Chronic vomiting in dogs is characterized by persistent or recurrent vomiting for more than two weeks. Vomiting can occur more than once a day or only once every few days.
Many pet owners do not consider chronic vomiting to be a true health issue, especially if the dog is not vomiting every day and, although occasional vomiting can be considered normal for most dogs, regular vomiting every few days isn’t.
VOMITING VS REGURGITATION
It’s important to understand the difference between vomiting, which is the act of bringing back up stomach content (often with partially digested food), and regurgitation, which is the act of bringing back up undigested food that did not reach the stomach.
Unlike vomiting, regurgitation is always a problem arising before the stomach while vomiting could be caused by a stomach, bowel or systemic disease.
CAUSES OF CHRONIC VOMITING
Chronic vomiting can be caused by a gastrointestinal disorder or a systemic disease, such as kidney failure, for example. In order to be able to treat chronic vomiting successfully, it is important to know what is causing the vomiting in the first place.
Among the most common gastrointestinal conditions causing chronic vomiting in dogs, we can find garbage ingestion and foreign body ingestion, the later either stays in the stomach causing severe irritation or blocks the intestines, partially or completely, resulting in vomiting and usually weight loss as well. Common foreign bodies include balls, socks, toys and bones. Other gastrointestinal conditions include IBD (irritable bowel disease), chronic constipation, Gastric ulcer, intestinal parasites, gastrointestinal chronic infection and gastric/intestinal tumors.
Many systemic diseases can also cause chronic vomiting in dogs, even though they are not always directly linked to the gastrointestinal system. Common systemic conditions causing vomiting include kidney failure, liver failure, pancreatitis, uterine infection (in unsprayed females), Addison’s disease, generalized infection, diabetes and food allergy.
DIAGNOSIS OF CHRONIC VOMITING IN DOGS
The first step for a successful diagnosis is a physical examination and full history of the past few months. Your veterinarian will ask you several questions regarding the frequency of vomiting, the content, the colour as well as the general state of your dog. This information can be crucial in order to determine what could be the cause of the vomiting and will give your veterinarian a good idea regarding the next diagnostic tools which will be needed to confirm it.
A complete blood test and a series of radiographs are usually the first diagnostic tests that your veterinarian will want to perform; these can provide a lot of information such as the presence of an infection in the blood or a physical obstruction from a foreign body in the stomach or intestines. A blood test can also give some clews regarding the possible occurrence of Pancreatitis, which will need to be confirmed with a more specific blood test.
Some internal conditions causing chronic vomiting are not always easy to detect, for this reason your veterinarian might need to perform some additional tests to get to the bottom of it. The next steps are usually a complete faecal analysis, which is aim to identify the presence of internal parasites and resistant bacteria; Abdominal ultrasonography is also an excellent tool that can help detecting many difficult to diagnose conditions such as tumors, foreign bodies, pancreatitis and even sometimes IBD. It is very important to have the ultrasound done by a vet who either specializes in this field or that at least have a lot of experience with abdominal ultrasonography.
Another important diagnostic tool is endoscopy, which is basically a small diameter tube with a camera attached at its end; It is inserted either through the dog’s mouth or rectum and provide a great visual field that can often help detect tumours, ulcers and foreign bodies in the gastrointestinal tract. It can also be used to take biopsy samples from the intestines which are extremely important to confirm tumour types and stage as well as other bowel diseases such as IBD.
As food allergy can also be the cause of chronic vomiting in dogs, food allergy blood test is also a diagnostic test that many vet will consider at some point, especially if other diagnostic tools did not provide a clear answer.
TREATMENT AND MANAGEMENT
Diet is a very important part of treating chronic vomiting, regardless of its cause; a bland diet (e.g. boiled chicken and rice) can help relieve the symptoms of vomiting in some cases wile a prescription diet could help with the management of chronic diseases such as pancreatitis, diabetes, kidney failure and food allergy. An appropriate diet for the specific condition of the dog is crucial in the long term management of the disease.
Medications are often used to help with chronic vomiting; the most widely used drug is probably Pepcid (famotidine) as it reduces stomach acidity and can help with many gastrointestinal conditions. Anti-vomiting medications such as Cerenia and Metoclopramide are also commonly given, especially when an acute crisis of vomiting occur. More specific medical treatment is given according to each unique condition – antibiotic for an infection, corticosteroids for IBD and fluid therapy for constipation and severe dehydration.
In some cases, such as pyometra (uterine infection), foreign body obstruction or tumors, a surgery may be needed to treat the condition. Such a surgery may be urgent and complicated; often it will require several days for a dog to fully recover from such a procedure and it might require 24-72 hours’ hospitalization post-surgery.