In this paper we search for distant massive companions to known transiting gas giant planets that may have influenced the dynamical evolution of these systems. We present new radial velocity observations for a sample of 51 planets obtained using the Keck HIRES instrument, and find statistically significant accelerations in fifteen systems. Six of these systems have no previously reported accelerations in the published literature: HAT-P-10, HAT-P-22, HAT-P-29, HAT-P-32, WASP-10, and XO-2. We combine our radial velocity fits with Keck NIRC2 adaptive optics (AO) imaging data to place constraints on the allowed masses and orbital periods of the companions responsible for the detected accelerations. The estimated masses of the companions range between 1-500 M_Jup_, with orbital semi-major axes typically between 1-75 AU. A significant majority of the companions detected by our survey are constrained to have minimum masses comparable to or larger than those of the transiting planets in these systems, making them candidates for influencing the orbital evolution of the inner gas giant. We estimate a total occurrence rate of 51%+/-10% for companions with masses between 1-13 M_Jup_ and orbital semi-major axes between 1-20 AU in our sample. We find no statistically significant difference between the frequency of companions to transiting planets with misaligned or eccentric orbits and those with well-aligned, circular orbits. We combine our expanded sample of radial velocity measurements with constraints from transit and secondary eclipse observations to provide improved measurements of the physical and orbital characteristics of all of the planets included in our survey.