Symptoms of torsion include a swollen, turgid abdomen; the sluggish action of the dog; his white, frothy, unsuccessful attempts at vomiting; and perhaps his scratching in the dirt to make a cool hole in which to
lie down. Also, the spleen will feel like a hard lump. The spleen is normally wrapped around some of the stomach and therefore splenic torsion accompanies gastric torsion. When this happens, the return of the blood that flows through the spleen is shut off causing shock, the "immediate" killer.

The first thing your vet is likely to do is attempt to push a tube down the throat into the stomach so the gas pressure can be relieved. If he cannot get past the twisted part of the alimentary canal, he may opt for
immediate surgery so he can un-twist the organs. One emergency veterinary service in the Detroit area uses a different kind of lavage tube in their treatment of acute torsion. The large diameter, stiff, black polyethylene pipe has a smaller, flexible tube inserted into it. This smaller tube is for warm water so that the stomach contents can be flushed out of the larger one for about fifteen minutes. In either case, once the dog has been stabilized, decisions can be made about whether to operate, or untwist a stomach or spleen still in volvulus.

Follow-up surgical techniques are numerous, but the one with the most success in preventing future torsion is a tube gastrostomy. In this procedure, a rubber or vinyl tube is put into the stomach through the
abdominal wall, and in a week the stomach wall at that point becomes attached with scar tissue to the peritoneum and abdominal wall. The tube is then pulled out. The surgical opening seals off in a few days, and since the stomach is fused to the abdominal wall, it is prevented from again twisting out of position. Regular gastroplexy, which is suturing the stomach to the abdominal cavity, is also widely performed. Because of these and other techniques, especially the rise of emergency clinics, the mortality rate among those that make it to the clinic while still alive has plummeted to about 15 percent. Another 15 percent or so die without being seen by the vet first.

Groups of scientists at many locations have been studying bloat for a long time, partly with help from such as Morris Animal Foundation, the GSDCA, and many others. So far, they have identified a number of likely causative factors, including behavioral traits.  Breed susceptibility is pretty obvious, with 25 percent or more of Great Danes, Saint Bernards, Weimaraners, and Irish Setters expected to suffer from bloat sometime during their lives. German Shepherd Dogs, Standard Poodles, Collies, and Gordon Setters are fairly high on the incidence lists, also. Some of the characteristics seen most often in dogs that had bloated include some stressful event, even minor, in approximately the eight hours prior to the incident, a fearful temperament, and consumption of fairly large quantities of non-food material. The only dogs I've had direct contact with that bloated were of impeccable character, but those may have been in the minority. Purdue researchers found no pattern in presoaking dry food or not, but a slight correlation between several smaller meals and less bloat. Others found no relation to soybean meal in the food, an
early target of breeders looking for a primary cause. Adding vegetables and canned or meat scraps appears to help lower incidence. Most dogs (60%) bloated not immediately after vigorous exercise soon after a meal, but in mid- to late evening when resting or sleeping.

There is a familial element in torsion/volvulus in many, similar to the way cancer "runs in families", but most cases don't give a clue to hereditary factors. As in "toxic gut syndrome" which is also seen a lot
in some GSD lines, it is almost impossible to tell which came first, the presence of abnormal bacterial populations and irritated intestinal or stomach linings, or the bloat itself.  Which is cause and which is effect is not going to be easy or even possible to determine. Some investigators suspect that breeders may be stuffing their small, young puppies' stomachs too much, with results that show up only later in life. Work goes on.

Less likely are other types of torsion, but they can be as life-threatening.  Splenic torsion can occur without gastric twisting, and an even rarer disorder is mesenteric root torsion. The mesentery is
the white, fibrous, web-like or film-like tissue that connects the various sections of intestines to each other and to the abdominal wall.
Blood vessels travel through the mesentery, and if there is a twisting  there, regardless of whether the intestine itself is closed off, the blood supply can be halted and the intestinal tissue can become necrotic.
Bloody diarrhea, vomiting, abdominal swelling and/or pain, and shock or general collapse can be symptomatic. It may be the same as what some call "twisted intestines". So few dogs survive that it is impossible to prevent recurrence or conclusively predict whether those are at greater risk for another attack than any other dog is.

COPYRIGHT 1999, Fred Lanting  May be reprinted with permission of author,
 with this statement:
This is an excerpt from Fred's revised "The Total German Shepherd Dog" (www.hoflin.com)  Fred is a long-time breeder and judge with international exposure, and also gives seminars on HD, as well as
Gait-&-Structure.

Fred Lanting, Canine Consulting.    mrgsd@hiwaay.net   Seminars: Canine HD & Other Orthopedic Disorders;     Gait & Structure (Analytical Approach); more