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Help, my dog is throwing up!

Vomiting in dogs is a very common occurrence and can arise from a wide variety of causes, from simple gastritis complex diseases of other body systems. Not only is it very distressing for both the dog and the owner, also offers a challenge for veterinarians. This article explains the multiple causes of vomiting in dogs, including adverse reactions to food, and the range of treatment options available.

What is Vomiting?

Vomiting is the expulsion of food, fluid or debris from the stomach or small intestine due to coordinated movements of the systems gastrointestinal, musculoskeletal and nervous. It is important to differentiate this from regurgitation, which is a passive process rather than a coordinated effort like vomiting.

Regurgitation is a sign of disease in the esophagus, such as obstructions (foreign bodies, such as a stick, bone or toy, or stricture), esophagitis (inflammation the esophagus) or megaesophagus (dilatation of the esophagus due to weakening of the smooth muscle). The main difference between regurgitation and vomiting is The regurgitation is effortless, while vomiting is accompanied by strong abdominal contractions.

How I can know vomiting and regurgitation apart?

Sometimes this is not easy to do. In general, when it occurs immediately after eating are more likely to regurgitation (although vomiting may happen next.) If the content of the material seems to be completely expelled undigested food, it also supports regurgitation. If the presence of bile can be confirmed however, is more likely to vomit.

The causes of vomiting

The most common causes vomiting related with diet, either through negligence diet (eg, overeating, eating overly rich or spoiled food) which causes acute (sudden) vomiting or adverse reactions to food (food allergies) which can cause chronic (long-term and intermittent) vomiting.

However, there are a number of other causes arising from any of the gastrointestinal system itself (stomach and small intestine) or secondary to disease elsewhere in the body (eg, disease liver or kidney). In the stomach, possible causes include:

1. Gastritis (inflammatory)
2. Stomach ulceration
3. Stomach Cancer
4. Obstruction (foreign bodies, telescoping of intestine)
5. Hiatal hernia (herniation of the stomach through diaphragm)

Possible causes in the gut include:

1. Infectious diseases (parvovirus, for example)
2. Worms
3. Disease inflammatory bowel
4. Intestinal Cancer

Secondary causes of vomiting that are caused by the disease in other parts of the body include:

1. Pancreatitis (infection or inflammation of the pancreas)
2. Peritonitis (infection in the abdominal cavity)
3. Hepatitis (liver inflammation)
4. Kidney failure
5. Pyometra (infection of the uterus)
6. hormone deficiency or excess (eg, Addison's disease, diabetes mellitus, septicemia, the imbalance of calcium)

Other possible causes that do not fit into the above categories are drug reactions (eg, digoxin, chemotherapy, NSAIDs) and neurological disorders.

Treatment of vomiting

Vomiting is a symptom not a disease itself. Whether or not the appropriate treatment depends on individual circumstances. If the dog is only vomiting occasionally, is bright and otherwise normal examination, treatment probably not necessary. Some dogs with sensitive digestive systems will vomit once or twice a month, regardless of any treatment, and if this otherwise well should be ignored.

For acute vomiting cases, the first step should always be to starve the dog for 24 hours (maintaining a lot of water ad lib available). After the period of starvation, the dog should be offered small portions of a very soft food such as chicken and boiled rice for a few days. The Meals should be fed as smaller portions several times a day instead of one large meal.

Despite treating the symptom itself often size and improves patient comfort, not replacement for establishing a correct diagnosis of the underlying cause, and certain medications can be harmful if given blindly (for example, metoclopramide give a dog with a gastric or intestinal obstruction). Indeed, cases of acute and severe vomiting require immediate treatment, such as dogs can quickly become dehydrated, develop electrolyte imbalances and aspiration pneumonia otherwise.

Manage the dog vomiting

There are 2 goals when dealing with a vomiting dog:

1. Identify the underlying cause
2. Stop the vomiting in a safe and effective

In many cases, anti emetic therapy (the technical term for vomiting is emesis, and therefore the drugs used to treat it are called antiemetics) is instigated immediately while the cause is being established.

A veterinarian will start by taking a complete history, with special attention to the normal diet, newer medications, vaccination status and description of symptoms. He or she must first make sure the dog is really vomiting and not regurgitating, which has a completely different set of underlying causes. It is also important to get a graphic description of the ejected material, whether it contained blood bile cool or what appears to be coffee granules (partly digested blood).

The next step is a thorough clinical examination, including the abdomen carefully, taking rectal temperature of dogs and assessing the hydration status. Once done, a veterinarian will have a slightly reduced list of differential diagnoses in mind. If the dog is not dehydrated, brilliant in their conduct, and the two vital parameters and feeling the abdomen were normal, the veterinarian often (and rightly) make a presumptive diagnosis of gastritis or gastroenteritis if diarrhea is present too, and antibiotics to combat bacterial infection likely. The owner is likely to then be sent home with instructions to starve the dog for 24 hours and give him soft foods for a few days with antibiotics. The owner is instructed to monitor the dog closely, and return immediately for signs of deterioration, or 2 to 3 days later for a routine check up.

If there is any outcome in the history or physical examination that trigger concern, then further tests are necessary. The first is usually the analysis hematology and blood biochemistry profiles. Urine and feces can also be analyzed, the latter, whether for nasty bacteria or parasites. Additional laboratory tests may be necessary in certain circumstances, such as bile acid stimulation testing if liver dysfunction is suspected, or ACTH stimulation test to identify adrenal disease.

The next stage of the work up involves imaging. The most useful abdominal radiography is (pictures), but ultrasound and endoscopy can also be very important. Radiography and endoscopy both have to be performed under general anesthesia, while ultrasonography can be made conscious. If the image does not reveal the underlying cause then biopsies may be taken either endoscopic guided or via exploratory surgery. Histopathology of these samples (the study of tissue microscopically) can give vital clues about the cause, particularly through differentiation between inflammation and cancer.

The final diagnosis option is the therapeutic trial. If the dog gets better on medication prescribed, then it must have been some kind of disease which responds to that drug. For this reason, wormers, antibiotics or an exclusion diet trial may be chosen.

The drugs used in the treatment of vomiting

1. Antacids and stomach protectors

These drugs are useful when is suspected stomach ulcer. Examples include sucralfate (acts like a bandage on the ulcer), H2 antagonists (reduce acid production) and omeprazole (also reduces acidity).

2. Metoclopramide

This drug blocks a neurotransmitter in the brain, called dopamine, which prevents activation the vomiting center in the brain (known as the chemoreceptor trigger Zone). It is only partially effective in doing this however, and has the additional effect of increasing forward motility of the intestine. This means that you should never give dogs that may have a stomach or intestinal obstruction. It can also cause mental changes such as hyperactivity and disorientation.

3. Phenothiazines (eg Acepromazine, ACP)

These are effective in blocking dopamine receptors before mentioned, and other receptors involved in the vomiting reflex. Normally used when metoclopramide has failed, but also have undesirable effects side such as blood pressure and sedation.

4. Antihistamines

Histamine receptors are also present in the area chemoreceptor trigger, that part of the brain that controls the vomiting reflex. Antihistamines are effective in blocking the vomiting that is due to motion sickness, but are little use against other causes.

5. Domperidone

Domperidone has a similar action to metoclopramide in blocking dopamine receptors and secondarily blocks serotonin receptors, but not the effects of the promoters of metoclopramide. However, with the side effects include enlargement of the vulva and the possible effects on fertility.

6. Maropitant

This is a new drug that is a neurokinin 1 (NK1) receptor antagonist. It can be given orally or by injection, and is very effective at stopping vomiting working both in the vomiting center in the brain and the stomach itself. It is considered as effective stopping vomiting that veterinarians must be careful to properly investigate the underlying causes potentially dangerous, which can be masked fatally by this drug.

About the Author

Dr Matthew Homfray is one of the veterinary pet experts at www.WhyDoesMyPet.com. Our dedicated community of caring pet experts are waiting to offer you advice, second opinions and support.

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