(a)  Mickey Tivers (staff clinician in small animal surgery at the Royal Veterinary College (RVC) and holder of the RCVS certificate in small animal surgery) and Dan Brockman (professor of small animal surgery at the RVC, holder of RCVS certificates in veterinary radiology and in small animal orthopaedics and diplomate of the American College of Veterinary Surgeons and the European College of Veterinary Surgeons).

"Acute GDV is a rare condition affecting predominantly large, deep-chested dog breeds. It is a potentially catastrophic disease associated with rapid deterioration and high mortality if it is not managed appropriately. Rapid medical and surgical treatment together with intensive postoperative care are necessary to optimise the chance of a successful outcome…Dogs suffering from GDV are frequently presented out of hours and represent not only a genuine emergency but a difficult clinical challenge. GDVs occurs most commonly in large or giant, deep chested breeds…The onset of clinical signs is usually acute and is often reported to follow a large meal and/or a period of exercise. Affected dogs typically demonstrate agitation, restlessness, lethargy, progressive abdominal distension, unproductive vomiting or retching and, in extreme circumstances, collapse. Clinically affected dogs present with signs of hypovolaemic shock, including tachycardia… It is worth remembering that in very large dogs the stomach may be covered entirely by the ribs, potentially masking abdominal distension."

(b)  Amanda Boag (lecturer in emergency and critical care/internal medicine at the RVC) and Dez Hughes (senior lecturer at the RVC and director of its emergency and critical care service).

 "Management of an animal with an acute abdomen presents one of the greatest challenges in veterinary emergency medicine. This clinical syndrome has a large number of possible causes, many of which require urgent surgery to optimise the chances of a successful outcome. Rapid assessment of the patient's major body systems (particularly the cardiovascular system) and early institution of supportive medical therapy are a priority while a definitive diagnosis is sought and a suitable treatment plan is formulated… The term 'acute abdomen' is generally used to refer to an animal that presents with a rapid onset of acute abdominal pain…Many of the possible aetiologies of this clinical syndrome require urgent medical and/or surgical intervention and, hence, diagnostic evaluation of these patients must proceed rapidly to allow early definitive therapy and improve an animal's chances of survival…Abdominal imaging of an acute abdomen should be performed in most cases, as soon as the patient is sufficiently stable."