Surviving Bloat

Brutus after surgery, with breathing tube still in, and a foot-long incision you can't really see here.

Bloat. It’s a word that inspires fear in the hearts of crazy dog ladies everywhere. No one really knows what causes it, and it can move from zero symptoms (or ones you don’t notice) to fatal in a matter of minutes. The stomach twists on itself and once the stomach and intestines die, there is nothing you can do.

On Tuesday, Brutus had emergency surgery for bloat, and so far is doing ok. It’s very scary that if I had not been working from home that day, by the time we got home from work he probably either would have been dead or past veterinary medicine’s ability to save him. After the surgery, the owner of the veterinary hospital passed by and said he didn’t know whether to say it was our unlucky day, or our lucky day.  I replied that I’d put it squarely in the “lucky” column.

To spread the good karma around, the rest of this post is sharing my experience with bloat in the hope that it could save another dog’s life.  Pay special attention if you have a deep-chested or large breed of dog.  It’s also a harrowing tale with a happy ending, and even a bit of dark humor at the end.

Basically, Brutus’s stomach spun all the way around so that it was pinched shut and cutting off the blood supply to all parts of the digestive system south of the stomach. It also wrapped around his spleen, which had to be removed. His distressed system began filling with gasses that had no means to escape his body. The big risk is the dog going into shock and the blood-deprived tissues and organs dying. Dogs can’t live without functioning intestines.

The trigger to rush Brutus to the vet was a single stretch. He had vomited earlier, but it was the stretch that sent me to the vet for possible bloat. 20 minutes later, it would be apparent to anyone that he was in terrible distress, but thankfully we were already pulling up to the vet at that point because minutes count.

Here’s how it went down: Brutus was fine Monday night and Tuesday morning. He ate breakfast in a joyous but relatively relaxed manner with nothing out of the ordinary. A few hours later, he vomited, and there was a bunch of grass and a scrap of green vinyl I couldn’t identify in there, which may or may not have caused some gastric upset that contributed to the bloat, who knows. He drank some water I offered him, and took a treat - my first “tests” for how sick he is, which he passed with flying colors. Next test, check gums for capillary refill and color – A-ok. I gave him a Pepcid, which we normally give him for his acid reflux (he’s kinda fragile for a giant dog) and proceeded to my conference call. A bit later, he retched and belched a couple of times then seemed to recover (thank you “mute” function on my phone.) OK, time for closer observation. Then, lying down next to me, he did a big stretch, stretching his back legs way out. Uh oh. Maybe he is trying to relieve some discomfort in his belly/bowels? I decided to embrace my crazy dog lady-ness and drop my conference call on the rare chance it was bloat, and not just him stretching for the heck of it.

When I got the keys and crated the other dogs, he was ecstatic about going on a trip. I thought for the umpteenth time how I was overreacting, but thought at least I’d be able to pick up some milk while I was out. During the drive, on which I was favoring speed over smoothness of ride, he began retching repeatedly and couldn’t sit still (also thank you to my cargo liner, though I wasn’t caring about that at the time.) When I opened the back hatch about 20 minutes later, panic began to set in. There was foamy drool all over the cargo area. He had to stop several times between the car and the office to retch. From the car to the exam room, I watched his belly start to blow up like a balloon. At this point, I figured it was either an obstruction or bloat, but either way an emergency. He was x-rayed and put on IV fluids, which he would need to complete before surgery to guard against shock. Two bags took a while to drip in, and in the meantime his belly now felt and looked like a 9-month pregnancy. He spent some time pacing with his legs set wide apart, groaning, drooling, and trying to pass gas to try to relieve the pressure he was feeling (which did succeed in expressing his anal glands quite a bit), holding his tail high over his body. He spent other time lying down, still groaning and drooling.  His tongue and gums became pale white.

The x-ray had shown what looked like an intestinal torsion, which is more rare (i.e. vets have less experience performing these kinds of surgeries successfully.) After the x-ray and starting the IV, our wonderful, caring, and skilled vet - whom I am so glad happened to be in that office branch on that day - informed me that if she opened him up and saw that his intestines were dead, she would be asking us to make the merciful decision not to wake him up.  I knew already that bloat was often fatal, but hearing it out loud is something else entirely.  Of course I lost it at that point, but had to quickly recover so that I could get Paul on the road toward us and hopefully not so erratically to provoke a crash. Paul did make it prior to the 2 IV bags being done, and Brutus was happy to see him of course. Throughout, Brutus still summoned a little tail wag for every visitor to the exam room.

A bit into the surgery, we were informed that it was his stomach that had turned, not the intestine, which was the first bit of good news. It was also apparent at that point that the vet had seen inside him and it wasn’t a total unsalvageable mess.

Some hours later, our vet emerged looking absolutely exhausted, to tell us we could see him as soon as he was moved from surgery into an exam room, and that everything went ok. Part of the surgery is to tack his stomach against his body to prevent recurrence. He’ll stay at the vet the rest of the week, because it is possible he’ll need a second surgery to remove part of his stomach, but this seems to be a contingency they are prepared to deal with if it happens. Then a week of feeding tiny meals every few hours, and six weeks of leash-restricted walking and crate rest, and he’s back to full duty.

We stayed with Brutus quite a while, until we were officially kicked out so that he could go in the back and rest. Here’s the only humorous portion of the story. He was pretty much out of it, sort of aware of his surroundings but just lying there sleepy. Then a vet who we normally don’t see, but who was the one to come out to our house last July to put Louie to sleep, stopped by to see how we were doing. As soon as Brutus heard that voice, he came alive and tried to get up, and we had to work to keep him lying down and still. Apparently he was saying, “Whoa there! No, hey, I’m ok, see? Look I’m standing up! No need for the grim reaper here. Good as new!” Apparently he wanted to be VERY clear, that today was not his day to go.  And thank heaven for that.