Boomer, an adorably effervescent, young Cairn Terrier, was referred to me for vomiting three days in a row. This mischievous little boy raided the kitchen garbage the day before the vomiting began. Neither blood work nor abdominal X-rays, performed by the referring veterinarian, provided a diagnosis. When I questioned Boomer’s family, I learned that their dog was bringing up clear fluid after drinking, and undigested food after eating. Additionally, none of the retching that dogs typically do right before vomiting had been observed. This history provided some big clues that redirected my thinking. Boomer was likely regurgitating rather than vomiting.
Vomiting occurs when food or liquid is expelled from the stomach or upper small intestine; it’s preceded by some audible retching (no different than when a person is nauseated and hovering over the toilet). The vomited material may be food that appears undigested or partially digested, clear liquid (if it originates from the stomach), yellow or green liquid or semisolid matter if it originates from the small intestine where bile is secreted.
Regurgitation differs from vomiting in that the expelled material almost always originates from within the esophagus—the muscular tube that propels food, water and saliva from the mouth down into the stomach. The regurgitated material consists of water, saliva, or undgested food that comes spewing forth without any audible retching or warning. Regurgitation typically takes the dog and anyone in close proximity completely by surprise.
Because the event is so sudden, the larynx (the opening to the windpipe) may not have time to close, and some of the regurgitated material can be inhaled into the lungs. This results in a serious condition called aspiration pneumonia and is usually associated with an abrupt onset of coughing and labored breathing.
The importance of differentiating vomiting from regurgitation
So, why is it important to differentiate whether my patient is regurgitating or vomiting? Here’s the reason why. The tests for determining the cause of regurgitation are different than those used to determine the cause of vomiting. And the more wisely diagnostic tests are selected, the more expediently a diagnosis is established (better for the patient as well as the client’s pocket book). Diagnostic testing for regurgitation involves evaluation of primarily the esophagus and sometimes the stomach. Evaluating the vomiting patient involves evaluation of the stomach and small intestine along with screening for other diseases such as kidney failure, liver disease and pancreatitis, all of which can cause vomiting.
So, what ever happened with Boomer? Given his history, I recommended X-rays of his chest cavity (where the esophagus lives). Low and behold, the images revealed a piece of bone lodged within his esophagus. Using an endoscope (a long telescope device) and some fancy foreign body retrieval devices I was able to nonsurgically remove the bone from Boomer’s esophagus. We treated the secondary esophageal inflammation with medications and counseled his family on preventing their little darling from tampering with the garbage! Thankfully, Boomer experienced a complete recovery.
Questions to ask your veterinarian:
If your dog has been “upchucking,” here are a couple of important questions to ask your veterinarian. By the way, bringing videotape of the event to the office visit may help your veterinarian know, with greater certainty, if your dog is vomiting or regurgitating.
- Is my dog vomiting or regurgitating?
- What are the potential causes of what we are observing?
- What tests can be run to determine the cause?
If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.
Thursday, October 9, 2014
Complications of Long-Term Regurgitation
It takes a dedicated owner to commit to hand feeding his dog and then keeping the dog's forequarters raised. Unfortunately, even with the most vigilant care, complications such as weight loss or inhalation pneumonia can occur. The latter happens if the dog breathes in when food or water is being regurgitated. Fluid enters the lungs to cause a potentially serious infection.
Signs of pneumonia include rapid shallow breathing, lack of appetite and listlessness. Any dog with a history of regurgitation that shows these signs should see a vet immediately. A prompt course of antibiotics could prevent the problem from becoming life-threatening.
Help! My Dog is Throwing Up Undigested Food: The Complete Guide
Dogs throw up and usually in the worst places - like hello, do you really need to throw up on the bed, carpet or couch?. Why does this happen and is it something you as a pet parent should be concerned about?
Anyone who has owned a dog (or multiple dogs) for a long time will tell you that sometimes vomiting just… happens. Your dog might throw up and then go on with their day like it never happened. How do you know if this is the case or if something more serious is going on? These tips will help you know when it’s no big deal and when to seek medical attention.
Symptoms: Dog vomiting and diarrhea
A dog vomiting occasionally may not be too concerning. Dogs vomit for many reasons as you can see from the causes listed.
If your dog vomits just one time, the best way to care for him is to keep an eye on him for any changes in behavior or if the vomiting persists.
If vomiting increases and your dog develops other signs of illness such as diarrhea, it’s important to get him to a veterinarian to be checked-out. Additional symptoms that your dog’s condition is worsening and needs to see a veterinarian may include the following:
- Refusing food or appetite loss
- Weight loss
- Abdominal pain
- Lethargic and loses interest
- Dehydration and change in water consumption
- Decrease in urination
- White gums
- Blood or dried blood particles in vomit
- Collapse or loses consciousness
When companion animals bring food back up, most owners notice a problem. What you may not know, is there are two different mechanisms for spitting up. food – vomiting and regurgitation.
Vomiting is when the contents of the stomach and upper intestine are forcefully ejected – owners will see abdominal effort as the material is heaved up regurgitation occurs when contents of the mouth, pharynx, or esophagus are expelled. For example, when dogs with megaesophagus (dilation of the esophagus) regurgitate, the food simply comes back up from the esophagus and is a very passive event.
The most notable signs of vomiting are nausea (drooling) and abdominal heaving. Pets also tend to look apprehensive when nauseated. Some dogs and cats may have grumbling/growling stomach sounds (borborygmi).
Regurgitation is less intense. It’s more of a burp in which some of the contents in the esophagus, either liquid or solid, come back up without the heaving and noticeable effort. Although there might be some gagging or a bit of coughing as the contents move up, there’s no forceful abdominal effort involved. Usually, the food brought up is undigested and is covered with mucus. Regurgitation generally happens quite soon after the pet eats.
Basically, vomiting is an active effort, whereas regurgitation is pretty passive.
Nauseous dog drooling
It’s not always easy to distinguish the product of vomiting from that of regurgitation, but some things your veterinarian will consider are:
- Heaving, retching, or abdominal compression doesn’t occur with regurgitation, but can with vomiting.
- The regurgitated bolus (a lump of food the amount of a single swallow) is usually tubular in shape.
- The regurgitated bolus usually has a neutral or alkaline pH. If the food made it to the stomach prior to being regurgitated, however, the pH may be acidic (as vomited food would be). Vomit which occurs from the upper intestine or stomach is very acidic as the stomach is a very acidic place. Your veterinarian may test the expelled material’s pH level.
- A regurgitated bolus does not have bile in it where as vomited food may
It is very helpful to know whether the food came up from vomiting versus regurgitation as the underlying cause can be very different.
Causes of regurgitation include:
- Sphincter issues
- Neuropathic causes
- Esophageal irritation and more
Vomiting has an extensive list of causes that include:
- Infectious diseases (parvovirus, coronavirus, leptosporosis to name a few)
- Toxin exposure
- Inflammatory diseases such as pancreatitis
- Intestinal parasitism
- Foreign body obstruction
- Cancer (usually older pets)
- Dietary indescretion
- Endocrine / Metabolic disease including issues affecting the liver and/or kidneys
- Autoimmune diseases such as IBD
- Many more
Knowing what to watch for can help you help your veterinarian diagnose and treat your pet appropriately faster!