DulceNationals3Prophylactic Gastropexy (Elective Stomach Tacking)
By Tracy Powell, DVM

    Great Danes are the number one breed for bloat and GDV. Bloat is when the stomach greatly expands in size, usually with air, but can also occur with food. This can be resolved by passing a stomach tube, administering simethicone, or a number of other ways. GDV (gastric dilatation-volvulus) is when the stomach enlarges in size and then twists on itself. This cuts off the blood supply to the stomach and spleen. Because the stomach has twisted, it essentially forms a tourniquet at each end so no air or food can escape. This is why we often see unproductive retching when it occurs. Bloat often leads to GDV. GDV is a surgical emergency and the cost can average anywhere from $2000 to $4000. Besides tacking the stomach during surgery, part of the stomach or the entire spleen may need to be removed because of the lack of blood supply. After surgery, fatal heart arrhythmias can occur. Because of the complications that may occur with surgery, potential loss of the Dane, and excessive cost of the surgery and post-operative care, many people are having prophylactic gastropexy surgery performed on their Danes.

    Prophylactic gastropexy surgery, or elective stomach tacking, is when the stomach is tacked down to the body wall. It can be done with one moderately sized incision (about 6”) or with a laparoscope (multiple ” incisions). There are numerous surgical ways to fix the stomach to the body wall. The most common are incisional, circumcostal, and belt loop. Incisional is when one incision is made in the stomach and a second is made in the body wall and they are sutured together. Circumcostal is when a piece of the stomach is wrapped around a rib. Belt loop is when a piece of the stomach is wrapped around a piece of muscle from the abdominal wall. 

    When a stomach tack is performed on a healthy stomach, the dog heals quickly and there are few complications. When a tack is performed on an unhealthy, bloated stomach, there is a greater chance for the tack to not hold or for other complications to occur. That is why I feel that electively tacking a Dane is much better than tacking after a bloat or GDV. LET ME BE 100% CLEAR – an elective stomach tack will not prevent bloat, but it will prevent GDV. So, the stomach can still fill with air or food, but it cannot twist on itself. Since bloat often leads to GDV, and bloat has a much better outcome than GDV, when bloat occurs in a tacked Dane it will have a better outcome than an un-tacked Dane.
    Elective stomach tacking can be done at any age, but dogs heal faster and have a quicker recovery when it is done earlier rather than later in life. Ideally, I would suggest by the age of 2. When a healthy Dane is tacked, the risks are the same as any procedure that requires anesthesia. Post-operative care is that of any abdominal surgery, including keeping them quiet for 14 days, monitoring the incision for swelling or discharge, etc. The only additional post-operative discharge instruction I give for an elective tack is to feed small frequent meals for 7-10 days after surgery. The average cost of an elective tack is $500-$800, but can it can vary greatly.

    I recommend prophylactic gastropexy for all Danes when they are spayed and neutered. While breeders usually recognize the signs of bloat or GDV quickly, many pet owners will not. It makes sense for the pet owners to have their Dane tacked while being spayed or neutered to decrease the chance of them missing the bloat/GDV and losing their dog. Some breeders will write this into their pet puppy contracts. Also, for the breeders that spay or neuter their Dane later in life, after breeding or showing, I recommend they tack their Dane at that time. Older Danes are more likely to bloat/GDV, so you decrease the risk by tacking the stomach when you spay or neuter them.

    I also recommend prophylactic gastropexy for any dogs that have bloated before and were successfully decompressed with simethicone, by passing a tube, or any other way. Once you know your Dane is likely to bloat, it is likely they will also get GDV. Some people choose to electively tack if they know that bloat/GDV runs in the pedigree of their Dane. Another reason people choose to electively tack is if their Dane easily stresses or will be traveling or showing a lot. 

    There are breeders who electively stomach tack every show Dane. This is when some people have ethical issues with the procedure. Some people say, “If we tack every Dane that is used for breeding, how will we know what lines it runs in to potentially avoid using that Dane in our breeding program?” Some people feel that it is better to leave the breeding Dane un-tacked so we will know if they will bloat. They feel that it should be “survival of the fittest” and that if a Dane bloats and dies, they will not, and should not, be used for breeding. These are all valid opinions and things to consider when electively tacking your Dane. Other people do not think dogs should be electively tacked because of the risk of anesthesia. While that is a valid concern, I can assure you that the risk of death under anesthesia is much less than the risk of death due to GDV. 

    I am surprised by how many veterinarians do not recommend prophylactic gastropexy and how many will not perform the surgery unless they have an emergency GDV. I believe in and perform the surgery often. Maybe as a Dane owner and breeder, I am so much more aware of how disastrous the outcome of GDV is. Every breed is predisposed to something, be it eye issues, hip issues, etc. One of our big issues in Danes is bloat and GDV. In my mind, why not try to prevent something that could be fatal to our Dane? When we are breeding, we should try to minimize the amount of bloat in our lines, but realistically, it will always be an issue. And it is an issue that we can’t completely get rid of. I think that as long as you understand the decision you are making when you choose to electively tack your Dane and what the implications are for using that Dane in your breeding program, you are the wiser breeder.