Interview Series: Pet Care Expert Talks Bloat and Torsion in Dogs

Melissa Massello
March 8, 2017

Has your dog been dry heaving lately? Here are one expert's tips for recognizing and treating the symptoms of bloat and torsion.

Bloat and torsion are two very serious (and sometimes fatal) conditions that often affect large breeds of dogs -- and that always require emergency medical care. So, in order to better educate our dog owners and pet care providers about prevention, recently interviewed Dr. Kiko Bracker, D.V.M., D.A.C.V.E.C.C., a board-certified specialist in emergency and critical veterinary care at the MSPCA's Angell Animal Medical Center in Boston. What are bloat and torsion?

Dr. Bracker: Bloat and torsion are two similar conditions that differ in the position of the dog's stomach. Bloat, which is less severe, is when the dog's stomach is full of gas (or could also be full of food, which we would call a food bloat), but the position of the stomach is normal. Torsion -- or G.D.V. -- is when the stomach fills with gas or food and then torses, or becomes twisted -- there's a kind of loop that forms in the intestine, which prevents anything from flowing out of the dog's stomach. Bloat can also lead to torsion. What are the most common signs and symptoms?

Dr. Bracker: The first thing you would notice is that the dog would have a swollen abdomen. The dog would usually be pacing, would seem uncomfortable or agitated. The dog would also usually have "unproductive vomiting" -- like a "dry heave." Outwardly, bloat and torsion look the same: when you tap on the dog's stomach, it's filled with gas. Simple indigestion in a dog would have an absence of gas; the dog might be feeling nauseous, or have heartburn, or might be vomiting. With bloat and torsion, the dog might be retching or dry heaving, but won't be able to pass the food or gas. To the pet owner, and on our physical exam, bloat and torsion are indistinguishable from each other. A radiograph is needed to differentiate between the two. What causes bloat or torsion (G.D.V.)?

Dr. Bracker: Some of the things we do believe to be triggers or predisposing conditions for bloat and torsion are:

  • Old age. Torsion happens more frequently in older dogs.
  • Gender. Male dogs have a higher frequency of torsion than females.
  • Meal size. Dogs who are regularly fed a large volume of food in a single meal per day, versus smaller meals multiple times a day, are at an increased risk.
  • Deep-chested breeds. Due to the way the internal organs are structured in the chest cavity, these dogs have an increased risk.
  • Type of dog bowl. Contrary to popular belief, feeding your dog from a bowl raised off the floor actually increases (not decreases) their risk of torsion (GDV). How can these conditions be prevented?

Dr. Bracker: Feeding your dog from a raised bowl does increase their risk of developing bloat or torsion (GDV). Another thing that is kind of interesting is that fearful or nervous dogs also have a greater likelihood of developing bloat or torsion (GDV), and calm, happy dogs seem to be mildly protected against these conditions. How serious are these conditions?

Dr. Bracker: Torsion has a great sense of urgency for surgical treatment, and bloat can be dealt with more conservatively. Although bloat can be an emergency, too, it's not necessarily as severe a problem. It is possible for bloat to progress to torsion, we don't know exactly how torsion develops, but if the stomach is full of gas or fluid or food, it makes it easier for the stomach to twist around, or progress to torsion. What are the traditional treatments for bloat and torsion?

Dr. Bracker: Torsion is absolutely a surgical problem -- you can't fix it without surgery, and otherwise it is fatal. Bloat is rarely surgical, but it's essential to get the air or food in the stomach out. In an air-bloated dog, we would try to pass a stomach tube and let the air flow out, or use a process called trocarization, in which a needle or catheter is used to remove the air. More often than not with food bloat, we would just hydrate the dog and let them digest it on their own. After suffering from bloat, however, the dog's stomach has been dramatically distended with gas, and the ligaments that hold it in place have also been stretched, causing the stomach to become a little bit "looser" inside the abdomen -- now putting those dogs at greater risk for developing torsion, or having their stomach twist. Are there any other preventive measures a dog owner can take against bloat or torsion?

Dr. Bracker: An elective gastropexy, where the vet attaches the dog's stomach to the inside of its abdomen wall so that the stomach can't twist around, is a good idea as a preventive measure against torsion or GDV for any large or giant breed of dog, or for any dog that has previously suffered from bloat. The chance of a dog getting torsion after it has had gastropexy is only about 5 percent. Along the same lines, and Great Danes are the best candidates, if your vet is already going to be surgically inside the abdomen of your dog -- say, with a female being spayed -- we highly recommend having the gastropexy done at the same time. What are the most common breeds of dogs that suffer from bloat and torsion?

Dr. Bracker: A Purdue University study found that purebred large and giant breed dogs had a 20 to 25 percent chance of developing bloat or torsion in their lifetime, while a Great Dane has a much higher chance, about 40 percent, of developing torsion over his/her lifetime--more likely than any other large or giant breed dog. Other dogs at the top of the list are: Bloodhounds; Wolfhounds (Irish Wolfhounds and Russian Wolfhounds, or Borzoi); Akitas; and Setters (English Setters, Irish Setters, and Gordon Setters). The Great Dane people are sort of leading the charge, and should particularly worry, because their breed stands above the rest. I can go through and list almost any larger breed of dog, but based on the numbers, we don't normally see a lot of Rottweilers or St. Bernards, even though these are big dogs. Any larger breed of dog is at significantly larger risk than a smaller one, however. Does the type of pet food an animal eats increase or decrease their risk of bloat or torsion?

Dr. Bracker: That's tough. There was a suspicion about 10 years ago that soy-based proteins caused a predisposition for torsion and bloating, and that doesn't seem to be the case. Another study came out and refuted that. And then there was another association between the size of the dog food kibble and GDV, and that was only studied in one breed--so that's pretty tenuous. If you look at the problem over the years, however, there do seem to be more cases of GDV now than in the past, and we seem to feed our dogs more dry food now, so it's possible that dry food could increase risk, but there are lots of other things that have changed over the past 20-plus years, so it's questionable. It is recommended by some groups to mix in some scraps of human food with your dog's food, but once you do that, you'll have other problems. What advice in general would you give to large breed dog owners (and other caretakers of large breed dogs) for preventing bloat and torsion?

Dr. Bracker: We mentioned some of the predisposing factors that should be avoided or minimized. Also, dogs shouldn't be walked or exercised around the time they're fed, and if possible they should be encouraged to eat more slowly, in smaller meals throughout the day. Those meals should be fed on the floor -- the bowls should not be elevated in any way. And that's pretty much it as far as simple prevention.

As far as noticing it early, you just have to be attentive and look for swollen bellies and non-productive vomiting. If you [or a pet sitter] ends up taking the dog to the emergency hospital and it turns out they don't have GDV, that's a happy diagnosis to make, and worth it even if it's at 2 o'clock in the morning.

Melissa Massello is a writer, editor, and dog lover based in Boston, MA. Her lifestyle and arts & entertainment writing has appeared in various newspapers, magazines, and online media since 1999. When not writing for, Melissa serves as the founder and editor-in-chief of a paperless magazine on budget-friendly living at

Tips and stories from parents and caregivers who’ve been there.

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