, or white and, you press with your finger, the color returns slowly or not at all, you have an extreme situation (phase 3).  You should start first aid immediately!

    BLOAT PHASES, SYMPTOMS AND RECOMMENDED ACTIONS   

PHASE 1
SYMPTOMS:

• 1.  Pacing, restlessness, panting and salivating.
• 2.  Unproductive attempts to vomit (every 10-20 minutes).
• 3.  Abdomen exhibits fullness and beginning to enlarge.

ACTIONS:
Call Veterinarian to advise of bloat case enroute. Transport dog to Veterinarian immediately.

PHASE 2
SYMPTOMS:

• 1.  Very restless, whining, panting continuously, heavy salivating.
• 2.  Unproductive attempts to vomit (every 2-3 minutes).
• 3.  Dark red gums.
• 4.  High heart rate (80 to 100 BPM).
• 5.  Abdomen is enlarged and tight, emits hollow sound when thumped.

ACTIONS:
Apply first aid if Veterinarian care is more than 10 minutes away. Then, transport dog to Veterinarian immediately.

PHASE 3
SYMPTOMS:

• 1.  Gums are white or blue.
• 2.  Dog unable to stand or has a spread-legged, shaky stance.
• 3.  Abdomen is very enlarged.
• 4.  Extremely high heart rate (100 BPM or greater)and weak pulse.

ACTIONS:
Death is imminent!  Apply first aid immediately.  Transport dog to Veterinarian as soon as possible (even while applying first aid if possible).

(2)   Listen to the dog's heartbeat using a stethoscope if possible.  If a stethoscope is not available, use your ears and eyes.  The heartbeat can be best heard on the left side of the dog's chest just behind the elbow and is strong enough to be visible on the chest wall (figure 1).  A normal heartbeat is irregular when the dog is resting and often consists of a double beat (thump...thump...thump-thump...thump...thump, etc). Using a timepiece with a second hand, count the number of heartbeats for 10 seconds.  Multiply the number of heartbeats x 6 to find the Beats Per Minute (BPM) (12 beats x 6 = 72 BPM, etc.).  The normal heart rate/pulse rate of a large breed dog is 60-80 BPM.

(3)   Take the pulse rate of the dog by pressing your fingers inside the dog's rear leg just below where it joins the body.  At this location, you can feel a cord-like structure called the Femoral Artery (figure 2).  Count the pulses for a ten second period and multiply by six to determine the rate of the dog's pulse (same procedure as discussed above).  You can also observe the strength of the pulse at this location.

4. Recommended actions:

A.   When your dog is showing any of the bloat symptoms you should:

• Attempt to determine the bloat phase he may be in.
• Call your veterinarian, discuss symptoms and ask for guidance.
• If you conclude your dog is in phase 1 bloat and you can reach your veterinarian within 30 minutes, do not apply first aid procedures.  Go directly to the veterinarian.
• If you conclude your dog is in phase 2 bloat and you cannot reach your veterinarian within 10 minutes you should attempt to insert a stomach tube before going to the veterinarian.
• For phase 3 bloat, if you cannot reach your veterinarian within 10 minutes apply first aid immediately. Attempt to insert a stomach tube. If this is not accomplished quickly, you should use Trocharization procedures to relieve the gas pressure! Death is imminent!

B.   DOGS MAY GO TO PHASE 3 BLOAT WITHOUT SEEMINGLY GOING THROUGH PHASES 1 OR 2.  PHASE 3 CAN BE FATAL IN MINUTES. BE ALERT!

5.   First Aid:

A.   In bloat Phases 2 and 3, attempt to pass a tube through the dog's mouth into the stomach.  Two persons are normally required for this procedure.   NOTE 1:  Pre-measure and mark each stomach tube for each Great Dane in the household.  To do this, place the dog in a sit position.  Measure the stomach tube on the outside of the dog from the front of the mouth to the last rib and mark the tube at the front of the mouth with a piece of tape

• Remove an eighteen inch strip of tape from the tape roll.  Insert the roll of tape in the dog's mouth behind the front teeth. Ensure the tape roll hole is pointed toward the dog's front and rear.  Using the strip of removed tape, tightly bind the dog's muzzle with the roll of tape in position (figure3).
• Lubricate the bevelled end of the stomach tube with K. Y. jelly  (be careful not to plug up the tube holes with the jelly).
• Carefully insert the tube into the dog's mouth through the hole in the tape roll (figure 4).  Some resistance will be felt when the tube reaches the dog's throat.  However, the dog will start to swallow as you push the tube deeper into the throat and the tube should enter the esophagus with little resistance.  It the dog does not swallow the tube or the tube seems stuck, gently move the tube back and forth until it enters the esophagus.
• Once the tube is in the esophagus, gently blow through the tube as you advance it toward the stomach.  This will expand the esophagus and allow the tube to pass more easily.

• The tube may encounter a resistance when it reaches the stomach because of muscle spasms in the stomach valve or twisting of the stomach (torsion).  If this happens, blow more strongly through the tube while turning the tube in a clockwise direction.  If the tube does not enter the stomach, continue blowing and carefully turn the tube back and forth.
• You will feel a quick, forward movement of the tube when it enters the stomach.  Caution! Do not insert the tube too far into the stomach and pierce the stomach wall.
• Immediately remove the tube from your mouth.  Gas will be expelled through the tube as it enters the stomach (figure 5).  Fluids will follow the gas.
• After the gas and fluids stop, you should squeeze the dog's abdomen to remove as much of the remaining stomach contents as possible.  To do this, stand over the dog facing the same direction as the dog.  Grasp the dog with locked wrists around the abdo men and squeeze firmly (figure 6).  Continue to remove the stomach contents for five/ten minutes.

• Cover the end of the tube with your thumb and carefully remove the tube from the dog.  Then, transport the dog to the veterinarian immediately.
  
  Note 2:  If you are unsuccessful in inserting the tube into the stomach after five minutes, it is probably not possible to pass a stomach tube.

B.   If you are unable to pass a stomach tube and the dog displays phase 3 bloat symptoms, you have a very short time to act to save the dog's life.  By this time, the dog will normally be gasping for air and unable to stand.  The abdomen will be very distended and sound like a drum when thumped.  The heart rate will be over 100 BPM and the gums will be white, blue or grey.

C.   Trocharization must take place immediately.  This action can save your dog's life.  The veterinarian will appreciate the fact that you took the Trocharization action and brought in a dog that has a chance of recovery.

• Locate the last rib on the dog's left side.  The stomach is located on the left side of the dog's abdomen under the last few ribs (you will not have any problem finding the stomach because it will be very distended).
• Remove the cap from the 14 gauge needle.
• Firmly grasp the blunt end of the needle and with a sharp motion, stab the needle into the dog's stomach on the left side behind the last rib (figure 7).  Gas will be expelled immediately through the needle.  Do not be concerned about hurting the dog because he is already in such intense pain from the bloat and torsion he will not notice the pain from the needle.

• Squeeze the abdomen (subpara 5.A. above), then remove the needle. Immediately transport to a veterinarian.

6.   Recommendations to help avoid Canine Bloat:

A.   Veterinarians continue to study the bloat problem and still have many unanswered questions.  Researchers prepared the following recommendations to help prevent canine bloat.  You should discuss these recommendations with your veterinarian and other Great Dane owners:

• Feed the dogs two or three times daily, rather than once a day, and at times when someone can observe them after they have eaten.
• Avoid vigorous exercise, excitement and stress one hour before and two hours after feeding.  Walking is okay because it helps stimulate normal gastrointestinal function.
• Feed dogs individually and in a quiet location.
• Make diet changes gradually over a 3-5 day period.
• Ensure water is always available but limit the amount immediately after feeding.
• Watch for any actions or behavior that may signal abdominal discomfort (abdominal fullness, pacing, salivating, whining, getting up and lying down, stretching, looking at abdomen, anxiety and unsuccessful attempts to vomit, etc.
• Establish a good relationship with a veterinarian. Discuss emergency procedures, preventative surgery (Gastropexy (circumcostal, tube, incisional)) and overall medical management of your dog.

Additional resource's for information on bloat are below:

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