Gastric Stasis in Dogs
When the stomach is interrupted in its normal operation, a condition called stasis can result. Stasis is when the stomach slows its contractions, and may even stop working altogether. This leads to bloating and build-up of gas in the stomach, which can be an uncomfortable condition for an animal. Interruptions in the working of the stomach of a dog can be brought on by several conditions.
Symptoms and Types
The main symptoms of stasis in dogs are:
- Pain in the stomach (abdomen)
- Bloating (distension)
- Rumbling noises from the stomach (borborhygmus)
- Vomiting
- Decreased appetite
- Weight loss
Causes
When movement (motility) of the stomach slows or stops, there are many things to consider as possible causes. Problems with the stomach itself and its ability to contract are rare causes of stasis, but do occur. These types of problems are uncommon in young animals.
The signs and symptoms of stasis are usually the result of an underlying problem that causes the stomach to stop working. Such problems may include:
- Stomach ulcers
- Cancer of the stomach
- Medications
- Stress, pain, or trauma
- Infection of the stomach or intestines (gastritis; enteritis)
- Obstructions or blockages in the stomach or intestine
- Surgery affecting the intestine or stomach
- Metabolic disorders of the body (anemia, hypothyroidism, acidosis)
- Distention and flipping of stomach (gastric dilatation-volvulus syndrome or GDV)
- Enlarged esophagus (megaesophagus)
Diagnosis
Your veterinarian will perform routine tests to rule out any potential cause of vomiting. Basic tests include a physical exam, complete blood count (CBC), blood chemistry profile, urinalysis, fecal examination and X-rays. If necessary, a special imaging technique called a contrast study may be used. This study will involve giving the dog an oral dose of liquid material (barium) that shows up on X-rays. Films are taken at various stages to examine the passage of the barium through the body.
Specialized tests may be necessary if routine and less invasive examinations do not point to the problem. In some cases, a flexible scope with a camera (endoscope) may be used to examine the stomach and intestine. This test requires that the animal be placed under anesthesia. Small samples of tissue (biopsy) may be taken for testing through the use of the scope. These samples will help rule out serious conditions in the stomach such as cancer.
Treatment
The majority of patients can be treated with dietary changes at home. Low-fat and low-fiber foods in a semi-liquid or liquid consistency are usually prescribed. Feedings should be given in frequent, small amounts. In many cases of stomach motility disorders, dietary changes alone will manage the problem. In cases that include serious vomiting and dehydration, dogs must be hospitalized and treated with fluids and electrolytes given intravenously (IV). Depending on the underlying disease process, surgery may be indicated to correct the problem (e.g., GDV or cancer).
Drug therapy can help increase muscle contractions and allow movement of materials out of the stomach in animals with long-term problems. The two main drugs used in the treatment of stasis are metoclopramide and cisapride. Metoclopramide is an oral medication with anti-vomiting properties which is given 30 to 45 minutes prior to feeding. Reversible side effects can occur with this medication and include behavior changes, depression, or hyperactivity.
Cisapride is an oral medication also given about 30 minutes prior to meals. It stimulates motility and is shown to be more effective than metoclopramide. Cisapride does not cause the same nervous system side effects; however, it may cause vomiting, diarrhea, and depression. This medication has been limited due to side effects in humans, but can be obtained by veterinarians through a special pharmacy that will compound the drug.
Other medications that may be used to promote gastric emptying and stimulate motility in dogs include erythromycin, clarithromycin, domperidone, rantidine, and nizatidine.
Living and Management
Dogs that do not have an underlying condition causing stasis of the stomach will generally respond well to dietary and drug therapy. Those that do not respond to therapy should be examined more extensively for possible obstruction. In some cases, an affected dog will need to continue medication and diet changes on a long-term basis.