Bloat in dogs: first signs, timeline and what to do

Bloat in dogs is a sudden swelling of the stomach with gas, food or fluid. In its dangerous form the stomach also twists, which traps everything inside and cuts off blood flow. The first signs are usually retching with nothing coming up, a tight swollen belly, restlessness and drooling. A dog showing them needs an emergency vet now, not in the morning.

There is no way to tell at home whether a bloated stomach has twisted, and nothing you can give that fixes it. What helps is knowing the signs, so you leave for the clinic early.

Bloat, GDV and a twisted stomach: what the words mean

Vets use two terms. Gastric dilatation is simple bloat: the stomach stretches with gas or food but stays in position. Gastric dilatation-volvulus, or GDV, is bloat with a twist: the swollen stomach rotates and seals itself at both ends.

Once the stomach has twisted, gas cannot escape in either direction, so the dog cannot vomit or belch. The stomach keeps swelling and presses on the large veins that return blood to the heart. The dog goes into shock, and the stomach wall and sometimes the spleen start to lose their blood supply.

Simple bloat can turn into GDV, and the two look the same from the outside. Any suspected bloat is treated as an emergency until an X-ray shows otherwise.

What are the first signs of bloat in a dog?

The early signs are easy to mistake for an upset stomach. What sets bloat apart is a dog that keeps trying to vomit and produces nothing, or only foam.

• Unproductive retching. Repeated heaving or gagging with nothing, or only froth, coming up.
• A swollen, tight belly. Often most obvious behind the ribs on the left side. It can feel hard and drum-like. In deep-chested and heavily muscled dogs the swelling can hide under the ribcage and be hard to see.
• Restlessness. Pacing, getting up and lying down, unable to settle, looking round at the belly.
• Drooling. Ropes of saliva, often with lip licking and repeated swallowing.
• Signs of pain. A hunched back, a stretched-out "praying" posture, whining or groaning when the belly is touched.
• Fast, shallow breathing or heavy panting.

Any one of these can have other causes. Our pages on restlessness in older dogs and sudden drooling cover them. Retching with nothing coming up, with or without a swollen belly, is the combination that should send you to a clinic straight away.

Signs that bloat is advanced

Pale or gray gums, a racing heartbeat, weakness, wobbling and collapse are signs of shock. A dog at this stage is in immediate danger.

The timeline: why minutes matter

GDV often starts within a few hours of a meal, commonly in the evening or overnight, though it can happen at any time. From the first retch, a dog can go from uncomfortable to collapsed within a few hours, and sometimes faster.

The damage builds. The longer the stomach stays twisted, the more of its wall is starved of blood and the deeper the shock. Dogs treated early do far better than dogs treated late, and untreated GDV is fatal.

So the plan is short. Phone the nearest open clinic to say you are coming with a suspected bloat, and go. Do not wait to see whether the dog settles.

What not to do at home

• Do not try to make the dog vomit.
• Do not give food, water, anti-gas products or any human medicine. None of them can untwist a stomach, and they cost time.
• Do not press on or massage the belly, or walk the dog around to "work it out".

Which dogs get bloat, and why age matters

Any dog can bloat, including small ones, but the risk is concentrated in large and giant breeds with deep, narrow chests. Great Danes are the best-known example, and we have a separate page on bloat in Great Danes. German Shepherds, Standard Poodles, Weimaraners, Saint Bernards, Irish Setters, Dobermans and Basset Hounds are also commonly listed.

Risk climbs with age. The ligaments that hold the stomach in place are thought to stretch over the years, which gives a full stomach more room to swing. A deep-chested dog that has never had a problem is more at risk at nine than it was at three.

Other things commonly linked to higher risk:

• A parent, brother or sister that has had GDV
• One large meal a day instead of several smaller ones
• Eating very fast
• A lean, narrow build
• A nervous or easily stressed temperament
• Raised food bowls, in some research on large breeds

Hard exercise straight before or after a meal is often blamed too. The evidence is weaker, but keeping mealtimes calm costs nothing.

Dog looks bloated but is acting normal

A dog with GDV rarely acts normal for long. It is usually distressed, cannot settle and retches, though the very early signs can be mild. A round belly in a dog that is bright, eating, comfortable and passing stool normally is unlikely to be a twisted stomach.

It still deserves an explanation, especially in an older dog. Common reasons for a belly that looks bigger:

• A very large meal, or a raid on the food bin. This is sometimes called food bloat. Call your vet or an emergency clinic for advice straight away, because a badly overfilled stomach can need treatment and can be hard to tell from early GDV.
• Weight gain, which tends to build slowly and evenly.
• A pot belly from hormone disease, most often Cushing's disease, usually alongside heavy drinking, panting and thinning hair.
• Fluid in the abdomen, which can build up with heart disease, liver disease or low blood protein.
• An enlarged organ or a mass, for example on the spleen or liver. A mass that bleeds can cause sudden weakness and pale gums, which is an emergency in its own right.

A belly that has grown over weeks needs a vet appointment in the next few days. A belly that has grown over hours needs a vet now, however the dog is behaving.

My dog's stomach is hard

A stomach that feels firm for a while after a big meal can be normal fullness, and some dogs simply tense their muscles when you press. A belly that is hard, tight and getting bigger, or one the dog will not let you touch, is different. With retching, drooling, restlessness or pale gums, treat it as bloat.

What the emergency vet does

Treatment starts before the diagnosis is complete, because the dog has to be stabilized first.

1. Treat the shock. Fluids into a vein, oxygen if needed, and pain relief.
2. Let the gas out. The vet passes a tube down to the stomach, or releases gas through the body wall with a needle, to take the pressure off.
3. Confirm the twist. An X-ray shows whether the stomach has rotated. Blood tests and heart monitoring show how badly the dog has been affected.
4. Operate. For GDV, surgery is the treatment. The surgeon returns the stomach to its normal position, checks the stomach wall and spleen, and removes any tissue that has died.
5. Fix the stomach in place. The stomach is stitched to the body wall, a procedure called a gastropexy, so that it is much less likely to twist again.

Most dogs stay in the hospital for a few days afterward. Irregular heart rhythms are a known complication, so the heart is watched closely.

Outlook after bloat

It is commonly reported that most dogs who reach surgery in time survive. The outlook is worse when part of the stomach has died, when the spleen has to be removed or when the dog was already collapsed on arrival. Older dogs and dogs with other illnesses have less in reserve. The vet treating your dog is the one who can give a real prognosis.

A dog that has bloated once is at high risk of doing so again unless the stomach has been fixed in place. A gastropexy makes a twist much less likely, but the stomach can still fill with gas, so the same signs still mean an emergency visit. Emergency surgery and intensive care are expensive: bills commonly run into the thousands of dollars and vary widely by clinic and region. If you have a deep-chested breed, it is worth knowing in advance what your pet insurance covers and where the nearest overnight clinic is.

Lowering the risk

Nothing removes the risk completely. These steps are the ones vets most often suggest for dogs at higher risk:

• Feed two or more smaller meals instead of one large one.
• Slow down fast eaters with a slow-feeder bowl or by spreading the food out.
• Keep the hour or so around meals quiet.
• Feed from the floor unless your vet has advised a raised bowl for another reason, such as a neck or swallowing problem.
• Ask your vet about a preventive gastropexy. In high-risk breeds it is often done at the same time as another planned operation.

Call the vet today if

Go to a vet or emergency clinic immediately, day or night, if your dog:

• Retches or tries to vomit repeatedly and brings up nothing or only foam
• Has a belly that is swollen, tight or growing
• Is restless, pacing and drooling and cannot get comfortable, especially after a meal
• Has pale or gray gums, a racing heart or labored breathing
• Is weak, wobbly or has collapsed

Call your vet or an emergency clinic straight away if your dog has eaten a very large amount of food, and the same day if your dog is vomiting repeatedly for any reason. If you are unsure whether it is bloat, treat it as bloat. A wasted trip is the good outcome.

This page is general educational information, not veterinary advice, and it cannot tell you whether your dog has bloat. Only a veterinarian who examines and X-rays your dog can diagnose bloat or GDV and decide on treatment. If you suspect bloat, do not wait or try home remedies: contact a veterinarian or emergency clinic immediately.