PLEASE READ!  If you read NOTHING else about bloat, PLEASE read this.....

A Message to Dog Owners from the Director of
the Purdue Bloat Research Program

Several times a week I receive a phone call from someone whose dog has died of bloat.
Usually my role is to provide a sympathetic ear and assure the callers that there was
nothing they could have changed to prevent the incident. Our current knowledge of bloat
does not allow us to identify specific events that ětriggerî an acute episode in susceptible
dogs, although some form of "stress" was probably involved. One of our long-term
research objectives is to better define what constitutes stress for dogs and to measure
their physiological response to it. However, the primary goal of the research is to
determine why some dogs are more susceptible to bloat than others, i.e., what are the
risk factors for bloat. This has led to studies of the physical conformation of dogs, their
diet, vaccination histories, and even to new ways to evaluate a dogís temperament and

The overall bloat fatality rate approaches 30% for dogs with a dilated, rotated stomach.
Approximately half of the dogs that die with a rotated stomach will do so before
veterinary medical or surgical treatment is obtained. Dogs may be found dead or die on
the way to the hospital, or may be euthanized by the veterinarian because of their poor
prognosis or the owner's financial considerations. In contrast, dogs properly treated have
>80% probability of surviving a bloat episode and then leading a normal life. Veterinarians
over the past 2 decades have reduced dramatically the postoperative fatality rate from
gastric dilatation-volvulus (GDV) from >50% to <20% by using improved therapy for shock,
safer anesthetic agents, and better surgical techniques.

Too often, however, owners of dogs that died of bloat tell me that they had recognized
that the dog had a serious problem and rushed the dog to a veterinarian, only to be told
that it was probably only a "belly ache," or that the dog's stomach was dilated, but not
rotated. Sometimes the veterinarian recognized dilatation, but not a rotation (volvulus,
torsion), passed a stomach tube to relieve the pressure, and sent the dog home. Or the
dog was diagnosed as having dilatation and rotation, and a stomach tube was passed to
relieve the pressure, but surgery (gastropexy) to permanently correct the rotation was
delayed, either because the dog was thought to be too ill to withstand the surgery, or
the veterinarian was not adequately equipped or prepared at the time to perform the
operation. The latter may occur if the veterinarian is in the midst of busy office hours or
if -- especially at night -- there is insufficient technical help available to properly perform
the surgery, which requires careful administration of anesthesia, appropriate fluid
therapy, and close monitoring of the dog's vital signs.

Numerous clinical reports from Europe and the United States show that gastropexy to
prevent gastric rotation should be performed as soon as possible following stomach
decompression on all dogs with gastric dilatation, whether or not the stomach is thought
to be rotated at the time. The recurrence rate of gastric volvulus in dogs treated for
bloat conservatively, i.e., without surgery, approaches 100%, whereas the recurrence
rate following gastropexy is <5%. The stomach of a dog that has had a gastropexy can
still dilate, but it is unlikely to rotate, so if dilatation does occur after gastropexy, it can
probably be treated conservatively.

What does all this mean to you? If your dog suddenly develops a distended abdomen,
appears uncomfortable, and gets progressively worse, rush the dog to a veterinarian,
preferably one equipped to do emergency surgery. Gastric distention is a life-threatening
condition, even if the stomach has not rotated. Immediate decompression is required
to relieve pressure on blood vessels and to restore circulation to the heart, because shock
can occur within minutes of the first clinical signs. Fluid therapy is indicated to treat
shock, and drugs may be needed if the heart rhythm is irregular. This should be followed
as soon as possible by surgery to reposition and immobilize (gastropexy) the stomach
before it is irreversibly damaged. The best indicators of how well the dog will do
postoperatively are its physical condition (state of shock) prior to surgery and the
appearance of the stomach during surgery (since dead or dying stomach tissue implies a
very poor prognosis). Intensive monitoring is usually required for several days
postoperatively in case complications occur.

If you suspect your dog has bloat, but the veterinarian dismisses it as a minor problem,
inquire about radiographs to rule out GDV. If dilatation with or without volvulus is
diagnosed and the stomach is decompressed, either by passing a stomach tube or by
piercing the stomach with a large needle (trochar) passed through the body wall, the dog
should be considered as a candidate for immediate surgery, unless its condition is too
unstable to tolerate anesthesia. If the veterinarian recommends that surgery be delayed
for any other reason, seek a second opinion immediately. Delay in surgery will increase
the chance of the stomach rotating if it hasnít already, or will decrease the chance of
the dog surviving if rotation has occurred.

Following is an excerpt of a letter that illustrates some of these points. "I noticed Kelly [an
Irish Setter] attempting to vomit with nothing coming up. Grass? Chicken bone? I watched her and we
continued to walk. She was happy and greeted people, wagging her tail, ... and had
fun. We went home and Kelly went upstairs where she attempted to vomit several
times. I immediately called my vet. Kelly and I arrived at the veterinarianís office
within five minutes of the phone call. I told the veterinarian that Kelly had vomited
two or three times with nothing coming up. I said that she looked a little broad
around the ribs. The veterinarian did a physical examination and concluded that
Kelly's problem was just a "stomach ache." ... I was directed to give her Pepto
Bismol®. I took Kelly home and she lay down on the bed. About 45 minutes later
she went out to the back yard. When I went out 10 minutes later, I found her
bloated up. I grabbed her, took her back to the veterinary hospital, but she died on
the operating table." (Comment: There is no guarantee that if radiographs
had been taken during the first veterinary visit, Kelly's outcome would
have been different. However, radiographs might have confirmed the
presence of gastric dilatation or volvulus, and thus the need for immediate gastric
decompression and surgery.) Be prepared -- Teamwork between you and your
veterinarian is your dogís best hope when it comes to bloat. For more information on the
early signs of bloat, talk with your veterinarian. Ask what treatment he/she recommends
for bloat, and if their hospital has a 24-hour emergency service. --Larry Glickman, VMD,

Life after Bloat -- Elly's Story

(Editor's note: Elly's story was sent to us by Pauline Anderson. Elly, who was in Purdue's
case-control study of bloat risk factors, underwent gastropexy. Her good post-bloat
condition illustrates a typical outcome of prompt emergency treatment and gastropexy --
even to the point of competing at shows.)

"I'd like to share a happy experience I had with Elly, my Standard Poodle, a bloat survivor.
First, let me give a little history of Elly's bloat incident. In November of 1993, Elly
suffered full-blown bloat twice in a 16-hour period. She was in a very serious condition
and the decision to go forward with surgery was the only one for
Elly if she was to survive. Elly was nine at the time of surgery. She
is now twelve and is enjoying a very happy life, although her
tummy still has a tendency to distend quite frequently. Fortunately
this condition has proven to be of little consequence and there
doesn't seem to be any discomfort for Elly, so we have learned to
accept it.

Now, let me get to the subject that prompted me to write. On
June 18, 1995, Elly earned her C.D. (Companion Dog Title) from
AKC. She received a special award of a silver bowl for being the
oldest qualifying dog at the trial. She also received awards for placing 4th and for being
highest scoring Poodle in Novice A and B. Elly virtually began and ended her obedience
career at eleven years young in less than 60 days, a full year and a half after her bloat
experience. I want to say bloat is not always the end of the world, thank God, and there
are still happy times to be had. Even special awards to be won." --Pauline Anderson

Honor Roll

We extend heartfelt thanks to all the individual dog owners and breed clubs for donations
for Purdue's bloat research through the Morris Animal Foundation and the AKC Canine
Health Foundation. These include the Akita Club of America, American Bloodhound Club,
American Rottweiler Club, Collie Club of America Foundation, Irish Setter Club of
America, Irish Wolfhound Club of America, Newfoundland Club of America, and
Weimaraner Club of America. We wish it were possible to publish all the names on our
honor roll of donors. Purdue has also received direct donations for bloat research from:

Cleveland Collie Club

Great Dane Club of Western Washington

Irish Setter Club of Milwaukee

Poodle Club of America

Saluki Club of America (in honor of Ch. Ariel Sonova Drama of Hasten, owned by
Cheryl R. Rosenberger)

In Memoriam

We are pleased to acknowledge memorial fund donations to Purdue's bloat research
program in honor of:

Misty Schott

Vinnie, a Standard Poodle owned by Pat and Rose Essy (donation from Dianne

Misty Schott, pictured below, a German Shepherd (donation from Jan Ruggles)

Epidemiologic studies of bloat and companion animal health problems by Purdue
University School of Veterinary Medicine are made possible by contributions from the
Morris Animal Foundation, AKC Canine Health Foundation, animal health companies,
private foundations, breed clubs (national, regional, and local), and individual dog
owners. We welcome your comments, suggestions, and support.

$$ Those wishing to donate can send contributions to Purdue
University in care of Dr. Larry Glickman, Bloat Research
Program, Veterinary Pathobiology VPTH 101, Purdue University,
West Lafayette IN 47907-1243. If you are making a donation in
memory of a bloat victim, and wish to have the dog's photo
published in BLOAT NOTEs and on the World Wide Web, please
indicate this when sending a photo.

Meet the Research Team --

Larry Glickman, VMD, DrPH, who directs the Purdue Bloat Research Program, is
Professor of Epidemiology and Environmental Medicine, Department
of Veterinary Pathobiology in the School of Veterinary Medicine at
Purdue University. Larry received his veterinary medical training at
the University of Pennsylvania School of Veterinary Medicine, and
was a veterinary practitioner for several years. Most of his career
has been spent in teaching and research. After earning his
doctorate in Epidemiology and Public Health from the University of
Pittsburgh Graduate School of Public Health, he taught preventive
medicine and conducted epidemiologic research in the veterinary
schools at Cornell University and the University of Pennsylvania; he
came to Purdue in 1988.

His broad research interests, reported in books and >150
scientific papers, include zoonoses, particularly roundworm
(Toxocara) infections in dogs and humans, rabies, and
cat-scratch disease; parvovirus infection in dogs;
heartworm infection in dogs and people; the efficacy and
adverse effects of canine vaccines; nutritional
requirements of dogs; distemper in dogs; cancer; and pet
overpopulation issues. Another strong interest has been
the role of pet animals and wildlife in identifying
environmental hazards.

He has summarized this work as follows: "Risk assessment is the process of
characterizing the potential adverse health effects of human exposures to environmental
hazards. The important elements of risk assessment are hazard identification,
dose-response evaluation, exposure assessment, and risk characterization. The
traditional sources of data used in risk assessment are findings of human epidemiologic
research and laboratory animal experiments. Because of the limitations of these
approaches, we have conducted epidemiologic studies in pet animals with naturally
occurring cancers to determine if the home environment is potentially hazardous to both
pets and their owners. We have shown that asbestos and insecticide exposures of dogs in
the home increases their risk of mesothelioma and bladder cancer, respectively. Because
the time between these exposures in dogs and the onset of cancer is considerably shorter
than for humans, cancers in pet animals serve as sentinel diseases or early warning
signals of a hazardous home environment. We are in the process of establishing a
network of veterinarians to identify these veterinary sentinel health events."

We are also using several species of fish to develop
biomonitoring methods to evaluate environmental
contamination by toxic chemicals such as radioactive
cesium and their potential to cause adverse health effects
in humans, e.g., effects of the Chernobyl disaster."

Research on bloat in dogs has been a family affair for
Larry and his wife Nita (profiled in the May 1993 issue of BLOAT NOTEs) since the late
1980s, when they first explored the use of the Veterinary Medical Data Base as a source
of information about this disease. Both their son Seth, now in the MD-PhD program at
the University of Pennsylvania, and daughter Danielle, a student at DePauw University in
Greencastle, IN, have worked on various aspects of the research.

The Bloat Research Program at Purdue was launched in 1991 with case-control, survival,
radiographic, and genetic studies of risk factors for bloat, funded by the Morris Animal
Foundation. With funding from breed clubs, individual donors, and most recently the
American Kennel Club Canine Health Foundation, the program has continued to grow.
The goal remains the same: to help veterinarians and dog owners develop practical
preventive measures to reduce the incidence of this disease. Larry realizes that, ěto
accomplish our goal, many more years of hard work are still needed.î However, he
readily accepts this challenge as long as dog owners and breed clubs continue to give their

Excerpts from Purdue Bloat Notes found at