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Midnight on Friday saw Paul and Nico and me down at the Animal Emergency Center in West Bridgewater, MA.

Nico has been pretty sick lately (we thought we’d have to put him to sleep a few weeks ago). It turns out he had Idiopathic Sterile Nodular Panniculitis — inflammation of the subcutaneous fat tissues, with no known cause. (The “nodular” part of the disease presented as swellings all over his neck and sides, some of which necrotized and burst.) As it’s an autoimmune disease, we suspect that a vaccination he’d had the week before he got sick overloaded his immune system and precipitated the disease.

While Nico’s much improved, he still has some times when he’s not feeling well. At this point that’s as much a result of the medication he’s on (massive doses of prednisone, which we’re now tapering off, thank goodness!) as it is the underlying disease. When he pants or acts restless, I know he’s not feeling well.

And that’s what happened Friday night. I’d let him out to pee at 10:45 that night (he needs to pee every couple of hours), and realized around 11:15 that I hadn’t gotten to sleep yet — and neither had Nico. He was panting, and was a lot more restless than usual. And his flanks seemed a bit tight, right behind the ribs.

I immediately suspected bloat. Nico had lost weight (and was lean to start with), and needed a lot of good food to help his body recover. I had been careful to spread his food out through three meals and several snacks (plus healthy training treats, especially during our almost-daily vet visits) because he’s a deep-chested dog and they’re at higher risk for bloat.

There were a lot of signs of bloat that I wasn’t seeing — he was willing and able to lie on his side without a lot of discomfort, he didn’t feel like he had a basketball in his abdomen, he wasn’t trying to vomit, and he still had gut sounds that said his intestines were working.

But he didn’t want to eat the bread I offered him, despite having been ravenous since being put on the prednisone. Not wanting to take any chances that his discomfort would turn into full-blown bloat, off we went to the emergency center.

What is “bloat?”

The technical term for bloat is “Gastric Dilatation-Volvulus” (”GDV”). “Gastric” = relating to the stomach, “Dilatation” = an abnormal enlargement, and “Volvulus” = torsion or twisting of the intestines, causing an intestinal blockage. Essentially, the stomach and/or intestines become engorged with too much food or water or air (swallowed air or internally produced gas), and this can cause twisting.

Cancer is the only disease that kills more dogs than bloat. (Well, actually, behavioral problems and sheer overpopulation kills more dogs than cancer, but that’s another topic.)

True bloat with a twisted or flipped stomach or intestine requires surgery to save the dog’s life, and the surgery’s not always successful. Time is of the essence: Bloat can kill a dog in only an hour or two. The distended stomach may press against the vena cava (the large vein that takes blood from the hindquarters to the heart), causing a drop in blood pressure and the onset of shock which quickly leads to death.

And the signs of bloat can be very subtle — restlessness and “NQR” (Not Quite Right) may be all you notice.

Fortunately, Nico was suffering from a lot of gas rather than full-blown bloat. The x-rays showed an enlarged stomach with a lot of food in it, and several large gas pockets in the intestines. Nico was already beginning to feel better when we got him to the emergency center, and seemed pretty much fully recovered by morning. But it was a scary thing, and could easily have turned into something even more serious.

So here are some links to information about bloat, to help prepare you, just in case:

Bloat in Dogs

Dog Owner’s Guide: Bloat

Understanding Bloat and Torsion (GDV)

Gastric Dilation and Signs of Bloat