Vomiting and regurgitation in dogs and puppies

All dogs and puppies might vomit from time to time, many because they 'bolt' their food down! But when does it become a concern and when is a visit to the vets required? If you have an adult dog that is vomiting frequently, it is worth noting down the time of day it is sick (after food, after a walk) and how many times it has vomited. This information can help the vet with diagnosis and treatment.If you have a puppy that is vomiting frequently you should contact your vet as a matter of urgency.

Is it really vomiting?

One of the important questions a vet may ask is what the vomit looks like. Although this is not the nicest subject the question can be significant to treatment.Sometimes owners can confuse vomiting with regurgitation. If a dog has just eaten some food and brings it up, almost as it went down, then this is normally regurgitation. If this happens regularly it could become a problem in its own right. The veterinary term for this condition is dysphagia - which means difficulty in swallowing. Because the animal might have dysphagia, it still will have the desire to eat. When an animal is lost that desire it is termed anorexic.Dysphagia can be divided into three types of the condition:Oral dysphagia - the dog could have problems swallowing due to a fractured jaw, a foreign body in the mouth etc.Signs of oral dysphagia - the dog is unable to pick up any food or food falls out of the mouth.Pharyngeal dysphasia - the dog may have a problem with its throat, such as a foreign body or tumour.Signs of pharyngeal dysphagia - the dog would be retching, gagging, choking and food can appear in the nostrils.Oesophageal dysphagia - the dog might have problems with its oesophagus (the pipe which carries food to the stomach). There are various conditions that can affect the oesophagus including it being too large or having a blockage.Signs of oesophageal dysphagia - this is one of the main causes of regurgitation which is usually associated with eating.

Diagnosis of dysphagia

Diagnosis would consist of observation of the dog in a veterinary environment especially their eating habits. The vet may also take x-rays of the mouth, throat and chest to determine any blockages. With these tests it may also be decided to use a special dye, which will show up on x-ray to assist diagnosis. Some veterinary centres may also use an endoscope (a camera that can be put into the mouth and passed towards the stomach).

Treatment of dysphagia

Only once the problem has been identified can the veterinary team treat accordingly. They may have to try and correct the problem surgically, change the diet of the dog or use medication to try and limit the condition. Sometimes simple measures such as feeding the dog with their bowl on a step can assist in minimising dysphagia.

Vomiting

Once it has been determined that the dog is indeed vomiting and not regurgitating, the veterinary team will identify whether it is primary vomiting or secondary vomiting (caused by other diseases of the body).

Primary vomiting

Examples of primary vomiting can include:

• Inflammation of the stomach and gastric system
• Stomach ulcer
• Stomach tumour
• Pyloric stenosis (a narrowing from the stomach to the small intestine)
• Foreign body the stomach

Diagnosis of primary (and secondary) vomiting

The diagnosis for both primary and secondary vomiting matches that of testing for dysphagia, in that a full medical history, physical examination of the dog, x-rays and possibly use of an endoscope, can be used to determine why the dog is vomiting. In addition and especially for secondary vomiting, blood testing may also be required.

Secondary vomiting

Examples of secondary vomiting can include:

• A build-up of toxins in the blood associated with renal disease.
• Diabetes
• Pyometra (a life-threatening infection of the uterus of the bitch)
• Hepatitis (disease of the liver)
• Pancreatitis (inflammation of the pancreas)
• Colitis (inflammation of the intestines)

Treatment

The treatment of both types of vomiting is essentially the same, however in the cases of secondary vomiting, the cause, once established, must be treated appropriately first. For example if a bitch has a pyometra, then this would require surgery as an emergency and the vomiting would be much less of a concern.For primary vomiting the first step would be to identify and then correct the cause, for example: surgically remove a foreign body from the stomach etc.For inflammation (which is caused to the stomach and gastric system in nearly all vomiting cases) the dog may have to be hospitalised in a veterinary centre and undergo the following treatment:

• Nil by mouth (in the case of very small puppies, a tiny amount of food may be given).
• Fluid therapy - a drip might be set up on the dog to replace essential minerals and to stop dehydration.
• Anti-emetics - these are drugs (for example metoclopramide) given to reduce vomiting, although they may not stop it completely.
• Stomach and gastric system protectors - medication that can be given to coat the lining of the stomach, when inflammation has been caused such as ulcers.
• Antacids - medication such as cimetidine, given to reduce the production of acid in the stomach, also used to decrease reflux (acid leaving the stomach and entering the dog's oesophagus).

After vomiting has stopped, the use of veterinary diets that are low in fat can be introduced before returning slowly to the dog's normal diet. In some cases the dog may have to stay on a special veterinary diet for the rest of their life.

Puppies and small breeds

With all cases of vomiting or dysphagia in puppies and small breeds, it is very important to get the correct treatment as a matter of urgency. If a dog suffers vomiting at a very early age or if they are a small breed, they have very little reserve and can become seriously ill very quickly. Many may go off food completely and become dehydrated very rapidly.