By Charlene Dunlap

GDV - a Chronicle

Few afflictions kill an otherwise healthy dog as quickly as Gastric Dilation (bloat) with Volvulus (torsion), or GDV. Only the luckiest survive with minimal damage.

In 2009 on her birthday, December 15, my eight year old Standard Poodle Sydney bloated and torsioned. Anyone who has witnessed a dog with GDV can attest to the horror of this heart-stopping  experience.

Monday, prior to the event, Sydney had had diarrhea and her gut was very active and loud. This was highly unusual as her gastro intestinal system has always been extremely healthy. Imodium helped and by Tuesday afternoon she seemed better; however, there were still noisy rumblings in her gut. It is unclear whether or not her intestinal distress had any relevance for what was to come.

December 15, 2009 Tuesday – Day One

Tuesday evening after I had fed the dogs and cleaned the kitchen, my husband Glenn and I settled in front of the TV to watch So You Think You Can Dance. Suddenly, Sydney shot out from the open crate between our two recliners and tried to vomit. We leapt to her side as she dry-retched three times. As she had eaten a meal less than an hour earlier, the amount of effort expended should have produced results. Standing squarely with head lowered, lips pulled back and down, she was clearly in distress.

There was no hardness or swelling in her belly area; however, when I put my hands on either side of her ribcage, I noticed a sort of sponginess. Having long known about, but never before experiencing, the horrors of GDV, I feared the worst. "Call Sydney's doctor," I directed, "and ask her for the location of the nearest emergency hospital." Within five minutes, Glenn, Jyah (our other Standard Poodle), Sydney, and I were in the van headed for an emergency specialty hospital, a 45-minute trip.

Blinkers flashing, we sped down the highway. En route, Glenn phoned the hospital to expect us. Sydney lay quietly. She did not whimper, pant, or breathe in a labored manner. Nor did she try to vomit again. She seemed almost calm . . . unlike Glenn and me. Fearful thoughts snaked through my brain and constricted my throat: my words wafted out thin and shrunken, withering before they reached Glenn’s ears.
I pulled up to the hospital entry, and Glenn quickly carried Sydney inside while I parked the van. Jyah and I joined them in a waiting room where a technician asked us about Sydney’s symptoms. As we spoke, Sydney stood with head down, eyes dilated, panting. On either side of her tongue, underneath and running the length on both sides, engorged veins bulged out like fat red worms.

The technician took Sydney for x-rays while we paced the floor. Twenty minutes later, a doctor gave us the results – gastric dilatation-volvulus syndrome. She had bloated and torsioned. He told us that surgery was required to save Sydney’s life, and he then asked us to take care of the financials beforehand, apologizing for this necessity. He also asked our permission to relieve the pressure in Sydney’s abdomen by inserting a needle, explaining that this procedure could possibly damage her spleen. He said that Sydney would need to remain in the hospital for from three to five days. After information was imparted, papers signed, and $3,000.00 paid, a specialty surgeon was called, and Sydney was prepped for surgery.

Glenn, Jyah, and I huddled together in the lobby to wait.

At midnight, the doctor, a board certified surgeon, came out to tell us that, for a bloat/torsion case, Sydney had the best possible outcome: there was no dead/dying organ tissue, no compromised spleen, and no loss of part of her stomach. He said they had also preformed prophylactic gastropexy (stomach tacking), a procedure done to help prevent gastric torsion, or twisting of the stomach, in the future. (However, this is not a guarantee.) (Due to the high incident of bloat in Standard Poodles, many owners automatically have the stomach tacked when a female is spayed.)
We were then allowed to visit Sydney in the recovery room. Still unconscious, she was lying flat in a large steel cage, her dry, red, crusted tongue lolling out the side of her mouth. She was wrapped in blankets. I fought back tears as I wanted her to feel only our calm, loving presence. I reached through the bars and gently stroked her face, telling her how much we all loved her. Whining softly, Jyah nosed Sydney’s foot. We all sent Sydney thoughts of love and healing, and we left, arriving home at 2:00 a.m.
None of us slept that night.

When talking to the technician, Glenn had mentioned that Sydney was a highly trained actress, and that Sydney and Jyah had several movie clips on their own website, and he gave her the URL. Embarrassed, I said, "Sweetheart, she’s not interested in that." However, she was interested, and it played an important part in what happened later that day.
Visiting hours were over at 1:00 p.m. and we left figuring on returning at 7:00 to spend the evening visiting hours with Sydney. She had rested most of her time with us, and we hoped she would be calmer after we left.
However, she was not calmer.
That evening we returned at 7:00, and once again Sydney was brought to the lobby. We asked if we could stay with her in the same room as before. The technician told us that we had been in the euthanasia room, and that she would check to make sure it was empty. My chest constricted. It made me slightly nauseous to think we had been with Sydney, whose health was seriously compromised, in a room where grief and pain was impregnated in the very walls. However, by the time I processed this, we were at the door, and the technician ushered us in.

She immediately told us how badly Sydney had been behaving. She said no matter what her caretakers tried that Sydney continued to fight her confinement by digging, straining, and jumping up . . . all extremely detrimental to her recovery. Then she suggested that Sydney might be better off recuperating at home – if we were willing to take the responsibility. (Of course we were!) She said it was extremely unusual to let a patient go home so soon after this type of surgery but that she would talk to the surgeon about it.

Then, before leaving, she smiled and told us that earlier, while some of the technicians and nurses were on their break, they had watched Jyah and Sydney’s movies on the Internet; that they had popped popcorn and made an event of it. She said that from seeing the movies and from looking through the website, she knew we were extremely caring "parents". Glenn cut me a look that said, "See, it helps when people know about you."

Shortly thereafter, the surgeon came in. He said he did not recommend Sydney going home but that he would approve her release under the circumstances, and he directed us to take Sydney to our own veterinarian the following day. Within half an hour, we were given instructions and medical supplies, had settled up, signed out, and were on our way. We arrive home just in time to see who won the finale on So You Think You Can Dance.

Things did not go smoothly that night.

Even with pain pills, any food or water on Sydney’s stomach caused her pain. Lying on multiple comforters on the floor next to Glenn, she cried all night. Not being able to ease her pain was extremely anxiety-producing for both of us, and by morning Glenn and I were both running on nerves alone. Jyah seemed equally distressed by Sydney’s discomfort.

December 16, 2009 – Wednesday – Day Two

Glenn, Jyah, and I arrived promptly at 11:00 a.m. for visiting hours. Given the magnitude of Sydney’s ordeal, we expected our visit to be restricted to a short time in the recovery room; however, a technician walked Sydney out to the lobby on leash. We knelt to greet her, and she managed a weak tail wag. Her midsection was entirely wrapped in gauze over wound with strips of green and red Vetwap. We were invited to sit with Sydney in a room that was painted in pastel shades: the walls were lined with sofas and dog beds, and there was a thick rug covering the floor.
Before leaving, the technician told us that Sydney had been very agitated since coming out of the anesthesia, that she kept digging and jumping against the cage. The technician said she hoped Sydney could finally get some rest with us, and she left, closing the door. For the next three hours, Sydney lay next to Glenn with one foot hooked over his leg, assuring herself that he would be unable to leave without her.

Our first five days revolved around caring for Sydney: Buprenorphine injection for pain every 12 hours, one Tramadol 50mg tablet for pain every 12 hours (half-way between the injections), a few spoonfuls of I/d food with homemade chicken broth every four hours, Sucralfate (a stomach coating pill) every 12 hours, 20 mg Pepcid AC every 12 hours (given half-way between the stomach coating pill), 5 ml fluids subcutaneously every 8 hours. All of these were carefully regulated throughout the day and night.
After the third day, we no longer bandaged and wrapped Sydney’s midsection as our veterinarian said the incision needed to be open to the air. However, we decided to keep a clean tee-shirt (with sleeves removed) on her, pinned up so as to keep her incision from touching any other surface but yet still allowing air to circulate. To avoid having to use an Elizabethan collar, we decided to keep the tee-shirt on her so she could not bother her incision until her staples were removed. (It worked.)

Each day, we cleaned the incision with chlorhexidine-soaked sponges and then sprayed it with a first aid spray that contained 20% benzocaine for pain and itch relief and 0.13% triclosan (an antiseptic).

December 17, 2009 – Thursday – Day Three

We have had the same veterinarians for the past ten years. After reviewing the fax sent from the hospital, examining Sydney’s incision, and listening to our account of the events, our veterinarian sent us home with a prescribed course of actions, one of which was to give Sydney two bags of fluid subcutaneously daily for the next several days. (This caused her to be incontinent during sleep and we had to keep a diaper on her.)
Doing a subcutaneous procedure was new to us. We were shown how to make a little "tent" in the skin at the back of Sydney’s neck, to insert the large gauge needle carefully so as not to puncture anything besides skin, and to keep the supply line from crimping. As the fluid flowed under the skin, it formed a large, squishy "ball" which we were to gently massage around the edges so the fluid would flow more easily under the skin throughout the body.

That night, Sydney slept very well. (I know because I was half-awake all night watching her.)

December 19, 2009 – Saturday – Day Five

Our veterinarian told us that, if all went well, by day five Sydney should show a marked improvement. However, we were to continue keeping her on a leash everywhere she went for the next four weeks . . . that she must not be allowed to play, jump, run, or do anything that might cause a set-back in her recovery.

December 21, 2009 – Monday – Day Six

By our second checkup with our veterinarian, Sydney showed marked improvement. We were instructed to cut back the pain meds by half, to discontinue subcutaneous fluids unless she did not drink enough liquids, and then, within the following week, to phase out all medications. Sydney’s incision was healing without incident and the staples were scheduled to be removed on the 28 th – Monday following the Christmas holidays. Food intake was to be given in four small meals a day – a permanent schedule.
December 25, 2009 – Christmas Day

We gave thanks for our Christmas present . . . the continued presence of Sydney in our lives.

December 28, 2009 – Monday – Day 13

On entering the examining room at the clinic, Jyah and Sydney immediately began sniffing the table and the floor. I said to Glenn, "They’ve never done this before. There must’ve been a cat in here." When our veterinarian came in, I told her about the dog’s unusual behavior. "Ferrets," she smiled. "They were all over the place, and they have quite a musky odor."
What a treat for the Poodles!

With Jyah supervising, our veterinarian removed a staggering number of staples from Sydney’s incision. Our biggest challenge now was to find ways to channel Sydney’s natural exuberance into mild activities until she was fully recovered.

During Sydney’s convalescence I surfed the Internet to learn as much as possible about GDV. Entering "Bloat, Torsion, or GDV in dogs" in the Internet search engine gives masses of information; however, in all the sites I went through, I found no guide to easy recognizion of GDV’s early symptoms. It seems luck was on our side because, even with early intervention, some dogs can still not be saved.   

We are very grateful.

* * * * * * * * * * * * * *

Before this occurred:

1) Sydney and Jyah had always eaten home-cooked meals (raw meat/cooked veggies/no grains).
2) They were fed two meals a day with frequent treats between meals.
3) The dogs were not allowed to exercise for one-hour after eating. 
4) Stress was kept to a minimal, although Sydney is very prone to stress.

Article written for the
Multi-Colored Poodle Club of America
January 2010 Newsletter