Gastropexy: Preventing Bloat in Your Dog

Every dog owner wants their pet to be as healthy as possible. That’s why veterinarians recommend puppies have a series of shots and dogs receive an annual physical examination. We also prescribe preventive medications like those to protect from heartworms and, as dogs age, more frequent examinations to address geriatric concerns like arthritis and thyroid disease. But in my mind there is more to consider, and in specific cases do, for our favorite furry friends…for example gastropexy.

A different type of stomach stapling
Literally translated from medical terminology, gastropexy describes the surgical attachment of the stomach to the abdominal wall. This is not a weight loss surgery, but a surgery designed to prevent the stomach from slipping out of place and twisting on itself. For families with large breed, deep-chested dogs, this surgery alleviates the worry about a twisted stomach, also called gastric dilatation and volvulus (GDV) or bloat.

Bloat is a life threatening condition where the stomach becomes distended with gas or food and then twists around itself. The twist blocks blood flow to the stomach and sets off a cascade of events leading to shock and, if not caught early, death. Correction requires emergency surgery to untwist the stomach and then surgeons typically perform a gastropexy to keep the stomach in place.

An ounce of prevention
Research has shown giant and large breed dogs, especially those with deep chests and narrow waists, are at risk for GDV. If a dog bloats and requires surgery to correct the problem, veterinarians recommend a gastropexy to prevent a second occurrence of GDV. Since we know certain breeds are at risk for GDV, I discuss a prophylactic gastropexy with families who have a large or giant breed dog. Prophylactic gastropexy has been shown to decrease mortality from GDV two-fold in Rottweilers and 29-fold in Great Danes. The surgery can easily be combined with spaying or neutering and can also be done non-invasively using laparoscopic techniques.

Research confirms
A recent study in the Journal of the American Animal Hospital Association confirms the ability of a gastropexy to prevent recurrence of GDV. Veterinary researchers evaluated dogs that had undergone prophylactic gastropexy due to their breed or dogs that had experienced bloat and required gastropexy. None of the 61 dogs in the study had a recurrence of GDV following gastropexy.

What dog owners can do
If you have a giant or large breed dog, discuss gastropexy with your veterinarian. If your dog has a distended abdomen, unproductive vomiting or retching, go to the nearest animal ER immediately since these signs are typical for dogs with bloat.

Thinking Outside of the Box: Creative Medical Solutions

Creative solutions to manage tough medical issues.

My colleagues at The Animal Medical Center have recently come up with innovative solutions to two very interesting cases that I’d like to share with you.

The PEG Tube for Bloat

Rufus has a percutaneous endoscopically-placed gastrotomy tube (or PEG tube for short). These tubes are commonly used at The AMC in both canine and feline patients who cannot or will not eat voluntarily. Rufus eats fine. His problem is gas in excessive amounts, so much so he becomes dangerously bloated – commonly known as belly bloat.

Dr. Sarah Stewart of The AMC's Internal Medicine Service determined that a strategically-placed PEG tube would relieve pressure and allow removal of excess stomach gas from Rufus’ stomach without the need for an ER visit.

The AMC team helped Rufus’ owners learn how to use the PEG tube at home to keep Rufus comfortable — and prevent hospital stays — while The Animal Medical Center team formulates a special diet and adjusts medications. I am happy to report that the PEG tube is working so well, in fact, that Rufus’ owners have already managed several bloat episodes at home, by themselves, without any medical support from us. The new diet is working and gas production is way down. Yesterday, Rufus had a low profile tube placed to make him more comfortable. I have included a photo of the new tube taken just after it was placed.

A Pleuroport for Fluid Removal

Mencheese, a beautiful, 13-year-old cat, has a tumor in front of his heart. The tumor is producing fluid which accumulates around his lungs. This fluid build-up makes it difficult — and uncomfortable — for Mencheese to breathe.

Dr. Janet Kovak, a member of The Animal Medical Center’s Soft Tissue Surgery Team, placed a pleuroport which provides a device that quickly and painlessly allowed us drain the fluid from Mencheese’s lungs until the chemotherapy controlled the tumor and stopped the fluid production. Dr. Kovak treats many types of soft tissue injuries or illnesses through the use of minimally invasive surgery such as thorocoscopy and laparscopy.

Take a look at the photo to see the pleuroport in action. Mencheese is sitting comfortably on a treatment table in the oncology treatment area at The AMC. You can’t see the pleuroport — it is under his skin — but you see the special needle and the tubing we use to drain the fluid. Keeping the fluid drained off his lungs has really improved Mencheese’s quality of life. He has been wolfing down cat food like he hasn’t seen a square meal in months!

Some readers may be familiar with a similar device called a vascular access port (VAP). Like the pleuroport, a VAP is surgically implanted. But instead of being placed into the space around the lungs, it is placed into a blood vessel. The VAP is used to draw blood samples and administer chemotherapy to cancer patients without the need for repeated blood draws or catheter placement.

The stories of Mencheese and Rufus are just two stories about “pets on the road to recovery” because of some creative care by The AMC staff and hard work on the part of devoted pet owners.

This blog may also be found in the “Tales from the Pet Clinic” blog from WebMD.

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For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.