Dogs and chronic vomiting: Causes and treatments
By Dr. Kristy Conn
Occasionally, we get left a nasty surprise from our adorable dog. We walk unsuspectingly into a room and notice the puddle of sick that our dog has left behind. After the initial annoyance though, the concern about the canine vomiting sets in. Is it just something our dog ate out of the backyard that caused the problem or could there be something seriously wrong? Dr. Kristy Conn is here to answer some common questions about chronic vomiting, including its causes and its treatment.
Chronic vomiting is vomiting that persists longer than a few days. It may be episodic or intermittent in nature but it persists over a long duration of time. It is a frustrating condition for dogs and their owners due to the large number of disease states that can cause chronic vomiting. Vomiting is merely a symptom, not a disease in and of itself, therefore getting to the root of vomiting requires some diagnostic sleuthing on your veterinarian’s part. Chronic vomiting needs to be worked up by your regular veterinarian unlike bouts of acute vomiting which tend to be self resolving. Acute vomiting can usually be managed by withholding water for 12 hours and food for 24 hours and then trying small amounts of a bland diet for 2 to 3 days such as boiled chicken and rice. Vomiting that persists for more than a couple of days should be worked up by your regular veterinarian as soon as possible for the best results.
Is it vomiting or regurgitation?
This is the first distinction to make and it is an important one. Knowing the difference between vomiting and regurgitation will provide your veterinarian with an essential clue for the diagnostic plan. It is very rare that a dog will vomit or regurgitate in the exam room where the vet can see it, therefore it is up to you to make the distinction when you observe your dog ill at home.
Vomiting is the forceful ejection of stomach contents out from the mouth. It is usually foul-smelling, partially digested food with bile. Vomiting is typically preceded by retching and during vomiting the dog will hunch up and the abdominal muscles will contract. Regurgitation in contrast is seemingly effortless. There is virtually no retching and the regurgitated material tends to be undigested food compressed into a tubular shape. Regurgitation tends to signal esophageal disease such as megaesophagus whereas vomiting has many gastric and non-gastric causes. Simply knowing the distinction between vomiting and regurgitation can help your vet find a diagnosis quicker.
Causes of chronic vomiting
The causes of chronic vomiting are myriad and include gastrointestinal causes and systemic causes such as kidney disease. Common gastrointestinal causes include: inflammatory bowel disease, viral or bacterial infection, gastritis (typically caused by garbage ingestion or changing the diet too quickly), pancreatitis, foreign body and neoplasia. Systemic causes include toxicities and kidney and liver disease. Typical diagnostics include bloodwork and radiography to start and endoscopy with or without biopsy for definitive diagnosis in some cases. Abdominal ultrasonography tends to be a low-yield diagnostic in chronic vomiting cases and should be pursued as a last resort only.
Fluid therapy may be necessary if there is dehydration present from the repeated vomiting. The rest of the treatment will depend upon what the underlying condition is. For example, antibiotics are used for small intestinal bacterial overgrowth and steroids are used for inflammatory bowel disease. Luckily veterinarians have a large arsenal of medications that target the gastric system such as anti-emetics that help decrease nausea and improve motility and H2-blockers that decrease acid production in the stomach.
When to call the vet
It is important as a dog owner not to ignore chronic vomiting as it usually signifies a serious problem. Please see your vet if your dog vomits repeatedly more than 2 or 3 days or if he has a habit of vomiting several times in a week.