Gastric Torsion – A Race Against Time

Why I Am Writing About This Topic

Few emergencies frighten owners of large dogs as much as gastric torsion. Two years ago, that fear suddenly became reality for my dog Charlotte. Within a very short time, what had seemed like a beautiful, warm summer evening turned into a life-threatening emergency in which every minute counted.

In this article, I want to share what happened, which signs alerted me, and why acting quickly can be crucial in cases of gastric torsion.

I also want to explain which typical symptoms owners of large dogs should know, what needs to be done immediately in an emergency, and what options there are to reduce the risk or improve the chances of survival.

One thing became very clear to me through this experience: You can never completely rule out gastric torsion. But you can be prepared. And that preparation can make all the difference when every minute matters.

The majority of our almost 10,000 dog-owning customers have large dogs. If this article helps save even one dog’s life, then it has already achieved its purpose. That is why we want to share our most important experiences and insights with you.

What is commonly referred to as gastric torsion is medically often called GDV: Gastric Dilatation-Volvulus, meaning dilation of the stomach combined with twisting.

1. My Experience with My Dog Charlotte

1.1 The Moment I Realized Something Was Wrong

It was a hot, humid Saturday evening in July. One of those summer evenings that should have been perfect. Charlotte, weighing 50 kg, and Ringo, weighing 60 kg, Great Dane-Labrador littermates and four years old at the time, had been having a wonderful time at the lake. They swam, played, and enjoyed the water. Charlotte repeatedly jumped from the SUP, the stand-up paddleboard, into the water and climbed back onto the board. It was one of those days that could hardly have been more beautiful.

Charlotte had an empty stomach because she had not eaten since the morning. Back at home, still with wet fur, she first went back to chewing on her bone. She did that for around ten minutes. Then it was time for dinner.

I put their food outside the door so that the dogs could stay outside a little longer and dry off. Less than a minute later, I saw Ringo happily eating. Charlotte also approached her food – but then she suddenly whimpered in pain and backed away.

At that moment, I knew: Something was seriously wrong.

1.2 The First Signs

I immediately brought Charlotte into the house. The first thing I noticed was that she was stretching her head forward, as if she had strained something in her neck or back. She paced restlessly, repeatedly sat down, and kept her head stretched forward. Again and again, she tried to stretch, but it was obvious that doing so caused her pain.

My first thought was actually not gastric torsion. I thought about a slipped disc, a pinched nerve, or an injury in the neck or back area because she was holding her head so rigidly.

Then came the moment when all my alarm bells went off. Charlotte sat down, and I saw her subtly turn toward her abdomen. That look toward the stomach. As a horse owner, I know this behavior very well: the abdomen hurts.

I had never seen gastric torsion in a dog before. But at that moment, I knew it could be exactly that.

1.3 The Decision: Leave Immediately

My next instinct was to grab the phone. Thank goodness the Ennetsee Clinic for Small Animals in Hünenberg, Canton Zug, is not far away. I called ahead to register Charlotte as an emergency, and less than 15 minutes after the first symptoms appeared, we were already sitting in the clinic waiting room.

Those 15 minutes were crucial. I did not spend time searching online, waiting, or hoping that things might improve on their own. All I knew was that my dog was in severe pain. And if it really was gastric torsion, I could not afford to lose time.

1.4 At the Clinic

By then, Charlotte was panting. It was a hot evening, but her face was clearly showing pain. Even so, she remained fully alert. She tried her best not to show how much she was suffering. That was typical of her as a strong dog: never show weakness.

While we were still in the waiting room, I noticed that her normally very slim abdomen looked bloated. When she turned to the left, I could see on the right side that her abdominal area looked different than usual. It was almost as though there were a bulge.

Then we were called into the treatment room to see the veterinarian on duty. She also confirmed that Charlotte did appear to have abdominal pain. At the same time, however, Charlotte had not once tried to retch or vomit unsuccessfully. Her circulation was stable and her breathing was normal.

That left us with a decision: Should Charlotte receive an antispasmodic medication for the abdominal pain – or should we take an X-ray just to be sure and rule out gastric torsion?

For me, the decision was clear: Absolutely take an X-ray. Because I knew my dog was in severe pain.

Charlotte walked into the X-ray room herself. A short while later, the veterinarian came back visibly alarmed. What had previously been a relatively calm examination suddenly became much more urgent. Charlotte had gastric torsion, and the X-ray had confirmed it. Now there was no doubt: She needed immediate surgery.

The veterinarian also confirmed that Charlotte’s chances were good because she had been brought to the clinic so quickly. One hour later, Charlotte was operated on by Mr. Andreoni.

That waiting time was almost unbearable. Time seemed to stand still. After an hour and a half without any news, I could not stand it any longer. I drove back to the clinic and waited outside the door. I could not bear the uncertainty. Not knowing how my dog was doing was unbearable.

There, the veterinary assistant who had been present during the operation found me crying outside the clinic. And she relieved my fear. Everything had gone well.

Charlotte’s spleen had twisted as well. However, there were no necrotic changes, meaning there was no dead tissue caused by the blood supply being interrupted for too long. Bringing her to the clinic quickly and the team operating without delay had saved Charlotte’s life. She suffered no permanent damage from the gastric torsion.

To significantly reduce the risk of another gastric torsion, a procedure called a gastropexy was performed. During this procedure, the stomach is surgically attached to the abdominal wall. This makes another torsion much less likely, although gastric dilation can still occur.

Two days later, Charlotte was allowed to come home. Her recovery was fast. The incision healed very well, and after ten days the stitches could be removed. They were already deeply healed because her wound healing had progressed so well. The hardest part was keeping her calm. Charlotte did not understand why she had to take it easy. In her opinion, just a few days later, she was already perfectly healthy again.

1.5 What I Learned From That Night

The difficult part was that Charlotte did not actually have a full stomach. She had not touched her dinner. There was probably only a small amount of bone in her stomach – but possibly a lot of air.

After swimming, panting, and all the excitement, a dog can swallow air. Because her coat was still wet, she may also have rolled around afterwards. In a large, deep-chested dog, such a moment may perhaps be enough: a stomach not filled with food but with air, some heavier contents from the bone – and then a movement during which the stomach twists.

Whether this exact combination triggered the torsion can no longer be proven with certainty. With gastric torsion, there is often not one single cause, but rather several factors that come together in an unfortunate way.

What remains very clear to me from this experience is this: Gastric torsion is a race against time. And if there is even the slightest suspicion, it is better to have one emergency examination too many to safely rule it out than to lose valuable minutes.

Gastric Torsion: My 10-Point Emergency Plan

If you have a large or deep-chested dog, you should know these points:

1. Know the risk factors.

Large dogs, giant breeds, and dogs with a deep chest have an increased risk of gastric torsion.

2. Know the symptoms.

Restlessness, pain, a bloated abdomen, panting, salivation, or unsuccessful attempts to vomit can all be warning signs.

3. Do not assume that every symptom has to be present.

Not every dog shows the classic signs. My dog, for example, did not retch even once and still had gastric torsion.

4. Do not rule out gastric torsion just because your dog is small or young.

Small dogs and even puppies can also be affected, although much less commonly.

5. Do not waste time searching online.

If you suspect gastric torsion, this is not the time for Google, forums, or Facebook groups.

6. Know the nearest veterinary clinic with a 24-hour emergency service.

Find out today which clinic in your area can diagnose gastric torsion, stabilize your dog, and perform emergency surgery if necessary. Even when you are traveling or on vacation, you should know where the nearest suitable emergency clinic is located.

7. Save the emergency clinic’s phone number in your phone.

In an emergency, every minute counts. Call immediately and clearly say: “I suspect gastric torsion.” This lets the clinic know before you arrive that this may be a time-critical emergency.

8. Plan the transport in advance.

Do you know exactly how to get to the clinic? Do you know how long the drive takes? Have you saved the destination in your navigation system?

9. Think in advance about how you would transport a heavy dog.

Could you lift a 50-, 60-, or 70-kilogram dog into the car by yourself? If not, who could help you? Do you have a ramp or another solution?

10. It is better to have one unnecessary emergency check than to arrive too late.

An unnecessary emergency examination is frustrating. A missed gastric torsion can be fatal.

With gastric torsion, the winner is not the person who recognizes the most symptoms. It is the person who does not lose time when there is a suspicion.

For me, the most important lessons from that night are:

• Time is everything.
• Not all symptoms have to be present. Charlotte never tried to retch, even though this can be a typical sign.
• You need to know which clinics to contact before an emergency occurs. In a stressful situation, too much time is lost if you first have to search for clinics.
• Even when on vacation, you should know where the nearest 24-hour clinic is and how to get there.
• It is better to go to the emergency clinic one time too many than regret waiting too long.

2. Typical Symptoms of Gastric Torsion

Gastric torsion can present differently from dog to dog. There are classic warning signs that are frequently described – but not every dog shows all of them. That is exactly what makes the condition so dangerous: gastric torsion should not be ruled out just because one typical symptom is absent.

Common and Classic Warning Signs

Typical signs may include:

• sudden restlessness, with the dog pacing and unable to find a comfortable position
• noticeable anxiety, discomfort, or a tense expression
• increased salivation
• retching or attempts to vomit without bringing anything up
• a bloated, tense, or hard abdomen
• visible abdominal pain
• the “prayer position”: front end lowered, chest toward the ground, hindquarters raised
• looking toward or turning toward the abdomen
• panting or rapid breathing
• weakness or pale gums
• a fast or weak pulse
• circulatory problems or collapse in advanced stages

Unproductive retching or trying to vomit without bringing anything up is particularly well known as a typical warning sign. But it does not always occur.

Charlotte did not retch a single time and never tried unsuccessfully to vomit. Her circulation was initially stable, and her breathing was normal. Despite that, she had gastric torsion.

That is why one of the most important points for me is: Do not wait for the “complete textbook picture.” A dog does not need to show all of the classic symptoms to have gastric torsion.

Signs That Were Noticeable in Charlotte

• She refused her food and backed away from it.
• She stretched her head noticeably forward.
• She appeared as though she had strained something in her neck or back.
• She paced restlessly.
• She repeatedly sat down.
• She tried to stretch, which was obviously painful.
• She subtly turned toward her abdomen.
• Her normally very slim abdomen appeared bloated.
• One side of her abdominal area looked different than usual, almost like a bulge.
• Her face clearly showed pain.
• At the same time, she remained alert and tried not to show how much pain she was in.

These signs matter because they show that gastric torsion does not always look obvious at the beginning. It can look like abdominal pain, back pain, a pinched nerve, or general discomfort.

Large, deep-chested dogs in particular may hide pain for a long time. Some dogs try not to show that anything is wrong even when they are already in severe pain. That is why you should not wait until the dog collapses or displays every classic symptom.

If gastric torsion is suspected: Do not wait. Do not Google. Do not first watch to see whether things improve. Call the veterinary clinic or emergency veterinarian immediately and clearly say: “I suspect gastric torsion.”

3. Risk Factors: Which Dogs Are Particularly at Risk?

Body Type and Predisposition

• Large dogs and giant breeds: Body size is the best-known risk factor. Large and very large dogs are affected much more often than small dogs.
• Deep, narrow chest: Size is not the only relevant factor; body shape also matters. Dogs with a deep and relatively narrow chest have an increased risk.
• Breed and genetic predisposition: Certain breeds are affected more frequently than average. Genetics also play a role. It is particularly relevant whether a close relative has already had gastric torsion. If a littermate, parent, or offspring has been affected, owners should be especially vigilant.

Age

• Increasing age: The risk increases with age. At the same time, it is important to remember that young dogs, small dogs, and even puppies can develop gastric torsion too, although much less frequently.

Feeding and Eating Behavior

• Feeding once a day and large meals: A large amount of food consumed at once may increase the risk. For dogs at increased risk, it can therefore be sensible to divide large amounts of food into several smaller meals.
• Fast eating and gulping: Eating very quickly is frequently mentioned as a risk factor. For dogs that gulp their food, a slow-feeder bowl or another method of slowing down eating may be helpful.
• Raised food bowls: Raised bowls were previously sometimes recommended, but are now viewed more critically and have also been identified in studies as a possible risk factor. A raised bowl should therefore not automatically be considered a preventive measure for at-risk dogs and should instead be discussed with a veterinarian.

Exercise, Stress, and Situation

• Intense activity shortly after eating: Dogs often want to run and play after eating. Whenever possible, however, intense activity should be avoided after a meal. Gentle movement is different from running, jumping, rough play, or vigorous exercise.
• Stress, nervousness, or a highly tense temperament: Stress, nervousness, and a very tense temperament are also described as possible risk factors. This does not mean that every sensitive or alert dog will develop gastric torsion. But in large, deep-chested dogs, stress may be an additional factor worth considering.

Medical History

• Previous gastric torsion or gastric dilation: A dog that has already experienced gastric torsion or severe gastric dilation is considered to be at particularly high risk of recurrence if no gastropexy has been performed. Gastropexy can significantly reduce the risk of another torsion, but it does not guarantee that gastric dilation can never occur again.

Weather, Season, and Air Pressure

• Weather, temperature, air pressure, and season have also been investigated in studies. However, the associations are not clear. It is therefore important to remain cautious when interpreting these factors. In Charlotte’s case, it was a hot, humid summer evening. Whether those conditions played a role cannot be determined with certainty. They may have been an additional stress factor – but this cannot be proven in retrospect.

4. Prevention: What Can Be Done to Reduce the Risk?

Gastric torsion can never be prevented with absolute certainty. But certain risk factors can be recognized, daily routines can be adapted accordingly, and most importantly, owners can be prepared for an emergency.

Possible Measures in Everyday Life

• divide large amounts of food into several meals
• avoid gulping, for example by using a slow-feeder bowl if necessary
• avoid vigorous activity after large meals
• reduce stress and excitement around feeding whenever possible
• observe the dog after eating, especially if the dog is known to be at increased risk
• do not automatically consider a raised bowl a preventive measure; discuss it individually with your veterinarian
• for at-risk dogs, discuss feeding method and food composition with your veterinarian
• discuss feeding, activity, and individual risk factors with your veterinarian
• for dogs at increased risk, speak with your veterinarian or veterinary surgeon about prophylactic gastropexy

5. What Improves the Chances of Survival in an Emergency?

The most important preparation is not just feeding management. The most important preparation is avoiding any loss of time in an emergency. Many people lose valuable minutes because they hope that it might only be a stomach ache. That uncertainty is exactly what makes the situation dangerous.

If gastric torsion is suspected, there is no such thing as embarrassingly overreacting. There is only acting quickly – or losing time.

That Is Why Every Owner of a Large or Deep-Chested Dog Should Know in Advance:

• Which clinic near me provides a 24-hour emergency service?
• Can this clinic diagnose gastric torsion, stabilize the dog, and perform emergency surgery if necessary?
• Have I saved the phone number?
• Do I know how to get there? How long will the drive take?
• What would I do if I were alone? How would I get a very heavy dog into the car?
• Who could help me in an emergency? Do I have a ramp or another transport solution?
• Do I also know where the nearest suitable clinic is when I am on vacation?

Spending a long time searching online costs time. And with gastric torsion, exactly that time can be crucial.

6. Conclusion: You Can Never Be Completely Safe – But You Can Be Prepared

Charlotte was lucky. Not because the situation was harmless, but because we acted quickly, because the clinic was within reach, and because the team was able to respond immediately.

What I took away from this experience is this: Gastric torsion can never be completely ruled out. Not through perfect feeding, not through caution, and not through experience. Even if you do many things right, it can still happen.

But you can be prepared. You can know the risk factors. You can know the symptoms. You can know which clinic to contact. You can have the number saved. You can plan transport in advance. And when the moment comes, you can choose to make one emergency trip too many rather than one too few.

Because with gastric torsion, one thing often matters most in the end: time.

Acknowledgements and Medical Review

My special thanks go to Alessandro Andreoni and the entire team at the Ennetsee Clinic for Small Animals. Charlotte was not only treated quickly and professionally there, but was also cared for with great attention and calm throughout this life-threatening emergency.

That night made it very clear to me how important it is to have a clinic within reach that offers emergency services and can act immediately in a situation like this. With gastric torsion, every minute counts – and it was precisely this fast and decisive response that saved Charlotte’s life.

I am deeply grateful to Alessandro Andreoni and the whole team for taking such good care of Charlotte and for helping her recover completely from this major operation.

The medical section of this article was reviewed by Alessandro Andreoni.

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