Gastric twisting

Extreme abdominal syndrome can often turn deadly in short laps of time. It's an extreme emergency.

The mechanisms:

The dilation or twisting of the stomach is caused by the massive accumulation of gases and of liquids in the dog's stomach.

The normal cycle of digestion produces gases, but they are evacuated as it happens.

In certain circumstances this mechanism is defective, especially when there is a rapid and important accumulation of gases. This produces stomach distension and the sphincter, placed over the stomach, blocks. This stops the evacuation of the gases.

Many studies have been done to find the cause of this syndrome and some theories have been made, most of them concerning the mechanisms that create the massive formation of gases in the stomach. But, the actual cause is still uncertain.

The dilation will always turn into twisting of the stomach. Both of these phenomenons are connected but, still to this day, the mechanisms of this twisting syndrome are unclear.

Once the twisting is under way (it can reach 180 to 270 degrees), the stomach swells. This blocks the blood flow and also compresses the vital organs. These effects lead to a state of shock with coma and a rapid death if it is not treated.

The dilation or twisting of the stomach is a serious emergency where every minute counts.

What are the pre-disposing factors?
Belonging to a race of big or giant dogs is a risk factor. (Great Dane, Saint-Bernard, Doberman, Rotweiller, Irish setter, Boxer, Wolfhound…)

But there are certain exceptions. Some small dogs are also vulnerable.

The age: The dilation or twisting of the stomach generally occurs to dogs that are 2 years of age or older. And there is an increase in the risk when the dogs are 4 years of age or older.

The type and ways of feeding:

The risks are greatly increased when a dog eats a big meal only once a day.

A great amount of water swallowed in small laps of time (many litters at once) is something to avoid. If your dog is really thirsty, give him small amounts of water at a time. While intense heat or when walking your dog, always remember to give him water.

Eating to much grass or other plants can form a cap at the level of the pylorus. (Sphincter that allows the stomach to connect with the intestines)

Food that is made with left over meat or with rancid greases is hard to digest. Also, a misbalanced diet, too rich in cereals is also a factor that increases the risks of dilation or twisting of the stomach.

Some particularity in anotomo-physiologics:

-Deep and narrow chest of the big races of dogs.

-Oesogastric dysfonctionment.

-Weakness in the hepatic and pyloric ligaments.

What are the warning signs to recognize imperatively?
Being able to recognize dilation or twisting of the stomach rapidly can save the life of your dog.

The first signs: nausea, vomiting efforts without effects, drooling. These signs happen after a meal is fallowed by exercises.

These signs are accompanied by a worried state. The dog is agitated or prostrated.

At this state it is important that the owner knows how to feel the stomach of his dog to see the first signs of the dilation of the stomach.

To do so, the owner has to place himself behind and over the dog. (Like if you where to sit on his back.) With both hands flat on the abdomen, going from front to back, feel the sides of the stomach to find the bottom of the stomach and also to find a sensation of swelling and volume.

At the slightest doubt, it is important to take your dog to the veterinarian.

Never forget that dilation or twisting of the stomach is a vital emergency where every minute counts.

A good precaution to take is to call your veterinarian before leaving to ensure his presence. If he is not there, locate another veterinarian near your location.

Never apply pressure on your dog's swollen stomach and never give him water, milk or vomiting agent.

The respiratory dyspnoea progressively appears with cardiac troubles (Irregular beating…) and circular troubles. (The mucous membranes are purple.) This is a state of shock. The need of resuscitation is essential.

How to notice?

If someone ever had an experience with a dog that had stomach dilation, the vision of the syndrome is forever remembered. The veterinarians can almost make a diagnostic over the telephone because the owner says, “My dog ate a good meal a moment ago, but now it looks like he swallowed a football because his stomach is so big.” The dog is unable to stay still, he tries to vomit a lot and he makes loud noises but nothing comes out, he is drooling a lot and he is very uncomfortable. He even has trouble breathing. If the dog is alone, he will fall to the side, the stomach is very bog and ready to explode. His heart rate becomes very weak. It also accelerated over the normal rate. (100-120 beats a minute.) The rate can climb up to 160-180 and even more. The heart beats are not loud and there is an irregulation in the rhythm.

The dog is in a state of shock and dies quickly. When the owner finds the dog hours later, he might think that the dog was poisoned, but this is false.

Steps to take:

Call a veterinarian and explain the situation.

Go see the veterinarian as fast as possible.

Try to find a knitting needle if the dog has been suffering for a couple of hours.

If the abdomen of the dog is very voluminous, if you feel that his stomach is hard and that the dog has been suffering for hours, it means that the dog has been sick for a couple of hours. Call a veterinarian right away to get help to pierce the stomach. This operation is hard, but it can save the life of your dog. Stab the needle between two ribs. (Around the 6th one if possible.) This operation is supposed to pierce the stomach and let gases out to relieve pressure on the other organs. But, the effect is temporary. (The hole will close within a couple of minutes.)

At the veterinarian:

First of all, they treat the state of shock with two catheters, two big needles that are placed in the veins and sutured to the skin. They give enormous quantities of serum (1 or 2 litters and sometimes more.) with different medications like anti-shock and analgesic. Then they quickly assure the decompression of the stomach. They have three options for this step.

Oro-gastric probe:

They pass an oro-gastric probe, a kind of tube made of rubber, in the stomach. It is 1cm wide and 1.50m long. This is inserted after a general anesthesia. If the probe reaches the stomach, the gastric content is aspired and when the stomach is empty they wash it with serum.


A sterile trocart or a big hypodermic needle is placed through the surface of the abdomen all the way to the stomach. A salutary whistling sound is heard as well as bubbling noises when there isn't foam. At the same a bad odor fills the operating room and the stomach deflates.


In the case where the dilation is complicated by twisting, the passing of a probe is impossible. If the dog is not dying, if his electro-cardiogram and his state of shock allow it, a general anesthesia is done and gastronomy is immediately performed. The veterinarians make an incision from the sternum to the pubic area. When they have access to the stomach they open and empty it. Then they perform a meticulous inspection. If thrombosis zones are detected on the surface of the stomach, they remove them.

Because the stomach turned on itself, it is sometimes necessary to remove the spleen. This process makes the operation longer and also increases the risks of shock after the operation.


To avoid a new dilation or twisting of the stomach, the veterinarians have a habit to fasten the stomach to the costal surface. There a re also other procedures that are used, but they are less common.

After the operation, the danger comes from the heart.

Even if everything went well, if the dog wakes up without a problem and if he does not rip out his catheters, he will still be in danger for 3 to 4 days. The danger mostly comes from the heart. Some ventricular extra systoles are in relation with troubles in heart rhythm that are shown on the electro-cardiograms. This can still happen even with modern day treatments. These extra systoles can prolong themselves with a ventricular fibrillation where the first and last symptom is death.

The dog is reintroduced to food by intravenous injections at first, then the dog can eat solid food, but by little portions that are spread out during the day. After a week or two, the dog goes back to his normal routine or he is introduced to a diet for dogs that have digestive problems.

Because of the gravity and brutality of dilation aggravated by twisting, because of the importance of the emergency operation that was performed on an animal in a state of shock and because the risks after the operation on the heart are present, dilation of the stomach on a dog is an event that is most often deadly.

The 12 commands of a good owner
These commands are very important and they have to be respected to avoid the syndrome of dilation or twisting of the stomach.

Do not let your dog do any violent exercises 1 hour before eating as well as 2 hours after eating.
Feed your dog in an isolated location where it is calm. If you have more that one dog, give them each they're own boll.
Place the boll at the height of your dog's chest.
Leave your dog's water to sit for 20 minutes before giving it to him. This will let all the gases evacuate the liquid.
Do not let your dog drink a big quantity of water after eating. Let fresh water in his reach all day, don't take it away.
Do not brutally change his diet.
Give your dog food that is prepared with premium quality materials (Cereals, Vegetables…)
The food has to be cooked and digestible. Be careful with dog food bags that are ripped or open. The content can rot and get contaminated with bacteria, making it dangerous for consumption.
After eating, let your dog rest. Give him at least 2 hours before bringing him for a walk or doing exercises.
Never let your dog brink a big amount of water after a big exercise. Give it to him in small amounts at a time.
Always be aware of what your dog eats. Keep trash cans out of their reach. Give your dog a balanced diet. (Not only cereals…) Don't give them bones.
If your dog is stressed, try to keep him relaxed for an hour before and after eating.

In conclusion

Just remember that all dogs can have dilation or twisting of the stomach, but some races are more in danger than others. It's an accident that is brutal and bad where every second counts. You must go to your veterinarian's office as fast as possible to have a chance to save your dog.

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