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Are Dogs That Are Fed from a Raised Bowl at an Increased Risk of Gastric Dilation Volvulus Compared with Floor-Fed Dogs?

Authors:

Abstract

p>There are only two studies that study the effect of raised feeders on the risk of Gastric Dilatation Volvulus (GDV) and their findings conflict. Only one study found a significant effect of feeder height, with large and giant breeds fed from a raised feeder being at an increased risk of GDV floor fed dogs. However, these authors found that, where the feeder was raised, the height of the feeder that increased the GDV risk was affected by the size of the dog. Large breed dogs were more likely to develop a GDV if fed from a bowl ≤ 1 foot tall, whereas giant breed dogs were more likely to develop a GDV if fed from a bowl > 1 foot tall. No studies found that feeding from a raised feeder reduced the risk of GDV relative to feeding from the floor. Therefore, the safest option in the absence of further evidence is to advise that owners of ‘at risk’ dogs feed from a feeder on the floor. This may not reduce the risk of GDV, but there is no evidence to suggest that it will increase the risk. <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" /
Are Dogs That Are Fed from a Raised Bowl at an
Increased Risk of Gastric Dilation Volvulus Compared
with Floor-Fed Dogs?
A Knowledge Summary by
Louise Buckley PhD RVN 1*
1 Harper Adams University, Edgmond, Newport TF10 8NB
* Corresponding Author (lbuckley@harper-adams.ac.uk)
ISSN:
2396-9776
Published:
2017
in:
Vol 2, Issue 1
DOI:
http://dx.doi.org/10.18849/ve.v2i1.57
Reviewed by:
Wanda Gordon-Evans (DVM, PhD, DACVS) and
Bruce Smith (BVSc, MS, FANZCVS, DACVS)
Next Review Date:
20 Jan 2019
Veterinary Evidence
ISSN:2396-9776
Vol 1, Issue 2
DOI:
http://dx.doi.org/10.18849/ve.v2i1.57
next review date: 20 Jan 2019
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total pages: 10
KNOWLEDGE SUMMARY
Question
Are dogs that are fed from a raised bowl at an increased risk of gastric dilation volvulus (GDV) compared with
dogs that are fed from a bowl on the floor?
Clinical Scenario
Raised feeding bowls are available commercially and are sometimes recommended by veterinary nurses to
assist elderly arthritic dogs to comfortably access their feed ration. A client with an elderly dog is attending a
senior wellbeing clinic and asks for advice on whether they should use one of these feeders. The dog is a
large or giant breed dog of the type at increased risk of developing a gastric dilation volvulus.
The Evidence
The literature searches uncovered two papers (Glickman et al. 2000; Pipan et al. 2012) that directly
addressed the PICO question. Of these, one of the studies (Pipan et al., 2012) found no significant effect of
feeder height on risk of having a GDV episode. One paper (Glickman et al., 2000) found that dogs that were
fed from a raised bowl were significantly more likely to present at a clinic with a GDV episode. However, the
height of the bowl that increased the risk differed according to whether the dog was a large or giant breed.
No studies found a decreased risk of GDV as a consequence of feeding a dog from a raised bowl.
Summary of the evidence
1. Glickman (2000)
Population:
Sample size:
Clinical bottom line
There are only two studies that study the effect of raised feeders on the risk of Gastric Dilatation Volvulus
(GDV) and their findings conflict. Only one study found a significant effect of feeder height, with large and
giant breeds fed from a raised feeder being at an increased risk of GDV floor fed dogs. However, these
authors found that, where the feeder was raised, the height of the feeder that increased the GDV risk was
affected by the size of the dog. Large breed dogs were more likely to develop a GDV if fed from a bowl ≤
1 foot tall, whereas giant breed dogs were more likely to develop a GDV if fed from a bowl > 1 foot tall.
No studies found that feeding from a raised feeder reduced the risk of GDV relative to feeding from the
floor. Therefore, the safest option in the absence of further evidence is to advise that owners of ‘at risk’
dogs feed from a feeder on the floor. This may not reduce the risk of GDV, but there is no evidence to
suggest that it will increase the risk.
Veterinary Evidence
ISSN:2396-9776
Vol 1, Issue 2
DOI:
http://dx.doi.org/10.18849/ve.v2i1.57
next review date: 20 Jan 2019
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total pages: 10
Intervention details:
Veterinary Evidence
ISSN:2396-9776
Vol 1, Issue 2
DOI:
http://dx.doi.org/10.18849/ve.v2i1.57
next review date: 20 Jan 2019
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Study design:
Outcome studied:
Main findings:
(relevant to PICO question):
Veterinary Evidence
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Limitations:
Veterinary Evidence
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2. Pipan (2012)
Population:
Sample size:
Intervention details:
Study design:
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Outcome studied:
Main findings:
(relevant to PICO question):
Limitations:
Appraisal, application and reflection
Only two studies were identified that addressed the PICO question and these two studies were not in
agreement. Thus, the evidence base for answering the question is relatively limited. However, it is pertinent
to observe that neither study identified feeding dogs from the floor as a risk factor for GDV. It is also
pertinent to note that most studies that investigate risk factors for a GDV have found that there are many
factors that have been found to be significantly implicated as associated with an increased risk of GDV. It is
beyond the scope of this Knowledge Summary to discuss these but it should be borne in mind by the reader
when considering the discussion below and the clinical bottom line provided.
Of the two studies, the Pipan et al. (2012) provides the more impressive sample size for GDV dogs (n = 1114),
compared with the Glickman et al. study (n = 98). However, despite this, it is difficult to conclude much about
the findings by Pipan et al. (2012). The authors provide scant information to support either how they
investigated feeder height as a risk factor or what they found. The only reference by the authors to their
findings in relation to the PICO can be found in the discussion section. They provide no numerical information
to allow the reader to evaluate this finding (e.g. was there a statistical tendency for the dogs fed from a
feeder to have an increased or decreased risk of GDV?).
The study by Glickman et al. (2000) provides more comprehensive statistical reporting of the data relevant to
the PICO question, but provides incomplete reporting of the dogs lost to follow up. Follow up losses are likely
to be high given that 13.3% of the dogs lost to follow up had already been lost during the primary study that
this study data was drawn from. This should be considered as it may severely distort the data if the losses
were not randomly distributed across the categories of dogs in relation to this PICO question. In this study,
feeding from a raised bowl was identified as a risk factor for both large and giant breed dogs. Furthermore,
Veterinary Evidence
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DOI:
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next review date: 20 Jan 2019
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there was an interaction between feeder height and whether the dog was a large or giant breed dog.
Specifically, lower raised feeders (≤ 1 foot) increased the risk for large breed dogs (but not higher raised
feeders (> 1 foot), whereas the converse was true for giant breed dogs. The authors provide no explanation
for this finding. They do not appear to have examined this finding further in relation to the other data that
they collected. For example, does the height of the feeder relative to the height of the dog affect the speed
at which the dog is able to consume its ration (fast eating was also identified as a risk factor)? However,
caution should be taken in over-interpreting the data as the length of time between owner completing the
questionnaire and the dog potentially developing a GDV could be almost five years. Therefore, additional
interactions sought between the potential risk factors are problematic as owner feed management practices
(e.g. feeder used) may have altered over the period studied. Furthermore, the small numbers of dogs
affected by GDV within each sub-category (e.g. large breed dog fed from a raised feeder) could mean that
these findings are simply chance findings.
The findings from the Glickman et al. (2000) provide an additional possible explanation for the lack of
significance identified by the Pipan et al. (2012). The Glickman et al. (2000) specifically studied eleven ‘at risk’
large and giant breed dogs. Both the control dogs and the GDV dogs were therefore drawn from a similar
population of dogs. By splitting the data into large and giant breed dogs they further homogenised the dogs
in relation to factors such as height of the dog. By contrast, the Pipan et al. (2012) study used an ad hoc
convenience sample of dogs of any type/breed/etc. This lack of relative homogeneity in the study population
may have reduced the ability of the study to detect raised feeders as a risk factor for GDV, if the risk posed by
feeding from a raised feeder interacted with morphometric measurements such as height of the dog.
However, by restricting the population studied to eleven breeds, caution should be exercised in extrapolating
the Glickman et al. (2000) findings to other breeds of dogs. The authors do not extend their analysis to look at
whether the relevant risk factors identified are present across each breed studied, but this may be due to the
small sample size within in each breed of dogs affected by a GDV. There is a need for additional investigation
in these areas.
The practical implications of the combined findings are that there is limited evidence in the research area of
this PICO. The more convincing of the two studies demonstrates a risk associated with using a raised feeder
but only for specific height / size of dog (large versus giant breed) combinations. Neither of the studies found
an increased risk associated with feeding from floor height. Consequentially, for the client keen to decrease
the risk of their dog developing a GDV, the safest option would be to advise that, in the absence of further
research, the dog should be fed from a bowl placed on the floor. If comorbidities exist (e.g. reduced mobility,
arthritis) that reduce the ability of the dog to feed from the floor such that feeding from a height is
considered beneficial, the practitioner should consider the height of the dog relative to the height of the
feeder, and advise accordingly.
Methodology Section
Search Strategy
Databases searched and dates
covered:
Search terms:
Dates searches performed:
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DOI:
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Exclusion / Inclusion Criteria
Exclusion:
Inclusion:
Search Outcome
Database
Number
of results
Excluded did
not answer
PICO question
Excluded
not English
language
Excluded
conference
abstract only
Excluded
duplicates
Total
relevant
papers
NCBI PubMed
25
23
0
0
0
2
Thomson
Reuters Web
of Science
25
22
1
0
2
0
CAB Direct
46
41
1
2
2
0
Science Direct
251
251
0
0
0
0
Total relevant papers when duplicates removed
2
CONFLICT OF INTEREST
The author declares no conflict of interest.
REFERENCES
1. Glickman, L. et al. (2000) Non-dietary risk factors for gastric dilation-volvulus in large and giant breed
dogs. Journal of the Veterinary Medicine Association, 217 (10), pp. 1492
1499 http://dx.doi.org/10.2460/javma.2000.217.1492
2. Pipan, M. et al. (2012) An internet-based survey of risk factors for surgical gastric dilation-volvulus in
dogs. Journal of the American Veterinary Medicine Association, 240 (12), pp. 1456
1462 http://dx.doi.org/10.2460/javma.240.12.1456
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Article
Full-text available
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 ≥ 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 dogyears 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. ( J Am Vet Med Assoc 2000;217:1492–1499)
Article
To evaluate risk factors for gastric dilatation-volvulus (GDV) in a large number of privately owned dogs across a wide geographic area. Internet-based, cross-sectional study. 2,551 privately owned dogs. A questionnaire addressed dog-specific, management, environmental, and personality-associated risk factors for GDV in dogs. Respondents were recruited through the posting of the electronic link to the questionnaire on websites for dog owners; the information was also disseminated at meetings of dog owners and via newsletters, e-mail lists for dog owners and breeders, owner-oriented dog publications, and e-mails forwarded by participants. Descriptive statistics and logistic regression analysis were performed. Factors significantly associated with an increased risk of GDV were being fed dry kibble, anxiety, residence in the United Kingdom, being born in the 1990s, being a family pet, and spending at least 5 hours a day with the owner. Factors associated with a decreased risk of GDV were playing with other dogs and running the fence after meals, fish and egg dietary supplements, and spending equal time indoors and outdoors. A significant interaction between sex and neuter status was observed, with sexually intact females having the highest risk for GDV. In dogs with a high risk of GDV, regular moderate daily and postprandial activity appeared to be beneficial. Feeding only commercial dry dog food may not be the best choice for dogs at risk; however, supplements with fish or eggs may reduced this risk. The effect of neuter status on GDV risk requires further characterization.