My Stomach in Knots

My Stomach in Knots

    An old colloquial phrase, one rarely used these days and a phrase usually meaning tension, the feeling before walking in front of a classroom or audience to perform or to make a speech.  For dogs, however, it is the second largest killer (second only to cancer).  More commonly known as "bloat" or "twisted stomach," the condition is rarely advertised (at least, we had never heard of it) even in veterinarian offices...but when it happens, you have only hours to save your dog.  Look up "lack of appetite" and "trying to vomit" and you'll likely read that it might be something your dog ate and that the condition will go away in 24 hours.  You might also wake up and your dog will be dead...here's what happened to us.

    We returned home from our 3-day getaway, and were greeted as normal by our two dogs (something we humans could learn more of, that of greeting your loved ones so enthusiastically each and every time they open the door coming home); we were equally happy to see them and after a  bit of play and petting, we fed them and began to settle back into our routine.  The dogs ran outside to check things out once again then returned to come upstairs and relax, back in their own beds just as we were...only something was different.  Our one dog, who rarely pants (the other one does all the time) was suddenly doing so, followed by an occasional short effort to throw up.  "You okay?" we asked, as almost all pet owners do, expecting their animals to answer even if it's just a raised eyebrow or two.  But something wasn't quite right.  She must have eaten something in the yard (not likely but one never knows).  Another dry heave, nothing coming up.  "Something's not right," my wife told me.  I began to look it up on my phone...blah, blah, blah, will usually go away in 24 hours the sites all said.  "There's something wrong," my wife said, "maybe we should take her to the emergency."  Really?  It was almost 9:30 at night by now and we were all tired.  I got up and had our dog stand.  Her stomach was really full, as in stuffed-full-of-air full.  Did she each that much (no)?  Another attempt to throw up.  We had stomach pills from earlier, prescribed by our vet for our other dog...let's try one of those.  She didn't want it (again, not like her).  I got her to take it; that should do it, I thought, or at least it'll make her feel better if her stomach is really that upset.  Then she continued panting.  She didn't look all that great.  "Maybe we should take her in," my wife repeated.  And now, even I was a bit concerned (men are usually slower to acknowledge such things, especially if things really are serious and they were not the first ones to think of it).  So I got her ready, put her in the car and off we headed to the Pet ER.

    Backing off a bit, let me tell you a bit about this rascal dog pictured below.  A friend told us to look at her picture on the site of the local Humane Society, perfect for your other dog she said.  We already had an older German Shepherd, a rescue taken as a puppy and one born with two dislocated hips.  She was nearing nine and was spoiled rotten so why on earth would we want another dog, especially another German Shepherd?  But we looked.  She was pretty cute, and at the time, almost ten years old.  We went to bed and each thought that maybe our dog would like another playmate, and the age would mean the dog was likely slower and more sedate and who knows, it might work out after all.  Come the next morning, we opened the website for another peek and to get a bit more information and...she was gone.  We quickly scanned the pages of those animals adopted.  Not there.  We checked again on the listings page.  Did we just miss her the first time?  No luck.  So we called.  The person looked her up (same results) and finally said she'd try looking in a different section.  In a minute or so, she came back on with this..."We still have her, but she's considered unadoptable?"  What?  Why, we asked.  Too old and also she needs meds every day.  And where is she now (fearing she was scheduled to be put down).  She's supposed to be picked up by a rescue society that works with German Shepherds, she told us.  Well, could be at least see her?  And grudgingly, that was that.  We arranged a meeting, saw her pass the "cat" test (where the dog is put in a room with a cat...necessary since we also have four cats, all rescues), and even tackled meeting our dog in an enclosed setting (and with their supervision).  Pass, pass, pass.  So home she came and other than a few alpha-dog fights I had to break up (I now have the initiation scars on my arms to prove my status as foolish referee breaking up two out-for-blood dogs fighting), she settled peacefully into our lives, the hierarchy all settled and the two dogs both acting like long-lost sisters, licking each other each morning and not fighting for anything, even food.  Which was part of the reason I brought her to the emergency room as well...our other dog was noticing that something was wrong (if you have animals, you can empathize with what I'm saying).

The adopted 10-year old (now nearing 12)

    So I'm in the Pet ER.  And if you've ever been, you know the routine, prices double for everything just as in a human emergency room.  After all, this is for emergencies and as such, is for late hours and last-minute conditions that might pop up.  But here's the surprising thing...it was packed!  Here it was, nearly 10 at night and the room was packed.  Cats, dogs, you name it...just about every exam room was full.  My dog was still panting, but calm, calm enough that I wasn't really worried.  Someone came out to weigh her and take her to the back for an Xray, check on that bloat, as I was told.  So I waited, and waited.  Then an assistant came out and said that the doctor would like me to wait in one of the now-open exam rooms (I was in the general waiting area).  So in I went and waited...and waited.  Then the news.  In walked the vet and said that the Xrays suggested that she had a twisted stomach.  They would try to insert a probe to see if they could simple let out some of the air but if that didn't work I would have to make a decision.  Uh, what sort of decision, I asked?  We either operate immediately or we put her down.  What???  I was shown a price list of what the expected costs would be.  Thousands.  What???, I asked again.  And if I do nothing, I asked.  She will die by morning, I was told.  What????  This is a pretty complicated operation.  And off she went to try the probe...let's see if this will work first, she said.

    I called the wife.  What???, she said.  Yes, they're saying we need to decide immediately (it was now 11 at night).  But how did it happen, my wife asked?  I don't know (in fact, very few vets know why it happens, even today).  The vet came back in, the probe didn't work.  What was my decision?  Have you done many of these operations?, I asked (after all, it was late and how many surgeons work the graveyard shift at a pet hospital).  As a matter of fact, yes, she said, and many on older dogs (anesthesia is harder on an older dog's recovery).  In addition, there is an orthopedic doc in the back who has also done these operations, she said (two vet surgeons working the graveyard shift?).  She looked at me.  Did I want to go ahead with the operation?  We need to start right away, she said (turns out, this is quite true with this condition, one where minutes really do count).  Okay, I said...okay.  And off she started to go, turning around one last time...if we're too late, she explained, that is if the organs have already turned necrotic, then we will simply close her back up and go no further.  Okay, she asked?  I nodded my head.

    So what exactly is this huge killer of dogs?  Properly called GDV or Gastric Dilatation-Volvulus, the condition generally hits large-chested dogs (the German Shepherd is #12 on the risk list, the standard poodle is #6) and needs immediate attention...as in right away.  You generally only have hours.  And even if caught in time, your chances of recovery for your dog are pegged at somewhere around 75%.  Delay an extra hour and the dogs' organs could begin to fail, their blood supply cut off, their breathing shortened.  As one site emphasized: If you believe your dog is experiencing bloat, please get your dog to a veterinarian immediately!  Bloat can kill in less than an hour, so time is of the essence.   
 
    Again, this blog is not any replacement for actual medical advice; but should you even suspect your dog might be having something this serious, time is short...get to a vet.   Here's quick summary of the symptoms (always double check with your vet): Attempts to vomit with little or nothing coming up; a hard bloated stomach; lethargy; not acting normal (doesn't want to eat); panting; restless and uncomfortable.  If many or all of these are showing, get your dog to a vet...now! 

    We were lucky.  For many, the outcome isn't as pleasant (there is nothing like seeing the vet stick her head through the door after hours of waiting, giving you the thumbs up)...eyes bright, she said, and looks like she'll recover fine; we got it in time.  She had attached the stomach lining to the wall, something that would heal and would prevent future occurrences (this if often done when your dog is fixed at an early stage, for bloat can hit puppies as well as older dogs).  We had indeed got to it in time, her organs back and functioning well right after surgery (again, sometimes this is not the case due to waiting too long).  For others, paying the bill would be the decision maker.  Sometimes, people truly love their animals but simple cannot afford the bill or agree to the procedure and walk out before the result is known (indeed, that had already happened the night I was there...the dog goes to the humane society and the information on the owner, which is usually false, goes to the police they told me...happens all the time).  Good intentions, just luck of the draw.  For many, family at home is more important and that true "gut-wrenching" decision has to be made whether to let this one member of the family go.  Sometimes, the vet told me, the dog is only several years old, healthy otherwise, but now suffering a twisted stomach...and the owner decides to terminate its life, unwillingly surely, but the affordable decision, financially but not emotionally.

    On this one issue, do check it out further if you have a dog.  We asked several of our local vets why no information on this deadly condition was posted?  It should be, they all said; but on return visits, nothing was there.  Perhaps it is too scary, perhaps they feel that it is better to let people just give a puzzled look as their dog acts odd and seems to go to bed with an upset tummy.  But isn't just one person knowing better than one person waking up to a loved one too far gone or worse, gone altogether?  At least that person would have had the ability to make his or her own decision...and perhaps to save his or her animal's life.  We certainly didn't know about it...but as we talked to neighbors and friends, we watched their heads nod in agreement, then tell us a story of something similar happening to a friends' dogs, all of which had died seemingly unexpectedly.  There seems to always be something new to learn in life...but in this case, perhaps learning is essential, and all to save a member of the family.  And all from an apparently simple upset tummy...