104 Explore the Reason behind Acute Vomiting- A Focus on Gastric Distension

Introduction

Have you ever experienced a situation where you are still happy with a slice of cheesecake or chocolate ice cream after a good dinner? I am not hungry anymore, but if it is for dessert, then yes, please! How can I still be able to eat more when I am “full” already? And what about vomiting after a huge meal? Well, it all starts with a phenomenon called gastric distension.

Physiological Gastric Distension

Physiological gastric distension occurs when food is swallowed into the stomach. This is a natural process. The stomach enlarges itself to accommodate the entrance and storage of the food, allowing room for more food.

Causes of Acute Gastric Distension in Dogs

Think of a dog’s stomach like a balloon. Normally, this “balloon” has some air, food, and liquid in it. A problematic situation is when the stomach is overstretched or distended too much due to the excessive presence of air, fluid, and/or food. At this moment, the size of a regular balloon grows bigger and bigger, giving rise to some serious diseases, for example, gastric dilatation and volvulus (GDV) in dogs. Vomiting might be noticed during acute gastric distension. The gastric distension can happen for a few reasons:

1. Rapid Ingestion of A Large Meal: when dogs devour a large meal, they can swallow a lot of air along with their food. Accumulation of excessive food, water, and extra air in the stomach can lead to gastric distension.
2. Intake of the wrong things or foods: dogs are known for their passion for food. It is not uncommon that something that should not be inside the stomach ends up there, like spoiled food or garbage. Excessive gas is produced in the stomach as these unusual contents go under digestion. Some foods that are high in fat or hard to digest can be more bloat-inducing in certain species of dogs.
3. Health issues: in some cases, a dog might have a health issue that makes it hard for them to function normally, leading to a buildup of gastric contents.

All in all, when the stomach gets filled up with too much air, fluid, or food, it is like the balloon getting over-inflated. This over-inflation is what we call gastric distension. The stomach stretches out more than usual, and it can become very uncomfortable for the dog, even making them want to vomit, just like how you might feel if you eat way too much at once.

Causes of Acute Gastric Distension in Dogs

Think of a dog’s stomach like a balloon. Normally, this “balloon” has some air, food, and liquid in it. A problematic situation is when the stomach is overstretched or distended too much due to the excessive presence of air, fluid, and/or food. At this moment, the size of a regular balloon grows bigger and bigger, giving rise to some serious diseases, for example, gastric dilatation and volvulus (GDV) in dogs. Vomiting might be noticed during acute gastric distension. The gastric distension can happen for a few reasons:

1. Rapid Ingestion of A Large Meal: when dogs devour a large meal, they can swallow a lot of air along with their food. Accumulation of excessive food, water, and extra air in the stomach can lead to gastric distension.
2. Intake of the wrong things or foods: dogs are known for their passion for food. It is not uncommon that something that should not be inside the stomach ends up there, like spoiled food or garbage. Excessive gas is produced in the stomach as these unusual contents go under digestion. Some foods that are high in fat or hard to digest can be more bloating-induced problematic.
3. Physical issues: in some cases, a dog might have a health issue that makes it hard for them to release gas normally, leading to a buildup.

All in all, When the stomach gets filled with too much air or fluid, it’s like the balloon getting over-inflated. This over-inflation is what we call gastric distension. The stomach stretches out more than usual, and it can become very uncomfortable for the dog, just like how you might feel if you ate way too much at once.

Diagnostics of Acute Vomiting – Gastric Distention

1. Physical exam: Acute gastric dilatation can be difficult to diagnose. Early clinical signs in the animal may include restlessness, decreased activity, dyspnea, and reduced appetite. Palpate the belly to check for signs of bloat or pain. Listen to the stomach area with a stethoscope for any abnormal sounds.
2. Blood tests: some dogs could have anemia, which can be detected by a blood sample
3. Imaging tests: take X-ray or ultrasound images of abdominal areas to check if there is an accumulation of gas or fluids.

• Activity: compare the two images below and discuss with your partner:
  • Try to look for the stomach in both pictures.
  • Which one looks normal to you
  • Think about what could be the dark area in the left picture.

Answer key for activity: the image on the left shows a dog with GDV, which occurs when distension keeps developing and causes the stomach to twist, right image is from a normal dog. Gas in radiological images would show as dark areas, while tissues and fluids would show as white-gray. By comparing the gas-defined boundaries in both images, we can see the stomach in the left image has been twisted and occupied the left side of the abdominal cavity, and the normal stomach in the right image is crossed from left to right.

Treatment

Rest the stomach: first,  we can tell the clients to stop feeding the dog for a short period of time. Like hitting the pause button on eating, giving the dog’s stomach time to settle down. Second, if dogs have been vomiting a lot, instead of letting them gulp water, we recommend small, frequent sips or even giving fluids through an IV if needed.

1. Relieving the Pressure: reduce the pressure in the stomach. If there’s a lot of gas, the vet might use a special tube to let the gas out. This tube called a stomach tube, is gently put into the stomach through the mouth. It’s a bit like letting air out of a balloon.
2. Medications
   a. Pain relief: if the dog is in pain, they might be given pain relief medications.
   b. Antibiotics: Sometimes, antibiotics are given to prevent or treat infections, especially if surgery is done.
   c. Prokinetics: Helps strengthen the muscles of the gastrointestinal tract and improves stomach emptying, which can be beneficial if the gastric distension is due to slow gastric emptying.

4. Surgery – In Severe Cases: in some very serious cases, where the stomach has twisted (a condition called GDV), surgery might be needed. This is to untwist the stomach and fix it in the right position.

After the surgery or treatment, it’s important for the dog to rest and recover. We recommend a special diet for a few days and advice on how to slowly get back to normal activities.

Treating gastric distension in dogs is all about quick action and relieving pressure in the stomach. With the right care from a vet, most dogs recover well. And remember, keeping an eye on your dog’s diet and exercise can help prevent this problem in the future.

Summary

Gastric distension could be physiological or pathological. When the enlargement process happens too rapidly due to large amounts of food or fast ingestion, acute gastric distension could occur and lead to symptoms such as vomiting and bloating. If left without caution, this situation might develop into life-threatening Gastric Dilatation-Volvulus (GDV) when the stomach gets twisted. Large amounts of meals, fast ingestion, pica, or other health issues could all cause acute gastric distension. Diagnostic tools include physical examination, bloodwork, and radiological imaging. Treatments require quick action to release the pressure during the early stages, medications and surgeries would be applied if the situation worsens.

Reference

1. https://vcahospitals.com/know-your-pet/bloat-gastric-dilatation-and-volvulus-in-dogs
2.  https://www.merckvetmanual.com/digestive-system/diseases-of-the-stomach-and-intestines-in-small-animals/gastric-dilation-and-volvulus-in-small-animals
3. https://www.acvs.org/small-animal/gastric-dilatation-volvulus/
4.  https://www.sciencedirect.com/topics/medicine-and-dentistry/gastric-distension
5. https://stanfordhealthcare.org/medical-conditions/digestion-and-metabolic-health/nausea-and-vomiting/diagnosis.html#:~:text=Blood%20tests%3A%20Using%20a%20sample,to%20assess%20your%20nutritional%20status