After a gastropexy, dogs are less likely to develop gastric dilation volvulus (GDV) since their stomachs are surgically tacked in place. Integrative veterinarian Dr. Julie Buzby explains which dogs might need a gastropexy, what the procedure entails, and how to help your dog recover. Plus, she discusses the pros and cons of prophylactic gastropexy for at-risk breeds.
Recently, a client brought her newly rescued one-year-old Great Dane in for a new patient appointment. In preparing for her newest furry family member’s arrival, my client had read up on Great Danes and knew about a life-threatening condition called gastric dilation and volvulus (GDV). She was particularly concerned because her Great Dane was also a speed eater, which is another GDV risk factor.
During the appointment, we talked about some additional risk factors and symptoms of GDV. I told my client that in my opinion, her new dog may be a perfect candidate for a prophylactic (i.e. preventive) gastropexy surgery. Like my client, you may have questions about gastropexy surgery for your dog, too.
What is a gastropexy in dogs?
If you break the word “gastropexy” down, “gastro” refers to the stomach and “pexy” means to surgically fix in place.
Therefore, a gastropexy is a surgical procedure that involves attaching a dog’s stomach to his or her abdominal wall. Gastropexy is sometimes called “stomach tacking in dogs,” which is a pretty apt description of the procedure.
Typically, a vet will perform a gastropexy surgery for one of two reasons:
- To prevent an at-risk dog from developing gastric dilation and volvulus (GDV).
- To decrease the risk of a GDV reoccurrence in a dog who is having surgery to correct a GDV.
Next, to understand gastropexy, we need an overview of GDV in dogs.
A brief overview of GDV in dogs
GDV is a life-threatening condition for dogs. As the name indicates, the stomach fills with gas (i.e. dilation) and twists (i.e. volvulus). It may also be called bloat in dogs, twisted stomach, flipped stomach, or other similar terms.
Typically, bloat occurs most frequently in large breed, deep chested dogs. (That said, the very first case of GDV I ever saw was in a Dachshund, which is still deep chested but not large). While Great Danes account for about 40% of dogs who develop GDV, there are other at-risk dog breeds including:
- Irish Setters
- Doberman Pinschers
- Saint Bernards
- Standard Poodles
- Labrador Retrievers
- Gordon Setters
- Basset Hounds
- Old English Sheepdogs
- German Shepherds
Additionally, there are other factors that could put a dog at risk for developing GDV such as:
- Eating very large meals or just one meal a day
- Eating fast
- Restricting water around the time of feeding
These eating habits are problematic because when the stomach fills quickly or with large amounts of food, this can impair normal movement of food through the digestive tract. As a result, the stomach may rotate, leading to a GDV.
GDV often progresses rapidly as the stomach continues to dilate. Eventually, the stomach can become so large it puts pressure on blood vessels in the abdomen, preventing blood from flowing back to the heart. It may also compress the diaphragm, making it hard for the dog to breathe. Additionally, a GDV can cause heart arrhythmias, shock, low blood pressure, and other life-threatening abnormalities.
A dog with a GDV will need emergency surgery to decompress the stomach and rotate it back into its normal position. Then the vet will typically tack the stomach in place to prevent recurrence.
Research on gastropexy surgery indicates that without a gastropexy, the chances of developing another GDV are as high as 80%. But a gastropexy drops the chances of reoccurrence to less than 5%.
As you can imagine, GDV is often fatal if untreated (or not caught soon enough). And sadly, even with prompt treatment, 10-30% of dogs with GDV will not survive.
What are the pros and cons of a prophylactic gastropexy in dogs?
For these reasons, prevention, in the form of a prophylactic gastropexy, is often the best medicine for at-risk dogs. However, I know it can be scary to think about your dog having an elective surgery, so it is important to consider the pros and cons.
As you can probably guess, the biggest pro of a gastropexy surgery is that it has a high likelihood of preventing your dog from experiencing a painful and life-threatening bloat. Fixing the stomach to the body wall greatly reduces the risk of the stomach twisting in at-risk dogs. However, it is not a guarantee that your dog will never develop a GDV. Technically, your dog can still bloat after a gastropexy.
Additionally, recovery from a preventative gastropexy is much easier than recovering from bloat and an emergency surgery. Typically, the healing time is much shorter in a healthy dog and these dogs tend to be less painful post-op. They are able to come home sooner because they don’t have to be monitored so carefully. Plus, performing anesthesia and surgery on a healthy patient for an elective gastropexy carries less risk than anesthesia and surgery on a patient with a GDV.
Finally, the cost of a prophylactic gastropexy is significantly less than an emergency gastropexy. On average, the cost of a prophylactic surgery will be in the hundreds of dollars. However, an emergency gastropexy will likely cost thousands of dollars. This is because of the emergency vet visit, diagnostics, intensive monitoring, fluids, medications, etc. that a dog with GDV requires in addition to the surgery itself.
Pros and cons chart
To help you weigh the pros and cons, I have also summarized them in the following chart:
|Pros of prophylactic gastropexy||Cons of prophylactic gastropexy|
|Has a high chance of preventing your dog from experiencing life-threatening GDV||Does not rule out the possibility of GDV completely|
|Recovery is easier when it is an elective surgery||Any surgery and anesthesia carries risk|
|Preventive surgery is significantly more cost effective||It is another expense early in the life of your dog|
Ultimately though, the best thing you can do is speak with your veterinarian about whether a prophylactic gastropexy could be right for your dog. Your vet knows you, knows your dog, and would be the best person to give individualized recommendations.
What should you ask your vet about your dog’s gastropexy?
While discussing the pros and cons of a prophylactic gastropexy, you may also want to ask your vet the following questions so you know what to expect before, during, and after the gastropexy:
1. At what age do you prefer to do the gastropexy?
Every vet may have different preferences regarding when to perform a gastropexy. However, most will probably recommend waiting until your is dog about one-year-old so he or she is close to adult size. Some vets will schedule the gastropexy at the same time as your dog’s spay or neuter and others prefer to do it separately.
2. Which gastropexy procedure do you use?
Your vet probably has a particular gastropexy procedure that he or she is comfortable with and/or feels would be best for your dog. Or if your vet doesn’t perform gastropexies, he or she can also refer your dog to a veterinary surgeon or different veterinarian in the area for the procedure.
There are five main types of gastropexies:
While this is one of the fastest techniques, incorporating gastropexies are usually not recommended. To do an incorporating gastropexy, your vet will incorporate the stomach in the incision used to enter and close the abdomen. The problem with this procedure is that if your dog ever needs an abdominal exploratory or other surgery, there is a risk that the vet will accidentally cut the stomach when making the new incision in the body wall.
A laparoscopic gastropexy is a minimally invasive surgery option because it uses a very small hole rather than a larger incision. The surgeon will insert a camera through the hole to act as his or her “eyes.” Then the vet will use the camera and another small tool to attach the stomach to the abdominal wall. This technique usually is less painful than other types of gastropexies and has faster healing time. However, not all veterinarians have the special equipment needed to do a laparoscopic surgery.
This type of gastropexy involves taking a tissue flap of the stomach and wrapping it around the last rib. An advantage of the circumcostal gastropexy is that it is one of the strongest types of gastropexy. This means the rate of developing GDV after this surgery is lower than some other techniques.
A belt-loop gastropexy involves taking the stomach and “tunneling” it through the abdominal wall. This results in a very strong attachment of the stomach to the abdominal wall.
This fast and simple gastropexy involves taking the muscular layer of the stomach and stitching it to the abdominal muscles. Incisional gastropexy is one of the most common techniques that veterinarians use.
3. What does dog care after the gastropexy involve?
If you have a recovering gastropexy dog, it is important that you follow your veterinarian’s post-op instructions closely. Your vet will give you detailed steps, but some general rules to follow include:
- Monitor the abdominal incision for redness, swelling, or discharge.
- Prevent your dog from licking and biting the incision.
- If given one, please ensure that your dog wears the E-collar (i.e. cone) that is sent home.
- Restrict your dog’s activity for 10 to 14 days. He or she should not jump, play, or run during this time.
- Do not give your dog a bath or allow him or her to go swimming for 10 to 14 days, or until cleared by your veterinarian.
- Administer your dog’s pain medications as directed and contact your vet if you see signs your dog is in pain.
Please note that if your dog had a gastropexy because he or she was diagnosed with GDV, your veterinarian will likely have a longer set of instructions about post-operative care. Bloat can increase the recovery time, and gastropexies after GDV are at an increased risk for developing complications.
Whether an emergency or prophylactic gastropexy, another important part of your dog’s recovery is adjusting your feeding routines. Even though gastropexies can help prevent bloat, good eating habits can reduce the risk even further.
Ideally, you would spread out your dog’s daily food intake over two to three meals a day. Each meal should be eaten slowly. If your dog is a vigorous eater, feed him or her using a puzzle or slow feeder bowl.
4. What are the possible complications of the gastropexy?
Your vet will give you an idea of what to watch for, but in general most complications after gastropexy surgeries are mild and similar to problems that can occur after any surgery. These can include:
- Decreased appetite
- Lethargic dog
- Decreased water intake
Two more significant complications include:
- Hemorrhage—Occasionally, a dog may begin to bleed excessively after surgery. Signs can include blood dripping from the incision, abdominal pain, or decreased energy.
- Incisional infection—If a dog licks or bites at the incision, it can become infected. You may notice the incision is red, swollen, or has discharge coming from it.
If you notice any of the symptoms on either list, please consult your veterinarian. Occasionally seemingly mild signs can be an indication of a more serious problem so it is best to seek your vet’s advice if you are worried.
The good news is that with proper monitoring and follow up care, you can help greatly reduce the risk of complications. Many dogs do very well after prophylactic gastropexies and heal as quickly as they do following a spay or neuter.
Talk with your veterinarian
If after reading this article, you believe that your dog might be a good candidate for a prophylactic gastropexy, please schedule an appointment with your vet. He or she will help you assess your dog’s risk of developing GDV in the future and determine if/when to perform a gastropexy.
Did you decide to have a prophylactic gastropexy on your dog?
Please share your experience and what factored into your decision.