Should my Dog’s Stomach be Tacked to Prevent Bloat?
Hello,
I have a five-month-old Great Dane, our vet is pushing us to have his stomach tacked. This is a very costly procedure, is it absolutely necessary?
Leonita
Baltimore, MD
Routine stomach tacking (technically known as gastropexy) is recommended by some vets for young members of certain breeds of dogs. The purpose of this surgery is to prevent a syndrome called bloat.
Bloat is one of the most terrible things that can happen to a dog. The stomach becomes twisted inside the abdomen, and then hyper-extends with gas. Blood flow through the body is compromised. The dog suffers intense agony. Without emergency surgery almost all bloated dogs die within 12 hours. Large numbers of affected animals die even with surgery. The surgery (and several days of ICU care that must occur during recovery) is phenomenally expensive. The recovery from surgery is long and painful.
Any dog, regardless of breed, age, or gender can suffer from bloat at any time. However, the syndrome is most common in deep chested breeds of dogs such as Great Danes, Standard Poodles and Labrador Retrievers. Bloat is most common in older dogs. Females suffer from the syndrome more often than males. Dogs suffer bloat most often at night, and the syndrome tends to occur with increased frequency in dogs who have visited groomers, boarding facilities, or, egad, veterinarians earlier in the day.
Make no mistake: bloat is just about the worst thing that can happen to a dog. Stomach tacking does reduce (but not completely eliminate) the possibility of bloat.
This brings up a question that has caused a great deal of debate among veterinarians: should young healthy members of high risk breeds such as Great Danes and Standard Poodles undergo stomach tacking in order to prevent the syndrome?
No consensus has been reached on the matter. However, most vets I know (myself included) would vote no. Putting a dog through a major surgery in order to prevent a problem that may never happen is probably not in the dog’s best interest. Bloat is horrible, but thankfully it is not very common.
However, I should point out that there is plenty of room for argument on this matter. Plenty of reasonable, thoughtful vets may disagree with my position.
Ideally I would perform stomach tacking only on dogs who were certain to bloat in the future and not perform the procedure on those who wouldn’t. Of course, if I could predict the future in that way I wouldn’t waste my time performing surgeries. I’d pick a few stocks and lotto numbers and retire in luxury.
Leonita, I would not recommend tacking your dog’s stomach. But I think you should visit a few more vets and get third, fourth, and fifth opinions on the matter. Neither my word, nor the word of your original vet should be taken as absolute.
Photo: This X-ray is very bad news. It shows bloat. By Joel Mills.
You have questions. 
Prophylactic gastropexy is such a controversial subject! Personally, I do recommend it for great danes at the time of desexing. I believe this is the only breed of dog where there is sufficient evidence to recommend this procedure. However, the choice whether or not to do so is up to the owner. Hopefully in a few years there will be some more scientific evidence on the matter.
Benefits of prophylactic gastropexy for dogs at risk of gastric dilatation-volvulus.
Ward MP, Patronek GJ, Glickman LT.
Department of Veterinary Pathobiology, Purdue University School of Veterinary Medicine, 725 Harrison Street, West Lafayette, IN 47907-2027, USA. wardmp@purdue.edu
The lifetime probability of death from gastric dilation-volvulus (GDV) for five dog breeds was estimated based on published breed-specific longevity and GDV incidence. These breeds were Great Dane, Irish Setter, Rottweiler, Standard Poodle and Weimaraner. Lifetime risk (95% CI) of GDV in these breeds ranged from 3.9% (0-11.2%) for Rottweiler to 36.7% (25.2-44.6%) for Great Dane. A decision-tree analysis for prophylactic gastropexy–using lifetime probability of death from GDV and expected cost savings for veterinary services as outcome measures–was undertaken to determine the preferred course of action in several dog breeds. Prophylactic gastropexy was the preferred choice of action for all breeds examined, with the reduction in mortality (versus no gastropexy) ranging from 2.2-fold (Rottweiler) to 29.6-fold (Great Dane). Assuming a prophylactic gastropexy costs US$ 400, the procedure was cost-effective when the lifetime risk of GDV was > or = 34%. The maximum and minimum estimated breakeven costs for the gastopexy procedure ranged from US$ 20 (Rottweiler) to US$ 435 (Great Dane). The cost-effectiveness of prophylactic gastropexy was most sensitive to the cost of treating GDV (US$ 1500). Prophylactic gastropexy raises ethical issues that need to be considered by veterinarians and dog breeders.
PMID: 12941556 [PubMed - indexed for MEDLINE]
Proceeding of the SEVC
Southern European Veterinary Conference
Oct. 17-19, 2008 Barcelona, Spain
SURGERY
What’s New in GDV Management?
A prospective study investigating the incidence of GDV among large (23-45 kg) and giant (>45 kg)breed dogs found that (assuming a normal lifespan of 10 years for large breed dogs and 8 years for giant breed dogs) the likelihood of developing GDV is 24 and 21.6%, respectively.2 Assuming a 30% mortality, the lifetime risk of dying is therefore 7%. The risk of developing GDV and dying as a result was substantially higher in Great Danes (42.4% and 12.6%, respectively). These data argue in favor of
prophylactic gastropexy in dogs from kennels with a high incidence of GDV.
I own Weimaraners, and this is my 2 cents.
I choose not to put my dogs under anesteshia for elective reasons… HOWEVER, had I known about the tacking procedure before my girl had been spayed I would have opted to do it at that time, and will likely have it done on our male pup when his time comes to be neutered.
I am curious, why are dogs that go to a groomer and/or boarding facilities more susceptible to bloat? Is it because of a change of diet, or the stress of being their?
Some years ago, I elected to do a rib gastroplexy at the same time as a spay on my Greater Swiss Mountain Dog. She had a really rough time of it, as these are two very major surgeries. She was unable to eat anything for four days (only able to lick ice cubes), and stayed at the vet’s office for those four days after the procedures.
I personally would not choose to do this again. It was just too hard on the dog.
Having lost one of my precious babies to bloat 15 months ago, you could say that I probably have a rather biased view towards prophylactic gastropexy being performed on my dogs.
While I am not in favor of any unnecessary surgery on my dogs I have discussed this fully with my vet and the next time any of them are having surgery they are having the proceedure.
Down here in New Zealand where we live the majority of Huntaways inparticular that are farm dogs have this proceedure done as a routine. These dogs are worth huge amounts of money and farmers don’t tend to like losing them to bloat. Pig hunters also get their pig dogs done as well, again because they don’t want to lose their valuable animals to something that can be prevented from being fatal.
Yes, the dogs that are prone to it still get bloat, but their stomach is physically unable to twist over on itself causing the build up of toxic blood inside it. I have been told that this is quite often what causes the dogs to die that are caught in time and operated on – the flow of toxic blood back into their systems.
So, while I appreciate the argument against having this proceedure done on your dogs because of something that “might” happen, once you have lost a beloved fur family member to this awful thing, one never wants to go down that pathway again.
I agree with the idea of not putting a dog through a surgery to prevent a possible problem in the future– however if the dog is already having surgery, for example a spay, why not do a preventive gastropexy at the same time?
I had an 11 year old dog who bloated and had gastric torsion. Yes, it is awful. Her stomach, start of the instestines, and spleen were twisted and she had to have emergency surgery. Luckily for her I knew the signs of bloat and I was able to get her to the emergency vet quickly.
I was surprised to read “several days of ICU care” and “recovery from surgery is long and painful” though because I did not experience either one of these things with my dog. They kept her in the emergency clinic overnight, and then had me bring her to my regular vet the next morning where she stayed for the day and went home with me that evening. They had me bring her in a day later for an EKG and recheck. Yes, there was some pain of course after surgery but she recovered very quickly (and uneventfully), especially considering her age. I did have the gastropexy done while she was in surgery as well.
We were doing some work on our porch when I noticed our male Great Dane was looking like a sick dog. My wife and I dropped what we were doing an took him to our local emergency veterinarians hospital. They took him in and returned in a few minutes with an xray of a beach ball. They asked “Do you want us to put him down” or “should we try to fix him”. We choose to have them work on him. Fortunately all went well and our Dane lived about eight more years with us. We had a female Dane that needed to be spayed. We had the tacking done for her since they had her open already. She lived a good life too.
Years ago, I had a chow who was about 15 years old. One night he appeared to be in distress and when I looked at him his abdomin was distended and HUGE. I never heard of “bloat” before, and I don’t know why, but I put his leash on and ran with him and would stop and take my hands and shake his belly back and forth, we repeated this everal times all of a sudden, he passed a large amount of gas (from both ends) and his belly went back down to normal and he was fine. I took him to the vet the next day, because it was the strangest thing I had ever seen and the vet told me that it was bloat, and that if it happened again, I would probably have to “make a decision” He told me what ever I did amazingly worked. Thank God it never happened again, he lived another 4 years and passed away at 19 yrs old. I know this sounds crazy, and I don’t know what possesd me to do what I did, but it worked.
Is it true that if you soak the dogs kibble and allow it to absorb water before they eat it that this will prevent bloating from occurring?
My sister has akitas and thats what she was told to do.
Actually, the surgery will prevent torsion, NOT bloat. You may still need to visit the vet promptly to alleviate the bloat. I had my female done at the time of her spay and she did just fine, no different than it would have been with a spay only, When doing the prophylactic gastropexy at the same time as a spay or neuter it is very inexpensive, maybe a few hundred dollars more. If it is done under emergency to save the dogs life it can be up to ten thousand dollars and that is no guarantee that the dog will survive. HOWEVER, one thing that I was told and I think everyone who considers this surgery needs to know is this: The procedure is done using a few stitches, which can pull out if the dog is allowed to jump, play, run etc. It is the adhesions (scar tissue) that form around the stitches that gives the strength and lasting result of not being able to torsion. For a minimun of four weeks she needed to be kept quiet. That wasn’t a problem with her, however taking her outside was trying as the neighbors dog was always loose and coming at her barking and would rile her a bit, only happened once though and it was during the fourth week. It is something to consider. I am having my fifteen month old male Dane neutered this month and will have it done on him as well, but it will be harder to keep him quiet, he is all boy and wants to rough house everyday.
Thank you Elizabeth for clarifying the distinction between bloat and gastric torsion (GDV.) When I first saw this topic the day it came up as an alert on my RSS feeder, that was the first thing that jumped out at me: that it implied (stated, actually) that gastropexy would/could prevent bloat (which is of course, untrue.) I was unable to post at that time, however, and am glad someone has corrected the implication. Bloat does not equal GDV; it is only the first step *toward* GDV. Bloat can occur without GDV, but not the other way around. (GDV=gastric dilatation/volvulus)
Dogs can (and often do) suffer gastric dilatation—bloat—(even after tacking) without volvulus (which it sounds like happened with Anna’s dog in the post above.) It is easily treated without surgery, if caught in time (i.e. before volvulus has a chance to occur.) But GDV is a different situation altogether, one which BEGINS with bloat, but progresses to the torsion which is what causes death if not surgically corrected under emergency circumstances on a patient which has been rendered physiologically unstable by the situation. In high-risk dogs, it OF COURSE makes much more sense to prevent this problem, as the risk from the preventative surgery is very low and recovery is almost always quick and uneventful. Saying the reverse is, in my mind, not much different than saying someone would rather risk their puppy getting parvo (and then being forced to treat and hope for survival) instead of vaccinating and almost guaranteeing the parvo will never occur in the first place, just because there is a possibility of reaction or autoimmune response to the preventative vaccine. One could rationalize that it was only worth the risk to vaccinate dogs “certain” to get parvo rather than take preventative steps for those who “might” (or “probably will” get parvo) without the vaccination. However, that would be unwise, imo. The benefits of the parvo vaccination greatly outweigh any risks. I think the same is true of preventative gastropexy to prevent GDV in certain breeds (which is indeed fairly common in some of them.)
You do however, make a mis-statemtent as well. Inexperienced or inadequately educated surgeons might tack the stomach in the way you mention (a very quick and easy procedure to do), which does have the potential to ‘come undone’ (fortunately not all that common) down the road……but the preferred way is to perform a rib gastropexy involving the strong holding layer of the stomach. That’s what should be done if the dog’s life is of very high value, monetary or otherwise. Unless the dog later breaks that very rib AND the scar tissue breaks down along with it (unlikely with this more secure method), there is essentially zero chance of the gastropexy site breaking down or “the stitches” pulling out to allow future gastric dilatation, since it’s held in place with a large strip of the dog’s own tissues, not just stitches. The *ideal* time to do it is indeed (as several have mentioned) during routine spay/neuter surgery (depends upon the age of spay/neuter being done, however.) But if a dog is intended for breeding, it should be done anyway, imo—once the dog is close enough to its adult size for it to be feasible.
That’s just my opinion (as a DVM) to add to any other opinions being collected. If you are considering this procedure for your deep-chested at-risk dog, second and third opinions should be sought, and I actively encourage them. :-)
BTW, good research on your post, Jess!
“….to allow future gastric dilatation….” should have read, “….future gastric dilatation/volvulus (GDV)….” Part of it got accidentally erased just before I hit the submit button.
(I don’t see an edit function.)
I have had five Great Danes. Two male Danes, aged two bloated and their stomachs twisted (23 years apart). Neither had been drinking or eating a lot or running around. After my current Dane bloated, his spleen had to be removed. We had his stomach tacked during that surgery. I decided to have my female Dane’s stomach tacked when she was spayed. Saying that the surgery and ICU care is expensive is very much an UNDER statement. I would tack all other Dane’s stomachs that I had so as not to go through the trauma (and my dogs going through that trauma) and expense again.
Dr. Deb,
I do not believe I made a mis statement by saying that the way my vet does the procedure the dog needs to be kept quiet for a minimum of four weeks so that the adhesions can form because my vet relies on a few simple stitches only. I am aware that there are better and more reliable forms of gastropexy, like the belt loop procedure, and the circumcostal gastropexy that you mention, but my vet does not do this and no vet that I have found in my state does it any differently than the simple method. I researched the different methods of gastroypexy and called everywhere in the state to find someone qualified to do a belt loop, but there was no one who had done it before. I thought I clarified in my post that the way my vet did the surgery was simple and that is why we needed to be cautious during the healing process, but I neglected to state that, for that I’m sorry.