If untreated, intragastric pressure will increase and, in turn, often result in cardiogenic shock and eventual death. Medical treatment alone is inadequate and as many as 81% of affected dogs die within a year of initial treatment if surgery is not performed. Additionally, during the surgical procedure to reposition the stomach, it is necessary to permanently affix the stomach to the body wall with one of a number of gastropexy techniques available to prevent recurrence. Failure to perform a gastropexy at the time of surgery results in a recurrence rate of at least 50%; when a gastropexy is performed, the recurrence rate is 6% to 10%. Given the unacceptably high risk of recurrence without gastropexy, it is considered standard of care to perform that procedure at the time of surgical treatment of GDV. The lifetime risk of certain predisposed dogs to develop GDV has been estimated to be 4% to 37%, with the Great Dane being at highest risk. Prophylactic gastropexies have been increasingly advocated in the veterinary field. However, this has been met with mixed opinions from owners and possibly veterinarians due to the invasive nature of the procedure.