Vomiting
This
information is not meant to be a substitute for veterinary care. Always follow
the instructions provided by your veterinarian.
Vomiting is a very common problem in dogs and cats. There are many causes of vomiting.
Primary or gastric causes of vomiting are those that are due to diseases of the stomach
and upper intestinal tract. Secondary or non-gastric causes of vomiting are caused by
diseases of other organs that cause an accumulation of toxic substances in the
blood. These toxic substances stimulate the vomiting center in the brain causing the
animal to vomit. (Anatomy of the digestive system:
dog /
cat)
A
problem that can be confused with vomiting is regurgitation. Vomiting is the ejection of
contents of the stomach and upper intestine; regurgitation is the ejection of contents of
the esophagus. The esophagus is a narrow, muscular tube that food passes through on its
way to the stomach. In health, food moves quickly through the esophagus to the stomach. If
the muscle of the esophagus loses tone, the esophagus dilates, a condition called
megaesophagus. A dilated esophagus does not effectively move food to the stomach and the
animal will regurgitate food usually shortly after eating. The food may also be inhaled
into the airways causing pneumonia and cough.
When you present your pet to the veterinarian because he or she is vomiting, the
veterinarian will ask questions in attempt to differentiate between vomiting and
regurgitation and to try to determine if your pet is vomiting due to gastric or non
gastric disease. Vomiting is an active process. The pet is apprehensive and heaves and
retches to vomit. If food is present in vomit, it is partially digested and a yellow
fluid, bile may be present. Regurgitation is fairly passive. The animal lowers its
head and food is expelled without effort. The food brought up by regurgitation is
usually undigested, may have a tubular shape, and is often covered with a slimy
mucus. The pet will often try to eat the regurgitated material. You may bring a fresh
sample of "vomit" for the veterinarian to examine. The pH of vomit
containing food is acid, the pH of regurgitated materials is higher.
Your ability to answer questions about your pet's activity, habits and environment will
help the veterinarian decide which causes of vomiting are most likely in your pet. A
history of any drugs your pet is receiving is important. Over-the-counter pain medications
such as aspirin and ibuprofen can cause severe stomach ulcers in dogs depending upon the
dose and duration of treatment. The veterinarian may ask you to describe the
appearance of the vomit, as well as describe how your pet looks when it vomits and the
relation ship of vomiting to eating. If the vomit contains blood it may be fresh, red
blood or look like coffee grounds if the blood is digested. Blood is most often seen with
stomach ulcers, stomach cancer or uremia (a collection of signs including vomiting seen in
pets with kidney failure). Stomach ulcers can be caused by drugs or the presence of a mast
cell cancer in the skin. Mast cell cancers release histamine that leads to stomach ulcers.
Regurgitation often, but not always, happens right after eating and the pet will try to
eat the regurgitated food. Vomiting occurs a variable time after eating or may occur
in a pet who is off food. Animals with a twisted stomach, gastric dilation-torsion, may
make frequent attempts to vomit without producing anything. Pets with a hacking cough may
retch and sometime vomit at the end of an episode of forceful coughing. An accurate
description in this case would lead to an investigation of the causes of coughing, rather
than vomiting.
If your pet vomits just occasionally and has a specific series of
actions associated with vomiting, you may consider video taping an episode of vomiting to
help describe the episodes to the veterinarian.
The physical examination of the vomiting pet can also provide information to narrow the
list of possible causes. The presence of fever, abdominal pain, jaundice, anemia or
abnormal masses in the abdomen will help the veterinarian make a more specific diagnosis.
The mouth should be carefully examined as some foreign objects such as string can wind
around the base of the tongue with the rest of the object extending into the stomach or
small intestine. A nodule may be palpated in the neck of cats with hyperthyroidism.
The list of non-gastric causes of vomiting is long.
Pancreatitis in the dog causes vomiting that is sudden in onset and often severe. The
dog may have a painful belly. Pets with pancreatitis often have a history of eating
garbage or fatty table scraps. Tumors of the pancreas can cause similar signs to
pancreatitis. Pancreatitis occurs in the cat but the signs are subtle and non specific and
often don't include vomiting
Kidney failure is a common cause of vomiting in dogs and cats. The kidneys can be
acutely (suddenly) damaged by poisons such as antifreeze or by severe dehydration.
Waste products that the kidneys normally get rid of, rise to high levels in just a few
days. The kidneys can also gradually lose their ability to remove waste products from the
body as the pet ages. Early signs of kidney failure include drinking and urinating large
amounts called polyuria and polydipsia or PU-PD. PU-PD may be present for months to years
before the kidney failure is severe enough to lead to waste product accumulation and
vomiting. Vomiting in chronic kidney failure may began as occasional episodes and progress
to severe, frequent vomiting. The pet with chronic kidney failure will often lose body
condition and may have pale gums due to anemia.
Non-spayed, middle aged female pets can develop a uterine infection called
pyometra. Pyometra occurs within 2 months after a heat cycle and often results
in discharge of pus from the vagina. The pet may frequently lick the vagina so discharge
may not be seen. Dogs develop pyometra more often than cats. Other signs may include PU-PD
and depression.
Liver failure causes vomiting as well as other signs depending on the type of liver
disease. Other signs of liver disease may include seizures, jaundice (a yellow
discoloration of the areas of skin not covered by fur), PU-PD and fluid accumulation in
the belly or legs.
Bladder obstruction or rupture will cause a sudden onset of vomiting. The urethra that
leads from the bladder to the outside can get plugged by stones or tumors. The
animal will strain and pass just a free drops of urine or none at all. They will
also have a painful belly. Bladder obstruction if not corrected, is fatal in just a few
days. The bladder can be ruptured by blunt trauma such as being hit by a car or kicked.
A
form of diabetes called ketoacidosis will cause vomiting along with depression and PU-PD.
Addison's disease is a deficiency of hormones from the adrenal gland and causes
vomiting, diarrhea and weakness. Addison's disease occurs most commonly in young to middle
aged dogs, most of which are female. Addison's is rare in the cat. The signs of
Addison's disease may be intermittent or may be very severe and constant.
Diseases of the inner ear can cause vomiting accompanied by incoordination, circling
and tilting of the head to the side. Motion during car rides stimulates the inner ear and
can cause vomiting.
A sudden onset of vomiting in young, poorly vaccinated pets may be caused by infectious
agents including canine distemper, canine parvovirus and feline panleukopenia virus.
There are many toxins including lead, insecticides, antifreeze and other chemicals that
can cause vomiting.
Cats with elevated thyroid function, hyperthyroidism, may vomit in addition to other
signs including, increased appetite, weight loss, hyperactivity and a poorly kept coat.
Heartworm disease in cats may cause vomiting in addition to coughing, respiratory
distress, weight loss and depression.
Primary causes of vomiting include acute gastritis often due to eating garbage or other
types of dietary indiscretions; the ingestion of large amounts of hair during grooming;
ulcers of the stomach; stomach or upper intestinal cancer; parasites; food allergies; the
presence of a foreign body stuck in the stomach or upper intestine; twisting and dilation
of the stomach; and intussusception which is a telescoping of one part of the intestine
into another piece of intestine.
The stomach is usually empty 6 to 8 hours after eating. Vomiting of food when the
stomach should be empty suggests an obstruction of the stomach or abnormal motion of the
stomach muscles that normally grind food and push the ground food out of the stomach.
Tests to differentiate primary causes of vomiting include x-rays or ultrasound of the
abdomen and endoscopy. Endoscopy is the technique of passing a flexible scope into the
stomach and upper intestine to examine the inside of these structures. It may be possible
to remove a foreign body with endoscopy and small biopsies of the lining of the stomach
and intestine can be taken for microscopic evaluation. Endoscopy requires general
anesthesia.
If the pet vomits sporadically, the results of all tests may be normal. Many healthy
dogs and cats vomit occasionally without identifying a cause. Sometimes the cause of
vomiting is as simple as the pet eating too fast.
The treatment for vomiting depends upon the cause. Nonspecific treatment for vomiting
includes fasting, and fluids to correct or prevent dehydration. In episodes of
sudden onset of vomiting, food is withheld for 24 - 48 hours and water for 24 hours.
Water should never be withheld from an animal with known or suspected kidney disease
without replacing fluids intravenously or subcutaneously (under the skin). If vomiting
stops, small amounts of a bland low-fat food are fed 3 to 6 times daily for a few days,
with a gradual increase in the amount fed and a gradual transition to the pet's normal
diet. Water is also reintroduced in small amounts on the second day. You may start
with ice cubes and then gradually increase the amount of water over the day if
vomiting does not reoccur.
If the pet is bright and alert and has had no previous
health problems, episodes of acute vomiting may be managed at home, although
veterinary consultation prior to home treatment is advised. Consultation with a
veterinarian in your region may reveal a recent outbreak of an infectious disease causing
vomiting or identify a cluster of recent poisonings. With this type of knowledge you
will want to have your pet evaluated rather than waiting a few days. Dogs and cats who
vomit for longer than a few days or are depressed or dehydrated should be presented for
veterinary evaluation.
Washington State University assumes no liability for injury to
you or your pet incurred by following these descriptions or procedures.
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Last Edited: Dec 19, 2007 4:40 PM
