I have been an emergency and critical care veterinarian for over 10 years and have seen thousands of dogs in crisis- here is some information that may be helpful for Swissy owners.

Common Emergencies

•I probably see more dogs for vomiting and diarrhea than anything else, but also a fair number of limping dogs, dog fight wounds, trauma and general malaise.

•It is never really a problem to go to the ER for something non emergent (I see plenty of ear infections) but you may have to wait a bit longer

Bloat

•Symptoms can be very similar to lick fits:

•Gagging, retching but nothing coming up and not wanting to eat

•Licking at things uncontrollably

•Abdomen distended and painful

•Distress

•ONLY TREATMENT IS EMERGENCY SURGERY

•Get to vet ASAP- often not able to differentiate from lick fit without xray although usually dogs with lick fits will eat readily and dogs with bloat will not

•Can prevent with gastropexy surgery

•Dog is stabilized on IV fluids for shock, pain medications and bloodwork is run

•A high lactate level can be a negative indication of how the dog will do after surgery but many dogs still do very well- requires more intensive care, and dogs are monitored for clotting problems as well as heart arrhythmias

•Stomach is decompressed with trochar or tube

•Dogs are prepped for surgery and taken in ASAP

•Surgeon evaluates stomach and spleen, re-positions

•Stomach tube is passed (if not passed before)

•Sometimes if stomach has been twisted for a while, sections of stomach die and need to be removed

•Sometimes the spleen twists with the stomach and needs to be removed

•Sutures stomach in place (gastropexy)

Splenic torsion and masses

•Normal spleen holds blood and immune cells and can be quite large in adult dogs

•Common symptoms of splenic torsion can be mild- off and on not eating, pale gums, abdominal discomfort, weakness

•If spleen is fully twisted or bleeding- symptoms such as collapse, pale gums and weakness are more common

•In the acute or sudden form the dog may collapse, show weakness, vomiting or abdominal pain with pale gums

•In the chronic form which can go on for days or even weeks, the dog often does not want to eat, may vomit, seem mopey or just off.

•The spleen on x-rays is usually large, there may be fluid in the abdomen, and sometimes there are little gas bubbles seen in the spleen

Swissies and Spleens

•There is anecdotal evidence for splenic torsion in GSMD – no published studies, so do not think that your vet is dumb for never having heard of it

•They do have larger than normal spleens and although that can be influenced by medications and other heath issues

•Almost all dogs when under anesthesia have very large spleens so assessing the spleen on exploratory may not tell as much as we would like but assessing the vessels and attachments should tell more information- often the dogs with the chronic forms have to have exploratory surgery to evaluate further

Foreign bodies

•Dogs eat stupid things- I have pulled out rocks, socks, toys, hooves, needles, carpet- you name it and dogs will eat it.

•Dogs typically present with vomiting (sometimes green), abdominal pain, and not wanting to eat.

•If you know your dog has eaten something, you may be able to get them to vomit it up or your vet may be able to remove it with an endoscope before it causes an obstruction- call the clinic for instructions.

Q: How can we prevent bloat in our Swissies?

A: Although almost everyone has their own trick, there are relatively few ways to prevent bloat. Bloat, or gastric dilation volvulus, is a twist in the stomach with rapid expansion that is life threatening and needs to be treated as a veterinary emergency. The stomach rotates on itself and is not able to empty, but keeps filling up with air. The blood supply to the stomach and spleen can be cut off and the dog rapidly goes in to shock.

The risk factors of bloat include size of the dog, depth of chest, stress level of the dog, amount of food fed and elevation of the feeding bowl. Larger, deeper chested dogs and especially dogs with a family history of bloat are predisposed, as are older dogs. Dogs that are fed larger meals and dogs that are fed from elevated bowls (it is a common misconception that elevated is better) are statistically more likely to develop bloat. Dogs that are under stress at shows, boarding or simply anxious in nature are also more predisposed.

So then bloat prevention methods could include decreasing stress in our dogs or at least being more aware during times of stress, feeding smaller meals and from floor height, and selection for dogs at less conformational risk. This would mean potentially not breeding the narrower deeper chested dogs and dogs with a family history of bloat.

Although “Swissy licks” has not been statistically associated with bloat, it stands to reason that these dogs are usually suffering from some GI upset at the time and are experiencing anxiety, both of which can predispose GDV. Early symptoms of bloat can look exactly like a lick fit- may dogs lick or chew at the floor and air trying to relieve their gut pain. As the stomach fills up with air, the owner may notice the belly looking larger, the dog acting more uncomfortable and the dog trying to vomit but nothing coming up. The unproductive retching and expansion of the abdomen with gas signal the need for emergency veterinary care. It is not recommended to try to decompress the stomach on your own with a bloat kit as this can cause laceration of the esophagus. Treatment of bloat is emergency surgery to reposition the stomach and tack it in place so it cannot twist again.

Gastropexy, or stomach tacking, can be done as a prophylactic procedure even in young dogs and is by far the best way to prevent bloat. There are multiple techniques including minimally invasive procedures. Incisional gastropexy involves a relatively large incision in to the abdomen, then smaller incisions in the outer stomach wall and inner wall of the abdomen and suturing the two together. This is the most common technique and is very effective in preventing bloat. Complications with this would be due to the large abdominal incision and need for several weeks recovery. The other surgical techniques including belt loop gastropexy and circumcostal gastropexy are slightly stronger but have higher risks of complications including lung puncture. The newer techniques with minimally invasive surgery including laparoscopic, laparoscopic assisted and endoscopic assisted techniques allow for smaller incisions, quicker recovery times and equally good prevention of bloat in the future. The down sides to the newer techniques are cost, availability, length of anesthesia and risks for trauma to the spleen due to the decreased visibility.

Dogs that suffer from lick fits should be examined by a veterinarian who can decide which medications or foods can decrease the risk of future episodes. Many owners experience helpful results from switching foods, acid-reducing medications or Gas-X, but it is very important to note that these lick fits can be the tip of the iceberg and can mask a life threatening early bloat event. My personal dog who suffered from lick fits responded very positively to prophylactic incisional gastropexy and it gives me the added benefit of not panicking that he is bloating.

There is still a very slight chance that a dog can bloat after gastropexy (less than 1% of dogs that have had the surgery), but studies of the risk of a giant breed dogs developing bloat in their lifetime were as high as 20% (other studies showed about 6%.)

References:

1. Glickman LT, Glickman NW, Schellenberg DB, Raghavan M, Lee T. Non-dietary risk factors for gastric dilatation-volvulus in large and giant breed dogs.
J Am Vet Med Assoc. 2000 Nov 15;217(10):1492-9

2. Goetham BV. Gastropexy (Review of Techniques). World Small Animal Veterinary Association World Congress Proceedings. 2015