July 22, 2026, 4:39 am | Read time: 6 minutes

Why Gastric Torsion Occurs

The exact causes of gastric torsion are not yet fully understood, but certain factors can increase the risk. The size and breed of the dog play an important role. It has been found that large dog breeds, especially those with a deeper chest, are more prone to gastric torsion. Breeds such as Great Danes, German Shepherds, Rottweilers, and Weimaraners have an increased risk.

The dog’s feeding behavior can also play a role. If a dog eats few but very large meals, the likelihood of gastric torsion increases. Other causes can include gulping down food quickly and drinking large amounts of water. If the dog does not rest after eating but instead runs around wildly, this can also promote gastric torsion.

Genetic predispositions can also play a role. If a dog has parents or siblings that have already suffered from gastric torsion, there is an increased risk for them.¹

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How to Recognize Gastric Torsion

1. Bloated Belly: A noticeably bloated and tense belly is one of the most common and obvious symptoms of gastric torsion. The belly may feel hard and be significantly enlarged compared to the dog’s normal state.
2. Restlessness and Discomfort: The dog becomes anxious, restless, and shows signs of pain. Dogs with gastric torsion want to lie down and get up repeatedly, pacing restlessly.
3. Unproductive Retching and Drooling: The dog may retch repeatedly and try to vomit. Usually, only foam comes out of the mouth. This unproductive retching is a sign that the stomach is already blocked toward the esophagus.
4. Breathing Difficulties: Due to the twisted and severely bloated stomach, breathing difficulties may occur. The dog then shows rapid, shallow breathing.
5. Pale Mucous Membranes: In advanced gastric torsion, the dog may exhibit pale mucous membranes in the mouth and eyes. This is due to poor circulation, as the twisted stomach can affect normal blood flow.

If one or more of these symptoms occur, a veterinary clinic or veterinarian should be consulted immediately.²

Treatment of Gastric Torsion

Gastric torsion in dogs must be treated immediately, and only by a veterinarian or veterinary emergency service. First, the dog is stabilized. Vital functions are monitored, and intravenous fluids are administered. Then, the stomach is decompressed using a stomach tube or gastropexy to release excess gases and fluids. In severe cases, immediate surgery is required, during which the stomach is carefully untwisted. After surgery, the dog continues to receive painkillers and antibiotics. The pet is also medically monitored for a few more days in the practice or clinic.

Costs Owners Should Expect

The treatment of gastric torsion is one of the cost-intensive emergency procedures in veterinary medicine. Total costs can range from about 1,000 to 2,600 euros, depending on the severity, clinic, billing factor, and length of stay. Typically, costs for diagnosis, emergency care, surgery, medication, and inpatient care add up to around 2,000 euros (at a standard fee rate).

Individual items include general examination, X-ray diagnostics, blood analyses, inhalation anesthesia, gastric torsion surgery with stomach fixation, and intensive monitoring. Especially in emergency services, a significantly higher amount can arise due to double or triple fee rates. Additional costs for medications, infusions, consumables, and follow-up examinations are also incurred.

Since such emergencies occur unexpectedly, pet health insurance or surgery cost protection is particularly recommended for high-risk breeds to be financially secure in an emergency.³

Early Detection Decides Life and Death

The chances of survival in gastric torsion depend heavily on the timing of treatment and the severity of the condition. If the dog is presented to a clinic in time and quickly operated on, the chances of recovery are generally good. In cases where parts of the stomach have already died, postoperative complications are to be expected–yet a positive outcome is still usually possible.

It is different if the dog’s circulation is severely weakened or severe arrhythmias occur. In such cases, intensive aftercare is necessary, and the prognosis worsens. Even if the surgery seems successful, complications such as thrombosis or circulatory failure can lead to death in the first 14 days after the procedure. Unfortunately, it often happens that dogs die despite correct treatment–whether during the operation, shortly afterward, or still during inpatient monitoring.

Nevertheless, the survival rate has improved significantly in recent decades. While almost every second dog used to die from the consequences of gastric torsion or anesthesia, the mortality rate today is about 15 to 33 percent. In favorable cases, dogs are often allowed to eat again the next day and can be discharged home soon with a bit of luck.

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Preventing Gastric Torsion in Dogs

It is often advised to feed large dogs several smaller meals throughout the day. If the animal eats too greedily, a slow feeder bowl is recommended. Built-in elements in the bowl prevent the food from being “inhaled.” A rest period after eating is also important. The dog should find a quiet spot or its bed and rest for at least 15 to 20 minutes.

Although many recommendations for feeding and exercise to prevent gastric torsion circulate, the fact remains: The only effective prophylaxis is the surgical fixation of the stomach to the abdominal wall–the so-called gastropexy. It reliably prevents the stomach from twisting, even if other risk factors exist.

Minimally Invasive Procedure Can Greatly Reduce Risk

This preventive measure is particularly recommended for deep-chested and genetically predisposed breeds such as Great Danes, Dobermans, Bernese Mountain Dogs, or Shepherds. The operation can be performed as a standalone procedure or during another routine procedure, such as neutering. In the traditional method, the stomach is fixed to the abdominal wall with absorbable suture material and grows stable within about three weeks.

Even more gentle is the minimally invasive endoscopic gastropexy, where the stomach is sewn to the abdominal wall through three small skin incisions. The advantages of this method: short surgery duration, low stress, minimal pain, and no follow-up required. Walks are possible just one day after the procedure–playing and jumping are allowed again after about a week. Thus, prophylactic gastropexy offers an effective, low-risk option for dog owners who want to prevent gastric torsion specifically.⁴