I hope your dog never gets bloat. Just in case he/she does, though, there are a couple of things to know.
1. Bloat is treatable by surgery. It is fatal if not treated.
2. Time is of the essence. If you suspect bloat, get your dog to a vet as fast as possible. You won't expect it; it's a surprise. Adjust your thinking quickly.
3. Suspect bloat if your dog's midsection is distended. DO NOT RELY ON YOUR DOG'S BEHAVIOR to tell you whether he/she is in grave danger. He may not look miserable--he might even act normal and happy.
4. There is a procedure your vet may not know about. Research and discussion could save your dog's life; see below.
John and I had our first experience with bloat last month. Unfortunately we did not catch it immediately and our dog's prognosis was grave. As time passes while tissues are compressed by the twisting and the distended stomach, blood supply is compromised resulting in necrosis. This was the case with our dog. Fortunately, as it turned out, this occurred on a Friday evening so he was in the care of the local emergency vet. Our emergency vet, it turns out, is not just open when other vets aren't: they are also specialists in emergency veterinary medicine. Our dog first had the standard surgery and gastropexy. They gave him a very poor prognosis because of the color of part of his stomach tissue (indicating necrosis). The next day his white count plummeted, indicating out-of-control infection. By this time the vets had conferred, and the owner of the practice suggested a procedure the original surgeon didn't know about. They operated a second time. They dealt with some other problems but the main things they did were an "invagination" procedure where they folded the compromised part of the stomach inward, stitching it up so it was inside the stomach and not where it could affect/infect the abdominal cavity, and they left the incision open so it could drain and they could observe.
This was a miserable time. They told me that recent research showed that good pain management resulted in significantly better survival rates, but the effect was that our dog, already weak, was also so doped up that he was barely conscious. If I stroked his head the muscles around his eyes responded, but he didn't open his eyes. His breathing was ragged, and after the second surgery they told me there was pus on the trach tube when they pulled it out. They had him on strong antibiotics and turned him over at regular intervals to help his breathing.
Late Sunday night they did a third, minor surgery to close the incision. They were amazed, they told me, that when they pulled the trach tube this time, he immediately stood up and walked into his kennel. At 2 a.m. they called me to say he was *eating* and could go home that morning. I had not expected it--I thought I was going to have to shuttle him back and forth between the regular vet and the emergency vet for a couple more days' hospitalization. They think the fitness of a two-year-old field trial dog made the difference here.
The vets told me that keys to recognizing bloat are that nothing can go in or out, so your dog won't be able to keep anything down if he even tries to eat, and he may look like he's trying to retch or belch, but is not able to. What surprised me, though, was how normal our dog was acting. He would fetch a dummy off the floor, and when we put him in the truck to go to the vet, we had a hard time getting the door shut because his tail was wagging so hard.
As I said, I hope you never have to deal with bloat. If you do, though, reacting appropriately (fast!) is the key to giving your dog a shot at survival.