Diet-related risk factors for gastric dilatation-volvulus in dogs of high-risk breeds

A nested case-control study was conducted among 1634 dogs with complete diet information in a 5-year prospective study to determine diet-related risk factors for gastric dilatation-volvulus (GDV). Cases included 106 dogs that developed GDV; controls included 212 dogs without GDV that were frequency matched to cases by year of GDV onset. Proportionate energy consumed from major food types and from carbohydrates was determined. Dogs were categorized as consuming either a low volume or high volume of food based on the median number of cups of food fed per kg of body weight per meal. Dogs fed a larger volume of food per meal were at a significantly (P<0.05) increased risk of GDV, regardless of the number of meals fed daily. For both large- and giant-breed dogs, the risk of GDV was highest for dogs fed a larger volume of food once daily.     

Cardiopulmonary measurements in dogs undergoing gastropexy without gastrectomy for correction of gastric dilatation-volvulus.

OBJECTIVE: To measure cardiopulmonary variables, including cardiac index, in dogs with naturally acquired gastric dilatation-volvulus (GDV). DESIGN: Prospective clinical study. ANIMALS: 6 dogs with GDV. PROCEDURE: In addition to typical medical and surgical management of GDV, the dorsal metatarsal and pulmonary arteries and right atrium of the dogs were catheterized to obtain cardiopulmonary measurements before and during anesthesia and surgery. RESULTS: All dogs underwent gastropexy but none required gastrectomy. Mean cardiac index and mean arterial blood pressure for this small population of dogs with GDV were not significantly different from those reported for clinically normal awake or anesthetized dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs with naturally acquired GDV without gastric necrosis may not have the classic characteristics, including decreased cardiac index and hypotension, of hypovolemic circulatory shock.     

Prospective evaluation of laparoscopic-assisted gastropexy in dogs susceptible to gastric dilatation

OBJECTIVE: To determine long-term outcome associated with laparoscopic-assisted gastropexy in prevention of gastric dilatation-volvulus (GDV) in susceptible dogs and to evaluate use of laparoscopy to correct GDV. DESIGN: Prospective study. ANIMALS: 25 client-owned large-breed dogs. PROCEDURE: 23 dogs susceptible to GDV were referred as candidates for elective gastropexy. These dogs had a history of treatment for gastric dilatation, clinical signs of gastric dilatation, or family members with gastric dilatation. Laparoscopic-assisted gastropexy was performed. One year after surgery, abdominal ultrasonography was performed to evaluate the attachment of the stomach to the abdominal wall. Two dogs with GDV were also treated with laparoscopic-assisted derotation of the stomach and gastropexy. RESULTS: None of the dogs developed GDV during the year after gastropexy, and all 20 dogs examined ultrasonographically had an intact attachment. Another dog was euthanatized at 11.5 months for unrelated problems. Two dogs with GDV successfully underwent laparoscopic-assisted gastropexy after the stomach was repositioned. CONCLUSIONS AND CLINICAL RELEVANCE: Laparoscopic-assisted gastropexy resulted in a persisting attachment between the stomach and abdominal wall, an absence of GDV development, and few complications. Dogs with a high probability for development of GDV should be considered candidates for minimally invasive gastropexy. Carefully selected dogs with GDV can be treated laparoscopically.     

Prevention of reperfusion injury in surgically induced gastric dilatation-volvulus in dogs

Canine gastric dilatation-volvulus (GDV) is a naturally acquired condition of large-breed dogs primarily and is associated with high mortality. The clinical course suggests that reperfusion injury may be important in the pathogenesis of GDV. To evaluate the role of xanthine oxidase and iron-dependent lipid peroxidation (which are purported mechanisms of reperfusion injury) in the pathogenesis of GDV-related mortality, we created experimental GDV in 21 dogs. These dogs were then treated with either allopurinol (a xanthine oxidase inhibitor), U74006F (an experimental lipid peroxidation inhibitor), or saline solution (NaCl, 0.85%). Three of 8 dogs died in the allopurinol-treated group, none of 5 died in the U74006F-treated group, and 4 of 8 died in the saline solution-treated group. Tissue malondialdehyde concentration, a nonspecific indicator of lipid peroxidation, was significantly (P less than 0.05) greater in the duodenum, jejunum, colon, liver, and pancreas of the saline-solution treated and allopurinol-treated dogs than in the same tissues of the U74006F-treated dogs after surgical correction of the GDV (ie, during reperfusion), compared with malondialdehyde concentrations determined before inducing GDV. The results of this study support the concept that lipid peroxidation associated with reperfusion injury is important in the pathogenesis and high mortality of canine GDV. Furthermore, this lipid peroxidation and mortality may be preventable by appropriate and timely treatment.     

Evaluation of cardiac performance of the dog after induction of portal hypertension and gastric ischemia

Objective: To determine changes in hemodynamic and cardiac energetic parameters in dogs after induction of portal hypertension and gastric ischemia. These blood flow alterations are similar to changes seen in splanchnic blood flow in dogs with gastric dilatation volvulus syndrome (GDV). Design: Original experimental study. Setting: Veterinary teaching hospital. Animals: Seven purpose‐bred, intact male dogs. Interventions: Standard midline laparotomy and median sternotomy were performed under general anesthesia. Dogs were instrumented to obtain arterial blood pressure, aortic flow, cardiac chamber pressures, central venous pressure, portal flow, and portal pressure. Colored microsphere technology was used for the determination of myocardial blood flow. Measurements and samples were obtained at baseline, following induction of portal hypertension, and after induction of portal hypertension and gastric ischemia. Measurements and main results: Left ventricular myocardial blood flow was increased from 81.8±20.1 mL/100 g/min at baseline to 127.7±57.2 mL/100 g/min (P=0.02) after induction of portal hypertension and gastric ischemia. Myocardial oxygen consumption increased from 142.2±27.4 J/min/100 g at baseline to 219.1±33.4 J/min/100 g (P=0.003) after induction of portal hypertension and gastric ischemia, but cardiac external work remained unchanged (13.67±6.2 to 13.27±9.6 J/min; P=0.78; power=0.79). Cardiac efficiency decreased from 11.6±6.1% at baseline to 7.6±5.1% (P=0.017) after induction of portal hypertension and gastric ischemia. Conclusions: Transfer of energy within the myocardium was less efficient after induction of portal hypertension and ischemia of the stomach wall. On the basis of these results, alterations in cardiac function associated with GDV may result from deterioration of cardiac efficiency.     

Gastric Myoelectric Activity after Experimental Gastric Dilatation-Volvulus and Tube Gastrostomy in Dogs

Gastric myoelectric activity was measured after experimental gastric dilatation-volvulus (GDV), GDV and tube gastrostomy, or tube gastrostomy in 12 dogs. Gastric myoelectric activity was recorded for 1 hour before (hour 0) and at hours 5, 24, 48, 72, and 96 after surgically induced GDV in six dogs. Three dogs with induced GDV and tube gastrostomy, and three dogs with tube gastrostomy only were also studied at hours 120, 144, and 168. The only significant change in the slow wave appearance or frequency from hours 0 to 48 was bradygastria at hour 5 in all three groups. A relative increase in the mean percentages of dysrhythmia from hours 72 to 168 in the dogs with a tube gastrostomy was caused by increases in tachygastria and arrhythmias. Dogs with GDV and tube gastrostomy had the greatest mean percentages of dysrhythmia, which were significantly more than those in dogs with GDV alone at hours 48, 72 and 96. The mean percentage of spike activity was less than or equal to 31 and varied widely. In general, there was less spike activity when the frequency of dysrhythmias was high. Thus, gastric myoelectric activity was disrupted from hours 48 to 168 after GDV with tube gastrostomy and after tube gastrostomy alone. Surgically induced GDV alone did not produce any significant or sustained dysrhythmias.     

Serum cardiac troponin I and cardiac troponin T concentrations in dogs with gastric dilatation-volvulus

OBJECTIVE: To determine whether serum concentrations of cardiac troponin I (cTnI) and cardiac troponin T (cTnT) are increased in dogs with gastric dilatationvolvulus (GDV) and whether concentrations correlate with severity of ECG abnormalities or outcome. DESIGN: Prospective case series. ANIMALS: 85 dogs with GDV. PROCEDURE: Serum cTnl and cTnT concentrations were measured 12 to 24, 48, 72, and 96 hours after surgery. Dogs were grouped on the basis of severity of ECG abnormalities and outcome. RESULTS: cTnl and cTnT were detected in serum from 74 (87%) and 43 (51%) dogs, respectively. Concentrations were significantly different among groups when dogs were grouped on the basis of severity of ECG abnormalities (none or mild vs moderate vs severe). Dogs that died (n = 16) had significantly higher serum cTnI (24.9 ng/ml) and cTnT (0.18 ng/ml) concentrations than did dogs that survived (2.05 and < 0.01 ng/ml, respectively). Myocardial cell injury was confirmed at necropsy in 4 dogs with high serum cardiac troponin concentrations. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicate that concentrations of cTnI and cTnT suggestive of myocardial cell injury can commonly be found in serum from dogs with GDV and that serum cardiac troponin concentrations are associated with severity of ECG abnormalities and outcome.     

Gastric emptying of nondigestible radiopaque markers after circumcostal gastropexy in clinically normal dogs and dogs with gastric dilatation-volvulus.

Using radiopaque particles mixed with food, gastric emptying was assessed in healthy dogs not subjected to surgery, in healthy dogs 9 to 35 days after circumcostal gastropexy, and, in dogs 1 to 54 months after surgical treatment and recovery from gastric dilatation-volvulus (GDV). Circumcostal gastropexy surgery did not alter the 90% gastric emptying time for radiopaque particles in healthy dogs. However, 90% gastric emptying time was significantly (P less than 0.05) increased after circumcostal gastropexy in dogs with GDV, compared with healthy dogs after the same surgical procedure and recovery period. These results imply that dogs with GDV have delayed gastric emptying of solid particles. Whether delayed gastric emptying of markers detected in affected dogs after surgical treatment and recovery was the result or the cause of GDV was not determined. Results indicate that circumcostal gastropexy could be recommended as a prophylactic procedure for GDV in large breeds with deep thorax, because delayed gastric emptying of markers secondary to the surgical procedure is unlikely.     

Treatment of reperfusion injury in dogs with experimentally induced gastric dilatation-volvulus.

In dogs, gastric dilatation-volvulus (GDV) is characterized by cardiogenic shock, with resulting hypoperfusion. Treatment goals include reperfusion of transiently ischemic tissues, which indicates that reperfusion injury may be a factor in the physiopathogenesis of GDV. Recently, we obtained data that indicate that reperfusion injury may be involved in experimentally induced GDV. Using this GDV model, we evaluated mortality in 24 dogs of 4 equal groups, treated with deferoxamine (an iron chelator), dimethylsulfoxide (a free radical scavenger), a combination of the 2 drugs, or isotonic saline solution. All 6 dogs that were given deferoxamine survived; however, 3 dogs of the dimethylsulfoxide-treated group, 2 dogs of the combination-treated group, and 4 dogs of the saline-treated group died. Results of the study indicate that mortality associated with experimentally induced GDV is reduced by appropriate and timely pharmacologic intervention to prevent or attenuate reperfusion injury, and that deferoxamine may be more effective than dimethylsulfoxide.     

Effects of Flunixin Meglumine on Dogs with Experimental Gastric Dilatation-Volvulus

Gastric dilatation-volvulus (GDV) was created experimentally and maintained for 90 minutes in 16 anesthetized, mixed-breed dogs. After the GDV was corrected, normal saline solution (0.044 mL/kg intravenously [IV]) was administered to eight dogs (controls), and flunixin meglumine (2.2 mg/kg IV) was administered to eight dogs. Microspheres labeled with radioactive cobalt, scandium, tin, or niobium were injected intravenously at baseline (before GDV) and minutes 90, 100, and 270, respectively, to determine tissue blood flows. Plasma endotoxin and prostacyclin were measured at the same intervals. Electrocardiogram, mean arterial pressure, portal pressure, and cardiac output were recorded continuously. Dogs were euthanatized at minute 270 and necropsied. There was no significant difference between treatment groups for any measured variable at any time. Endotoxin levels increased significantly during GDV. Prostacyclin levels were lower in dogs treated with flunixin meglumine than in controls at minutes 210 and 270. Histopathologic findings were similar for all dogs and consistent with those associated with endotoxemia. Flunixin meglumine treatment did not alter cardiac indices or tissue blood flows significantly. However, elevation of prostacyclin was inhibited by flunixin meglumine, which suggested that continued effects of endotoxic damage might be attenuated or inhibited.     

Evaluation of splenectomy as a risk factor for gastric dilatation-volvulus

Objective-To evaluate whether dogs undergoing splenectomy had an increased risk of gastric dilatation-volvulus (GDV), compared with a control group of dogs undergoing enterotomy. Design-Retrospective case-control study. Animals-219 dogs that underwent splenectomy for reasons other than splenic torsion (splenectomy group; n = 172) or enterotomy (control group; 47) without concurrent gastropexy. Procedures-Medical records were reviewed for information on signalment, date of surgery, durations of surgery and anesthesia, reason for splenectomy, histopathologic findings (if applicable), whether gastropexy was performed, duration of follow-up, and date of death (if applicable). Follow-up information, including occurrence of GDV, was obtained via medical records review and a written client questionnaire. Results-Reasons for splenectomy included splenic neoplasia, nonneoplastic masses, infarction, traumatic injury, and adhesions to a gossypiboma. Incidence of GDV following surgery was not significantly different between dogs of the splenectomy (14/172 [8.1 %]) and control (3/47 [6.4%]) groups. Median time to GDV for the 17 affected dogs was 352 days (range, 12 to 2,368 days) after surgery. Among dogs that underwent splenectomy, sexually intact males had a significantly higher incidence of GDV (4/16) than did castrated males and sexually intact or spayed females (10/156). Incidence of GDV among sexually intact male dogs did not differ between groups. Conclusions and Clinical Relevance-Results did not support a recommendation for routine use of prophylactic gastropexy in dogs at the time of splenectomy. Other patient-specific risk factors should be assessed prior to recommending this procedure.     

Relationship of plasma gastrin immunoreactivity and gastroesophageal sphincter pressure in clinically normal dogs and in dogs with previous gastric dilatation-volvulus

Fasting and postprandial gastroesophageal sphincter pressure (GESP) and plasma gastrin immunoreactivity were measured in 6 dogs from 9 through 60 months after treatment for and recovery from gastric dilatation-volvulus (GDV). The GESP was not significantly increased in these dogs, compared with that in clinically normal dogs in either the fasting or postprandial state. Corresponding plasma gastrin immunoreactivity was not significantly increased in dogs of the GDV-recovered group, compared with that in clinically normal dogs (fasting or postprandial). An exaggerated increase in GESP in response to food-induced gastrin release was not observed in dogs of the GDV-recovered group. Exogenously administered pentagastrin (3-micrograms/kg bolus, IV) increased fasting GESP in clinically normal dogs over a 4-minute test period (P = 0.01). Gastric distention in response to oral administration of isosmolar saline solution (500 ml) did not significantly increase GESP or plasma gastrin immunoreactivity in clinically normal dogs. In anesthetized clinically normal dogs, gastric distention in response to use of balloons filled to exert intragastric pressure of 30 mm of Hg also did not cause significant increase in plasma gastrin immunoreactivity. Increased GESP, secondary to hypergastrinemia or gastric distention, is an unlikely cause of eructation failure in dogs with GDV.     

Effects of gastric distention-volvulus on coronary blood flow and myocardial oxygen consumption in the dog

Gastric distention-volvulus (GDV; at 50 mm of Hg gastric inflation pressure) was experimentally induced in 8 dogs anesthetized using pentobarbital. Hemodynamic indices including heart rate, mean arterial pressure, cardiac output, and coronary blood flow (4 dogs) were measured during a 20-minute period of GDV and for 10 minutes after decompression. Arterial and coronary venous oxygen tensions were also measured for calculation of myocardial oxygen extraction (7 dogs) and myocardial oxygen consumption (4 dogs). Dogs were monitored for 72 hours postoperatively for the occurrence of arrhythmias, then were euthanatized for gross and histologic examination of the heart. Experimental GDV resulted in significant (P less than 0.05) decreases in cardiac output (89%), mean arterial pressure (45%), and coronary blood flow (50%) compared with control values. Myocardial oxygen extraction increased (30%) and overall myocardial oxygen consumption decreased (50%), compared with control values. Evidence of subendocardial necrosis was seen in 6 dogs, 4 of which had developed ventricular arrhythmias 8 to 24 hours postoperatively.     

The use of retrievable electrodes for recording gastric myoelectric activity after spontaneous gastric dilatation volvulus in dogs.

Gastric myoelectric activity was measured in 10 dogs with spontaneous gastric dilatation-volvulus (GDV). Myoelectric activity was recorded with temporary, retrievable wire electrodes placed on the serosal surface of the stomach after derotation and tube gastrostomy. Gastric myoelectric activity was recorded for 1 hour daily, beginning with the day of surgery (less than 24 hours), 24, 48, 72, 96, 120, 144, and 168 hours after surgery. Recordings were also obtained for 1 hour daily after feeding, beginning 24 hours after surgery. Bradygastria was the predominate dysrhythmia immediately after surgery and at hour 24. The mean slow wave frequency was more than normal at hours 48 to 168 due to an increase in tachygastria and arrhythmias. The slow wave frequency significantly decreased after feeding at hours 120 and 144. The overall mean percentage of dysrhythmias was significantly decreased after feeding at hour 72 only. The mean percentage of spike activity ranged from 37.7 +/- 12.5 to 75.7 +/- 6.2 throughout the 8-day study period. Thus, gastric myoelectric activity was disrupted in these dogs with spontaneous GDV and subsequent tube gastrostomy. Feeding did not greatly diminish these dysrhythmias.     

Occurrence and recurrence of gastric dilatation with or without volvulus after incisional gastropexy

This study investigated recurrence of gastric dilatation without (GD) or with volvulus (GDV) after incisional gastropexy (IG) in dogs that underwent IG for prevention of GDV. Signalment, concurrent surgical procedures, presence of GD or GDV at the time of IG were obtained from medical records of dogs that underwent IG. Owners were contacted to determine whether the dogs experienced GD or GDV after IG, dates of postoperative GD or GDV episodes, survival status, date of death for deceased dogs. Gastric dilatation and GDV recurrence rates were calculated for 40 dogs that had at least 2 y follow-up from the time when IG was performed and for dogs that experienced GD or GDV during the follow-up period. No dogs experienced GDV after IG and 2 dogs (5.0%) experienced GD after IG. The results suggest that GD and GDV rates after IG may be comparable to recurrence rates after other methods of gastropexy.     

Comparison of the Recurrence Rate of Gastric Dilatation with or Without Volvulus in Dogs after Circumcostal Gastropexy Versus Gastrocolopexy

OBJECTIVE: To compare the recurrence rate of acute gastric dilatation with or without volvulus (GDV) after circumcostal gastropexy (CCGP) or gastrocolopexy (GCP) in dogs. STUDY DESIGN: A prospective, double-blind, multicenter, randomized, controlled, clinical trial with two groups (A and B). ANIMALS: Fifty-four client-owned dogs presented for treatment of GDV. METHODS: Dogs with acute GDV that had not previously had a gastropexy performed were included. The preoperative treatment before gastropexy was standardized. A CCGP was performed on dogs in group A, and a GCP was performed on dogs in group B. Postoperative treatment was standardized, but deviation did occur according to the special needs of particular patients. A minimal follow-up time of 180 days was required for dogs not excluded from the study. The median follow-up time in group A was 700 days; in group B, it was 400 days. The occurrence of abdominal pain and gastrointestinal problems after surgery were recorded by the owners. RESULTS: There was no significant difference in the recurrence rate of GDV between the two groups. At the end of the study, the recurrence rate was 9% and 20% in group A and in group B, respectively. CONCLUSIONS: Both surgical techniques are effective in preventing recurrence of GDV.     

In vivo effects of tepoxalin, an inhibitor of cyclooxygenase and lipoxygenase, on prostanoid and leukotriene production in dogs with chronic osteoarthritis

OBJECTIVE: To evaluate in vivo effects of tepoxalin, an inhibitor of cyclooxygenase (COX) and lipoxygenase (LOX), on prostaglandin (PG) and leukotriene production in osteoarthritic dogs. ANIMALS: 7 mixed-breed adult dogs with chronic unilateral arthritis of a stifle joint. PROCEDURE: Dogs were treated in accordance with a randomized 3-way crossover design. Each dog received an inert substance, meloxicam, or tepoxalin for 10 days. On day 0 (baseline), 3, and 10, dogs were anesthetized and samples of blood, stifle joint synovial fluid, and gastric mucosa were collected. Concentrations of PGE2 were measured in synovial fluid and after lipopolysaccharide stimulation of whole blood; PGE1 and PGE2 synthesis was measured in gastric mucosa.Thromboxane B2 (TxB2) concentration was measured in whole blood. Leukotriene B4 (LTB4) concentration was determined in gastric mucosa and in whole blood after ex vivo stimulation with a calcium ionophore. RESULTS: Tepoxalin significantly decreased LTB4 concentrations in the blood and gastric mucosa at day 10 and TxB2 concentrations in the blood and PGE2 in the gastric mucosa and synovial fluid at days 3 and 10, compared with baseline values. Meloxicam significantly decreased PGE2 concentrations in the blood at days 3 and 10 and synovial fluid at day 3. Meloxicam also decreased PGE1 and PGE2 synthesis in the gastric mucosa at day 3. Meloxicam did not affect LTB4 synthesis in the blood or LTB4 concentrations in the gastric mucosa. CONCLUSIONS AND CLINICAL RELEVANCE: Tepoxalin has in vivo inhibitory activity against COX-1, COX-2, and 5-LOX in dogs at the current approved recommended dosage.     

马齿苋水提物对热应激小鼠空肠结构及吸收功能的影响

旨在探讨马齿苋水提物（aqueous extract of Portulaca oleracea L.）对热应激小鼠空肠结构及吸收功能的影响。将40只昆明种小鼠随机分为4组（n=10）：空白对照组（C）、热应激组（HS）、马齿苋水提物组（AEP）、维生素C组（Vc），HS、AEP和Vc组每天于（40±1）℃环境下处理0.5 h，连续热应激6 d后将小鼠转置于室温下给药治疗。给药7 d后眶窦采血，并采集小鼠空肠；测定小鼠血清中D-木糖、葡萄糖含量；HE染色观察空肠组织病理学变化；qRT-PCR法检测空肠黏膜ZO-1、SGLT1及GLUT2 mRNA的相对转录水平。结果显示，与C组比较，HS组小鼠空肠黏膜绒毛高度极显著降低（P<0.01）；血清中D-木糖的含量极显著降低（P<0.01）；空肠黏膜中ZO-1、SGLT1和GLUT2 mRNA的相对转录水平均极显著降低（P<0.01）；与HS组相比，AEP组小鼠空肠绒毛高度极显著提高（P<0.01）；血清中D-木糖及葡萄糖的含量均显著升高（P<0.01或P<0.05）；空肠黏膜中ZO-1、SGLT1和GLUT2 mRNA的相对转录水平均显著升高（P<0.05或P<0.01）。高温处理可导致小鼠空肠黏膜脱落及吸收功能下降，而在给予马齿苋水提物治疗后可通过提高空肠ZO-1 mRNA表达量修复空肠黏膜结构，通过促进空肠黏膜SGLT1和GLUT2 mRNA的转录量改善吸收功能。马齿苋水提物能在一定程度上修复热应激导致小鼠空肠黏膜结构损伤，改善热应激小鼠肠道的吸收能力。     

Non-dietary risk factors for gastric dilatation-volvulus in large and giant breed dogs

OBJECTIVE: To identify non-dietary risk factors for gastric dilatation-volvulus (GDV) in large breed and giant breed dogs. DESIGN: Prospective cohort study. ANIMALS: 1,637 dogs > or = 6 months old of the following breeds: Akita, Bloodhound, Collie, Great Dane, Irish Setter, Irish Wolfhound, Newfoundland, Rottweiler, Saint Bernard, Standard Poodle, and Weimaraner. PROCEDURE: Owners of dogs that did not have a history of GDV were recruited at dog shows, and the dog's length and height and the depth and width of its thorax and abdomen were measured. Information concerning the dog's medical history, genetic background, personality, and diet was obtained from the owners, and owners were contacted by mail and telephone at approximately 1-year intervals to determine whether dogs had developed GDV or died. Incidence of GDV, calculated on the basis of dog-years at risk for dogs that were or were not exposed to potential risk factors, was used to calculate the relative risk of GDV. RESULTS AND CLINICAL RELEVANCE: Cumulative incidence of GDV during the study was 6% for large breed and giant breed dogs. Factors significantly associated with an increased risk of GDV were increasing age, having a first-degree relative with a history of GDV, having a faster speed of eating, and having a raised feeding bowl. Approximately 20 and 52% of cases of GDV among the large breed and giant breed dogs, respectively, were attributed to having a raised feed bowl.