(Gastric Dilatation-Volvulus)
Hannah is my 13.7 year old Giant Schnauzer grandma girl who has had three episodes of bloat in the last two years. The first being March 2000 after inhaling too much air while she was eating. There was no torsion so we were lucky as she was 11 years old at the time of her first event. I was sitting right there (thank God) and saw her stomach blowing up before my very eyes, it was horrible. She kept circling and trying to vomit and poop and couldn't do either. She was screaming out in pain and it took me a couple minutes to realize what was going on. Her stomach started to look as if she was pregant and about to whelp a litter and then like someone had a pump in her mouth blowing her up like a balloon. I realized it was bloat! I grabbed a lead and Hannah and we raced out the door to the ER 12 miles away. I called enroute to tell them I had an 11 year old GS in bloat and to have a crash cart ready. They did and whisked her away from me before my van was even stopped running.
She went straight into exray.
Exrays showed there was no gastric torsion so this was "only" bloat. A little easier because she could be sedated and tubed to get all the air and gas out immediately. After the immense swelling went down she was given a warm waterlavage to get the rest of the contents of the stomach out so it doesn't create more gas, causing a repeat bloat. Hannah spent the night at the ER so they could get her stableized and make sure she didn't blow up again. She got to come home 24 hours later and was very sore. She was put on reglan to help calm her stomach before each meal for about 30 days. Reglan is given 30 minutes prior to the meal and it helps to feed a bloat dog 2-3 smaller meals a day than one huge meal.
Second Bloat Event (October 2002)Over two years pass with no probs whatsoever and out of the blue Hannah bloats again around midnight in Oct 2002. I had just gone to bed and heard her pacing around and realized she had gone out the dog door and didn't come back in in the normal amount of time. I got up to check on her and couldn't find her. She was in the bushes all roached up and I thought, "Oh no, not again!" I grabbed her collar and told her to come on we were gonna go in the car. She wasn't as blown up this second time and I was trying to remain calm, telling her she was good girl and it was ok and I talked to her all the way to the ER. Once again, I called the ER enroute to tell them I had a 13 year old GS in bloat and to have a crash cart waiting on us at the door. Same procedure this time too. Exrays first then sedation and tubing. No gastric torsion this time either, thank God. Hannah spent the night, was on IV's and had a warm water lavage to remove the rest of the contents of her stomach. I picked her up the next morning and she spent the day at my regular vet under supervision so I could go to work. My vet gave her a torbugesic injection to her relax and she slept the entire afternoon away. I went to pick her up and she seemed to be much better than when I had left her about 4 hours earlier
Third Bloat Event (March 2000)Third bloat event was two nights ago, Dec 29,02 in the late afternoon. I came home from a couple hours of errands and as soon as I saw Hannah's posture, I knew. Thank God I came home when I did otherwise I would have come home to a dead dog. This time, I tried to follow the directions in the Bloat Book and get the tube down Hannah's throat to relieve the pressure and hopefully buy us some time. Thankfully, I had a torbugesic (pre-measured injection from my vet)on hand from last time so I gave her the injection before I tried to tube her.
I got the tube in, put the wood block in her mouth so I wouldn't get chewed up but there is nothing eaasy about doing this. You are trying to insert a tube down a dog's throat who is already in major pain and not very cooperative. (regardless of what the Bloat Book says about this) I did hit the stomach because there was an escape of horrible smelling gas and I could hear gurgling. But Hannah was fighting the tube so I took it out and we left for the ER immediately. Had I had a stronger pain reliever on hand, I could have tubed her with out the fighting and think I I would have been more successful than I was. I TRULY think a pain reliever/sedative given as soon as you notice the bloat will buy you some time and allow you to tube your dog much easier. I have friends with Filas and Mastiffs and this is what they do and they say it truly makes all the diff in the world. I will never be without torbugesic around the house from now.
(Of course, all of this is done with the permission of my vet as they know my ability with my own dog. Always, always seek veterinarian help with a bloat dog as quickly as you can! Time is of the most importance with a bloat dog.)
This time there was gastric torsion according to the exrays. You don't have a lot of time when they are torsed so I asked the vet to sedate her and try to get a tube in there and flip the stomach back. Didn't look too promising and I thought this was it for my grandma girl. She was fading fast but thank God the vet was able to get the tube in and the stomach flipped back. When she told me this I just broke down and lost it totally. Hannah spent the next 8 hours there and had the same procedures as before. IV's, warm water lavage to clean out the stomach. They are anesthesized to do this procedure. I picked her up and took her to Kirbie's chemo doc the next morning so he could begin the process of preventing this from ever happening again.
Hannah had her stomach tacked and a gastric tube inserted into the wall of her abdomen where the pyloris was attached to the wall. Once this pyloris attaches itself to the wall of the abdomen, the tube will be removed and a "valve/button" will be attached surgically. This is a permanent external "open/close" switch, if you will. If Hannah starts to bloat again, I can open the valve and let all the air/gas escape and prevent the blaot. Her stomach cannot flip again as it has been tacked but she can bloat again so I made the decision to have this procedure done. We just can't do this bloat again. ITs too hard on her and it just wipes me out. It is the most horrible thing to watch and know that your dog could die within minutes if you don't act immediately.
These pix are of the first portion of this procedure to install the valve. This tube/hose opens right into Hannah's stomach. i can hang it down, take the plug out and whatever liquid stuff is in there will come out along with any air/gas. You need to do this outside or over a container so it doesn't run all over the floor, its gross. In two weeks the hose will be removed and the valve will replace it. The valve is about two inches long and flat with a tiny little rubber stopper in the middle of it. You open the stopper and any air/gas in the stomach can esacpe so this is how bloat will be prevented imn the future. I can leave this open when I am at work or at night when we are asleep so there is no build up if she has eaten something that might produce gas. They truly do not know why this happens. Hannah never did it before she was 11 and didn't do it again until a copuple months ago. Its one of those unsolved mysteries to the veterinarian medical profession. Thank God! that even though there is no cure for it, there is a surgical solution to prevent from ever happening again.
The blue stuff is vet wrap to help keep the hose some place other than just hanging down.
Closer shot of the hose.
The valve/button will go where the hose is attached to her side.
You can see Hannah's posture is still a bit roachy from the pain but she is MUCH better than just 24 hours ago, thank goodness.
Hannah has had a good week and is doing amazingly well! She is eating 4 small half cup meals a day and loving each one, lol. She was very sore for several days and didn't do much other than eat and sleep. I took her to work with me Fri and Sat. so I could keep an eye on her and feed her mid day meals. She has been wearing a tee shirt to protect the external tube and because it has been a little chilly here.
All has gone very well until this morning, she chewed the tub right off! I change her shirt every day and when I was changing her shirt this monring I couldn't find the tube, ack! It was in her crate! The hole in her side is very small but doesn't look damaged so I put another shirt on to protect the hole and am hopng no damamge has been done that can't be repaired relatively easily tomorrow. I hope this doesn't mean she is gonna try to remove the flat "gas cap" once its in place!
Monday, Jan 6,03Hannah had to have surgery to repair her chew job. Doc basically re-did the tube inside and out. The part of the tube in her stomnach was still there so he went in to remove that and insert the new tube through the pyloris (which was still in place) so it wasn't major damage, thank goodness. She goes back on the 20th to remove the tube and install the gaastric button (gas cap) if we don't have any more set backs. Hannah is now sporting a "bite not" collar to prevent her from being able to reach around anc munch this tube off. She can eat and drink and sleep in it, she just can't bend her heck around to chew behind, yea! I'm still keeping a shirt on her to cover the tube and help keep it clean and out of the way so it doesn't get caught on anything
Here's a pic of the "bite not" collar to prevent Hannah from reaching around and chewing this second tube off.
Rosie kissing her best friend, Hannah.
Took Hannah for a check up today to make sure everything is as it should be with the tube. There's been some discharge the past couple days that concerned me so I wanted doc to see whats going on. Its normal and nothing to be concerned about so I am relieved. Here's a pic of Hanny without the shirt on so you can see how this is healing up and how much better she looks now.
2.5 weeks later, Wed., Jan 15,03
Gastric button is in place, no more tubes, YEA!~!!
Once the swelling goes down the Gastric button should lay flat against her body.
This is the closed postion for the button, bulb part is in Hannah's stomach.
Open position
My parting thought on bloat is, GET YOUR DOG TO THE VET as soon as possible in order to save your dog's life! Time is crucial and can be the difference between life and death in a matter of minutes.
3 weeks later, Fri., Jan 17,03Well, we had a bit of a set back 2 days after the button was put into place. Infection set in somehow so we had to remove the button, open Hannah back up to flush all the infection out of the area where the tunnel should have been formed with the pyloris by now. The good news is that the stomach isn't involved. It has healed up where it was tacked on the left side to prevent torsion and the right side is healed where the pyloris was moved. The area that isn't healed and was infected is under the skin, where the tunnel should be formed for the gastric button to go into the stomach.
Doc had to go in again so she now has two more big suture lines from the repairs. He put another tube in to hold the place around where the tunnel needs to heal and he also put a drain tube in this time. The drain tube can come out in 4-5 days but the tube stays in 2 weeks, just like the first time.
This time there is no yucky pus stuff stuff so I hope and pray this will be the final time we have to do this. Hannah is on double antibiotics this time, baytril and cephalexan and the tube is barely sticking out of the hole so she can't get a hold of it to chew it off again. I think she chewed it because she knew it was infected as she has done in the past when something was healing that needed air or attention. It occured to me to put a muzzle on her at night or when I can't be with her to be sure she can't get to the bit of tube sticking out ths time. She can still reach the area with the "bite not" collar. I can't believe I didn't think of a muzzle before or no one on any of the dog lists I am on thought of a muzzle, lol. That would have prevented her chewing it off but obviously not the infection so I don't know that it would have helped then anyway.
Here is a pic of Hanny resting after the third surgery with the muzzle on Jan 17, 03
Hannah sprung a leak yesterday so we ran over to let doc check everything out. Everything is still in place so it ended up being no big deal. The end of the tube broke off in the hemostat that's been there for two weeks now. We stopped the antiobiotc on Wed and by Fri I noticed a bit of swelling around the "hole" and some redness. We put her back on antibiotics and hopefully will be putting the button back in place on Wed. Feb 12, 03. Here's a couple more pix of the tube with the hemostats on it to hold closed. I'm running out of ideas to keep the clamp in place, lol. That is a bandana, ver wrap and alead around her front. The vet wrap and bandana are attached to the lead to keep them from slipping back and pulling on the tube
These are drastic actions but I felt it was the only thing left to do for Hannah. She isn't ready to to the Bridge yet so we really didn't have any option other than this. I don't think its for everyone, but if it means keeping your dog alive and bloat free and you don't mind the maintenance that goes with it, then it might be an option for your dog too.
These are pix of the final result! This bloat valve is sutured just under the skin so granny doesn't have anything to get a hold of with her teeth. This one is also much easier to maintain than the smaller plastice one with the lid. This is one piece with a flap in the middle. If she bloats the air/gas should just release through the middle flaps. If it doesn't, I have a small hard plastic stick that resembles a coffee stir to stick in the middle so the air can escape.
After all of this we have ben through, the gas cap has managed to pull away from the stomach so I opted not to do any more surgeries. I can't believe after all we have been through the thing is no longer working, lol. I let Hannah have the satisfaction of chewing the thing out Memorial Day weekend. This is now July and she is doing fine and much happier not having to sleep in the wire basket muzzle and have a device in her side to worry with anymore. Live and learn is all I can say. It seemed like the right thing to do at the time, but given what we went through and what I know now, I would not do this again, nor would I recommend having it done to your dog.
Interesting Dietary Risk Factor study done at Purdue on ingredients of dog foods they could be possible causes for bloat. Also warning against using elevated bowls as part of the study.M
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