We were in a rented beach-front vacation home on the Outer Banks of North Carolina (Avon on Hatteras Island) -- 312 miles and six driving hours away from our home in Washington, D.C.  It was nearing midnight on a beautiful, breezy October evening marred only by annoying illegal fireworks on the beach that had terrified all the dogs in the house for the better part of an hour.  Gidget, normally fearful of thunder and other loud noises and even anxious when the car drives over rumble strips in the road, had been frightened by the fireworks to the point of panting vigorously.

While I had long known that exercising too near mealtimes could precipitate bloating, I had no idea that there is perhaps an even stronger correlation with panting from anxiety -- which draws gas into the stomach. 

After a long day that had begun with a gorgeous sunrise walk and fishing on the beach, the six people and five dogs in the house were  getting ready to turn out the lights for the night.  I was walking into my bedroom when I noticed my 9-year old Samoyed’s, Gidget’s, absence and asked of no one in particular where she was.

“She’s downstairs trying to vomit,” said Jim, one of the house guests staying in a downstairs bedroom.

“She’s ‘trying’ to vomit?” I wondered aloud as I walked downstairs to see what she was doing.  Sure enough, when I got to the bottom of the stairs there was Gidget, unsuccessfully attempting to vomit.  No bile, nothing.  I had never before seen her do that.

This is what is known as “unproductive” or “non-productive” vomiting.  And it is a Big Red Flag -- an indicator that bloat and torsion of the stomach are occurring.

“Bloat” a.k.a. Gastric Dilatation Volvulus (GDV) kills an estimated 60,000 dogs each year.  It is most prevalent among bigger breeds, with apparent correlation

to deep-chested dogs, including Samoyeds.

Thinking that some stomach contents would surely be coming forth, I gently steered Gidget off the carpet and into the nearby laundry room with its tiled floor.  Several more times this unproductive vomiting occurred as she paced around the room.  She belched lightly.  Her back was slightly hunched.

Three more Big Red Flags of Bloat:  belching/burping, pacing and a hunched or arched posture.

Unsure of what was going on but beginning to suspect bloat was a possibility, I carried Gidget upstairs to my bedroom and placed her standing on the floor.  She subsequently hopped onto a large ottoman where she had slept the night before and laid down, looking pretty comfortable and easing my concern a bit.  The vomiting attempts had ceased.  Four of us kneeled on the floor around her to gauge her condition and look for further indication that something was amiss.  It was not obvious to any of us that Gidget was in mortal danger.  After several minutes of laying (apparently comfortably) on the ottoman, Gidget became fidgety and stood up. 

All her life Gidget had been very stoic.  At nine weeks old, she had not even flinched when the vet inserted the rectal thermometer or administered vaccinations.  She would not indicate any discomfort until an ear infection was raging.  She had never before in her life behaved quite as she was this night. 

To know if something is amiss, you have to be attuned to your dog’s behavior and physicality in healthy times.  It could save your dog’s life in the future to know what their abdomen and tummy feel like today.  If bloat occurs, their abdomen will feel tight, perhaps even hard.

I ran to my car to retrieve a dog first-aid book and a first-aid kit that I’d assembled in the past year with the assistance of Gidget’s regular vet and knowledgeable dog people around the country.  At the behest of some articles I’d previously read on bloat and one particularly knowledgeable friend in Washington State who has Dobermans, the Dog First-Aid kit includes Gas-X tablets.  The First-Aid book reinforced my concerns about bloat.  And so I asked Brenda to force a Gas-X tablet down Gidget’s throat, which may have bought Gidget enough time to survive until surgery.

Ask your vet what items should be in a Dog First-Aid kit.  Ask them to explain bloat and demonstrate on your dog where you would check for signs of bloat and what those areas would feel like.  Ask them to show you how to force a pill down if you do not already know.  Ask them to show you how you could tell something was wrong with blood flow (i.e. “shock”) by looking at your dog’s gums.

Except for the attempts at vomiting, the symptoms were subtle.  But they added up to something being wrong with Gidget. And I knew that if we were home in Washington, D.C., I would be taking her to the emergency vet that instant. 

John grabbed the keys to his crew cab truck and his wife, Brenda, grabbed her purse (containing the blessed Blackberry).  Emmy, Jim and Carol stayed at the house to be with the other dogs.  One of the Samoyeds, 15-month old Blaze, had been entrusted to me while her owners were in Florida.  She was unnerved to see Gidget and me leaving.  Emmy stayed upstairs with her throughout that night. 

We did not know where the nearest 24/7 veterinary hospital was but we headed north toward Nags Head and the more populated areas of the Outer Banks.  Brenda had once taken their Samoyed, Arlo, to a vet there and they had an after-hours emergency number.  But we called that number several times -- saying that we were in route with a 9-year old Samoyed suspected of experiencing bloat -- and never got a return call.  Six days later I still have not received a return call from that Nags Head veterinarian office.

In advance of taking your pets out of your hometown, research emergency veterinarian hospitals near your vacation destination.  Print out and keep in your vehicle maps, directions, addresses and phone numbers.  You do not want to be fumbling around for this information when you are under duress and your dog is in a deadly situation. 

Holding Gidget throughout the drive, I began to make a series of telephone calls starting with Gidget’s regular vet in the DC area:  Alexandria Animal Hospital.  I will be forever grateful to a veterinarian technician named Jesse who works there because through several long telephone calls during the drive, she educated me on bloat and what was happening with Gidget.  She also provided the address and phone number for the emergency veterinary hospital in Chesapeake, Virginia, that was going to save Gidget’s life. 

Cell phones and Brenda’s Blackberry which enabled her to get detailed directions to the emergency hospital were life-saving technologies on this evening.  And John’s truck having plenty of fuel saved precious minutes.  In a bloat situation, time is extremely finite.

With the Nags Head veterinary hospital not responding to our calls to their emergency after-hours telephone number, we continued north toward the Greenbrier Veterinary Emergency Center near Norfolk, Virginia.  It is 121 miles away from the rental house in Avon.  That was the longest drive of my life, and no doubt Gidget’s.  In the backseat with Gidget, I placed repeated calls to Jesse at Alexandria Animal Hospital to get her read on what I was seeing in Gidget’s actions (she belched once and vomited bile -- good things in a bloat situation).   

We got to the hospital around 2:30 a.m.  I lifted Gidget out of the truck and she walked in, gingerly.  The surgeon immediately felt her abdomen (said it was tight but not definitive) and got her x-rayed.  The x-ray revealed that her stomach had bloated (not as big as they usually see) and had folded over on itself (torsion).  

Within minutes they were preparing for surgery.

The surgeon informed us after the two-hour operation that other than slight bruising where the stomach folded, her internal organs did not incur any damage.  There was no “necrosis” (tissue death) of the stomach, spleen or any other organ.  This is what you hope to hear if in a bloat situation.  The emergency surgeon informed the attending daytime physicians that Gidget's stomach was "beautiful."  

To prevent stomach torsion in the future, the surgeon sutured Gidget’s stomach to the abdominal wall. This procedure is called:  gastropexy. 

Many owners of breeds (such as Great Danes) even more prone to bloat-torsion have prophylactic gastropexy performed on their dogs when they’re young, often when they are already being anesthetized or opened up for some other procedure, such as spaying.  It will not prevent a future bloat incident, but torsion is far more lethal.

The prognosis from the get-go after surgery was very positive and Gidget's recovery to this point has been fantastic.  By the end of the day of the surgery (Tuesday),  the only vital signs that were not normal were her kidney values, which were slightly elevated.  A normal occurrence, they said, after experiencing shock.  By Wednesday, her kidney values were back to normal.  And after being taken off the continuous pain medication IV, her eyes brightened, she smiled and wagged her tail.  She received Tramadol pain pills for four additional days.   

Another figure they monitor in bloat-torsion cases is lactate (indicative of tissue damage), and that was back to normal by Wednesday, as well.  On Thursday, she began eating (very little) and drinking on her own -- and pulling at the leash to walk out of the building.  She went home on Friday (Day 4).  The abdominal incision staples were removed on Day 12.  She is expected to be fully recovered four to six weeks after the surgery.  It will take far longer for me to recover from knowing that Gidget suffered hours of hideous pain while in route to the hospital.  And that she very nearly died in my arms. 

PREVENTION

There is a lot of information about bloat-torsion on the Internet.  Unfortunately, little of it is definitive as to what exactly causes bloat and torsion and what can be done to prevent it from occurring.  That is because no one knows for sure.  As articles at the links below indicate, certain body types (deep-chested, large dogs), personality types (fearful, prone to stress), behaviors (eating/drinking soon before or after vigorous exercise), diets, age and DNA are believed to be factors in some or many cases.  But there is no check-list of things you can do which will guarantee that your pup is never the victim of bloat.

Gidget’s background includes a grandmother who bloated (and is still alive at age 16), her father who has suffered acid reflux (Gidget has, too), she’s scared of loud noises (including thunder, fireworks and certain road pavements at high speeds).  She’s nine years old and her bloat-torsion attack was preceded by dinner closely followed by protracted fireworks that sounded like bombs.  The fireworks caused her to hide and pant excessively. 

Your dog’s chances of surviving a bloat episode hinge  on your ability to swiftly recognize the symptoms and quickly get them to a veterinarian facility equipped to perform the life-saving surgical procedures to remedy bloat or, even worse:  torsion.