Gastric Torsion: A Horribly Unhealthy Kind of Twist

Torsion, gastric torsion, gastric dilatation-volvulus, GDV; these are terms you never want to hear applied to your dog.  They all mean the exact same thing- your dog’s stomach is distended with gas and has twisted on itself, and emergency surgery offers the only hope for saving his life.  Here’s a visual aid to help you understand what happens when a dog develops gastric torsion.  Picture a fanny pack in your mind.   The pouch of the fanny pack represents your dog’s stomach.  One strap of the fanny pack is the esophagus that transports food from your dog’s mouth down into his stomach.  The other strap is the upper small intestine (duodenum) that transports food out of the stomach.  Now hold one strap of the fanny pack in each hand and twirl the pouch until it twists on itself causing the straps to crimp.  This is what happens when gastric torsion occurs- the stomach twists on itself, cutting off normal blood flow to the stomach and surrounding structures.  Additionally, gas and fluid continue to accumulate within the stomach and cannot flow out via the crimped esophagus or duodenum, so the stomach progressively distends. A dog in this situation quickly lapses into a state of shock and surgical “decompression” or untwisting of the stomach is the only way out of this nightmare.  Time is of the essence- the longer the stomach remains twisted, the greater the likelihood of irreversible devitalization (death) of the stomach tissue.

Image Credit: HoundFancy, 2001


Initial symptoms of gastric torsion include a bloated appearance through the midsection (the ribs look like they are expanding outward), drooling, nonproductive retching/vomiting, restlessness, weakness, shallow breathing, rapid heart rate (if it can be felt through the chest wall), and pale gum color.  If you observe such symptoms, quickly make some phone calls to find the closest veterinary hospital capable of performing immediate surgery on your best friend.  The sooner surgery can be performed the greater the likelihood of a successful outcome.  Irreparable damage to the stomach tissue is often the deal breaker if the torsion is not corrected quickly.  At the time of surgery, not only is the stomach derotated, it is tacked (attached with stitches) to the inside of the abdominal wall to prevent a repeat spinning performance.  Additionally if the spleen or portions of the stomach wall appear devitalized (deprived of normal blood flow for too long) they will be removed.  If surgery is successful, the dog typically has a minimum two to three day post-operative stay in the hospital for round the clock monitoring for post-operative complications.   

Truth be told, we really don’t know much about what causes gastric torsion.  Clearly, there is a breed/conformation association- large deep-chested breeds such as Great Danes, Irish Setters, Standard Poodles, Irish Wolfhounds, Boxers, Dobermans, Weimaraners, and Rottweilers are particularly predisposed.  Affected males definitely outnumber females. One study documented that elevating the food bowl actually predisposes to gastric torsion.  Other studies have indicated that the following factors may also be part of the recipe that results in gastric dilatation-volvulus: eating only one meal per day, eating rapidly, eating dry foods that list oils or fats among the first four label ingredients, exercising in close association to mealtime, being underweight, and being of an “anxious” rather than “happy” personality type.  The only known way to prevent gastric torsion from occurring is by performing a prophylactic (preventive) gastropexy procedure (sutures are used to tack the stomach wall to the inside lining of the abdominal cavity).  This does not prevent the bloating (stomach distending with gas), but does prevent the life threatening twisting part of this miserable disease process.   

Would you like to participate in a study to learn more about why dogs develop gastric torsion?  If your dog has ever bloated (distention of the stomach without rotation) or has experienced gastric torsion, I encourage you to take this survey  It is being conducted by Dr. Cynthia Otto from the University of Pennsylvania School of Veterinary Medicine in collaboration with researcher, author and lecturer, Dr. Carmen Battaglia. A summary of the results and findings will be posted at in November, 2010.  If you and your dog did have direct experience with a gastric torsion, I sure as heck hope yours was a happy ending.   

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life

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4 Comments on “Gastric Torsion: A Horribly Unhealthy Kind of Twist

  1. My 5 yo Greater Swiss Mt Dog had a history of vomiting, was evaluated for this as well as an ultrasound which found a very enlarged spleen. I got a second opinion from an internal medicine vet and although I asked about tacking his stomach it was not recommended. One week later he torsed at midnight. His spleen was removed, biopsied and showed no disease.
    He had none of the “classic” risk factors, was fed twice a day on the floor, correct weight, calm dog etc. other than he is a deep chested dog.
    His first symptom was that he fell down yipping like something bit his hind leg, shortly afterward he vomited white foam, rushed him to an ER within the hour and they saved his life.

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  3. I have lost three dogs to bloat/torsion. Each one had surgery. One lived for 14 months had second surgery died two weeks later. I have completed the survey in the past.
    My first dog I lost in 1998. I lost his two (linebred) granddaughters in 2009 and 2010. I wonder if there is a genetic link. Coincidentally, all three were liver colored German Wirehaired Pointers. And I am VERY careful about food, water, exercise. It was my worst nightmare.