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What is Chronic Vomiting?
An occasional bout of vomiting is common in dogs; however, persistent, chronic vomiting is usually indicative of an underlying disease. Chronic vomiting often leads to decreased absorption of nutrients and subsequent weight loss. Chronic vomiting is ongoing vomiting (more than once in a day) and should be treated as an emergency as it can indicate a life threatening situation.
Symptoms of Chronic Vomiting in Dogs
Symptoms of chronic vomiting include:
- Vomiting more than once during a day
- Producing partially digested food
- Producing yellow fluid (bile)
- Producing white foam
- Producing mucus or watery substance
- Producing blood or blood-tinged substance
Causes of Chronic Vomiting in Dogs
Causes of chronic vomiting include:
- Change in diet
- Food sensitivity/intolerance
- Garbage ingestion/bone ingestion
- Toxin ingestion (heavy metal/pesticide/auto coolant/chocolate)
- Intestinal parasites
- Chronic cough
- Motion sickness
- Ingestion of a foreign object
- Intestinal obstruction
- Severe constipation
- Bacterial infection
- Viral infection
- Pyometria (in intact females)
- Vestibular disease
- Addison’s disease
- Kidney failure
- Liver failure
- Bladder obstruction or rupture
- Volvulus (bloat) or gastric dilatation
- Vomiting: Expelling contents of the stomach
- Regurgitating: Expelling contents from the esophagus that have not yet reached the stomach
Diagnosis of Chronic Vomiting in Dogs
If your pet has vomited once and is bright and alert and eating and going to the bathroom normally, the vomiting may be an isolated incident. However, keep an eye out for more vomiting, inability to keep food down, and abnormal or absent bowel movements for the next few days.
If your pet has continued to vomit you should take them to the veterinarian as it could be an indication of poisoning or other life threatening condition. Collect a sample of the vomit in a plastic bag or container if possible for the vet to examine. The veterinarian will take a history to determine if your pet has ingested garbage, a foreign object or toxic substance. She will want to know when the vomiting started, how frequently it has been occurring, and what the vomit looks like (does it contain food, yellow bile, mucous, foam, blood).
The veterinarian will perform a physical exam and palpate the abdomen to feel for any abdominal masses or other abnormalities. Depending on the pet’s history and physical exam, the following diagnostic tools may be employed to determine the cause of the vomiting and appropriate treatment.
- Radiographs: X-ray can help visualize tumor, foreign body, or other abnormality.
- Endoscopy/colonoscopy: Can help visualize tumor, foreign body, or other abnormality.
- Bloodwork: Examines function of the liver, kidneys and other body systems.
- Ultrasound: Aids in visualization of the intestines and stomach contents.
- Fecal examination: Examines bowel contents and presence of intestinal parasites.
- Exploratory surgery: When the cause of chronic vomiting cannot be resolved or when other diagnostics indicate a mass or foreign body, exploratory surgery may be necessary.
Treatment of Chronic Vomiting in Dogs
Depending on the results of the diagnostics and extent and duration of the vomiting, the following treatments may be utilized to stop the vomiting and address the abnormality:Bland Diet
The veterinarian may recommend feeding your pet a bland diet for a period of a few days. A bland diet consists of foods that are gentle on the digestive system while providing the necessary nutrients. It is low in fiber, fat and protein and high in carbohydrates, composed of a single lean protein source and a single carbohydrate. The most common bland diet consists of boiled white rice and boiled skinless chicken breast (no bones). Cottage cheese, egg whites and low-fat yogurt are also permitted. There are a number of commercial bland diets you can ask your veterinarian about.
The bland diet should be fed as long as your veterinarian recommends. Once the bland diet can be stopped, the regular diet should be introduced gradually over a 7 day period, adding a small amount of regular food to the bland diet a bit more each day until the pet is eating only regular food.Medications
- Anti-emetics – Prevent nausea and vomiting
- Antibiotics – Treat infection
- Corticosteroids – Treat inflammation
- IV fluid therapy – Restores electrolytes and rehydrates
- Subcutaneous fluid therapy – Restores electrolytes and rehydrates
- Dewormer – Rids of intestinal parasites
In the case of a foreign body, pyometria or tumor, surgery may be required to treat the condition. Foreign body and pyometria surgeries are often emergency situations and performed the same day of diagnosis. The pet will likely spend up to 72 hours in the hospital to be monitored for recovery as this is an invasive procedure. After surgery and hospitalization, when the pet is allowed to go home, they are supplied with medications for pain, antibiotics, and possible other medications. They will be given an Elizabethan collar (cone/e-collar) to prevent licking at the incision site. The pet will have staples or sutures removed in 2-3 weeks. In case of surgery, it is important the pet remain still, inside the house in a clean environment and inactive usually for a period of at least two weeks. Surgeries have good outlook and the pet often returns to normal activity levels within 1-3 months.
Recovery of Chronic Vomiting in Dogs
If a pet has been vomiting or is nauseous, it may be necessary to provide food and water in small portions over an extended period of time rather than offer a full water bowl or full meal. This prevents the pet from choking or ingesting too much material at once on a sensitive stomach.
It is important to follow your treatment plan as indicated by the veterinarian. Dietary changes, medication management and/or surgery recovery guidelines will produce positive results if correctly applied. Monitor your pet carefully and be aware of any changes in eating and bowel movements. If vomiting continues, be sure to alert your veterinarian.
To prevent gastrointestinal problems that can be costly and difficult to manage in your pet, be sure to keep garbage, human food, chemicals and laundry items like socks, washcloths, and other small fabric items out of reach of your pet. Choose toys that are not easily destroyed and that will not be swallowed easily.
Cost of Chronic Vomiting in Dogs
Chronic Vomiting can be an expensive treatment in dogs and can range from $500.00 to $8000.00 depending on the cost of living and severity of your Dog's chronic vomiting. On average, the national cost of treating chronic vomiting in dogs is $3500.00.
Chronic Vomiting in Dogs Treatment Advice
Chronic Vomiting Questions and Advice
My dog ( 8 year old 55 lb yellow lab) has had a problem with vomiting and some diarrhea for four months. It started out as once every 5 to 8 days. Then it would increase and then disappear before re-appearing. All this time she was eating the same food she had eaten since being a puppy (Kirkland chicken and rice formula). This went on for two months. My vet did a thorough exam, blood work, fecal and urine analysis, regular x-rays and then barium x-rays. All the tests were negative. The vet put my dog on Cerenia and Carafate for 12 days and we tried a bland diet of chicken and rice. After that treatment she was ok for a short time. Then the vomiting returned. Often she would vomit only large amounts of foam and bile.
I then went to a clinic where they gave her another complete exam and tried antibiotics and an anti-acid. That didn't help. We then put her back on the Cerenia for 8 days which stopped the vomiting.
Over the pat month, her appetite has become less and less. She has not eaten form of dry dog food. When she does want to eat food of any kind, she will only take very small bites of food. She chews everything into very small pieces.
When she vomits she will do it four or five times before it stops. Then she will wheez and have stomach contractions for a few minutes or sometimes as many as ten minutes.
I am at a loss as to what to do next. The recommendation is to do a full body ultrasound but have read many recommendations that say that tends to be a low-yield diagnostic in chronic vomiting cases and should be pursued only as a last resort only.
To say I am desperate for help would be the ultimate understatement.
Chronic cases of vomiting and diarrhoea can be difficult to solve due to the variety of conditions affecting dogs having these general symptoms. Usually when a dog has vomiting and diarrhoea, we think about infectious gastroenteritis, food allergy or poisoning. Previously your Veterinarian had given Bella Carafate (which is an anti-ulcer medication) and Cerenia (which is an antiemetic – anti-vomiting) which improved her condition for some time; it is possible that if Bella was suffering from gastric ulcers, they returned after the end of treatment because the Carafate and Cerenia only treated the symptoms and not the underlying cause of the ulceration. Gastric ulcers are usually accompanied by bloody vomit and dark tarry faeces. An infection wouldn’t usually resolve after treatment with Carafate and Cerenia. Poisoning (or gastric irritation to a toxin) is possible but unlikely if you have been watching her constantly and haven’t noticed her consuming something she shouldn’t. Both liver failure and pancreatitis may cause vomiting and diarrhoea; if the blood work came back normal, liver failure could be ruled out but pancreatitis needs a separate diagnostic test called pancreatic lipase immunoreactivity test which together with clinical signs are a strong indicator for pancreatitis. Looking at her food and seeing if there is something in her diet which she may have developed an allergy or intolerance to may be worth exploring. Sometimes, clinical signs are vague and diagnostic tests aren’t specific giving a diagnosis which may lead Veterinarians to try many diagnostic tests to see if one would turn up a cause. Regards Dr Callum Turner DVM
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The statements expressed are only for informational purposes and should be independently verified by your local veterinarian.