At the end of a long hard week, I think the theme of the week was vomiting dogs. While there are plenty of highlights to a busy week (Ember is healed enough to be off pain meds; Hava’s ears are much better; Cora’s misplaced testicle was found and removed; Sadie was adopted and fixed and many more), there were more than usual serious cases of canine vomiting.

Dogs vomit for many reasons and many of these are not serious. When Sammi comes back with a question from an owner about vomiting, my first question back is “How is the dog feeling?”

Dogs have a tendency to eat things they should not. Ranger used to vomit up corn cobs about two in the morning. His stomach knew he wasn’t going to be able to digest it and rejected it after he digested all the other things he ate with the corn cobs. Likewise toxins or other irritants can be rejected. Whiskey, my yellow lab, will eat so fast that his stomach cannot expand enough to hold the food. Up it comes and he will eat it again. That is another sign that it might be okay. If they go to re-eat the vomit, it is probably okay.

Dogs can vomit because of gastroenteritis (inflammation of the stomach and intestinal tract); intestinal obstruction caused by foreign material, tumors, organ displacement, etc.; inflammatory bowel disease; parasites; exposure to toxins; some types of cancer; liver disease; kidney disease; infections (bacterial, viral, or fungal); diabetes mellitus; Addison’s disease; pancreatic disease; hemorrhagic gastroenteritis; gastrointestinal ulcers; head trauma; drug side effects; and/or food allergies or intolerance.

If they are sick, it is important. If not, it depends on how long and how often they have been vomiting. James Bond had been vomiting for a while. He had been to another vet, but didn’t trust them. I wasn’t sure the owner was going to get along with me either, but he came back in the next day when James Bond wasn’t any better. After another day of vomiting, JB was severely dehydrated. A day of fluids helped, but he was not well and his army veteran dad was out of money. I volunteered to keep JB for the weekend on fluids at my cost. On Monday, it was clear that he was going to need more. His dad signed for him to be put to sleep. I went back to get a 3D pawprint and JB looked up with sad lab type eyes and I couldn’t do it. I went back and talked to his dad. I had hoped he had a foreign body that we could do surgery and fix, but he had a severe pyloric outflow stricture. It was almost impossible for food to leave the stomach, so for months, JB had been vomiting the food back up. I did the surgery to diagnose and make sure it was not an easy fix, but still euthanized JB on the table. Afterward, I called his dad and talked to JB’s grandmother. Nobody was happy with the outcome, but we tried our best. I hope JB’s owners know that.

Dixie was the next vomiter. She had a high white blood cell count, high amylase and was positive on the pancreatitis test. Actually, she had pancreatitis severe enough to cause problems with insulin production and cause temporary diabetes. Like most cases of pancreatitis, she initially did very well on IV fluids and IV antibiotics, but after 48 hours took a turn for the worse and died. Her necropsy showed a thickened, reddish brown pancreas. Dixie had the, thankfully, rare form of acute necrotizing pancreatitis which is almost always fatal.

Vomiting in dogs is usually accompanied by nausea. The drooling, licking lips, and swallowing excessively are signs of nausea. Sometimes they eat grass. We don’t know exactly why dogs do this, but grass might mix with worms or ingesta to better vomit them up. Or grass might protect the esophagus from sharp objects like bone shards when the dog vomit. Regardless, vomiting is a very active process. The abdominal wall contracts and causes the heaving.

Stella had plenty of nausea. When Lindsay went home for lunch, Stella had vomited numerous German Shepard sized piles throughout the house. The vomit smelled and looked like diarrhea. If they hadn’t seen the action of vomiting, they would have thought it was stool. Vomit that smells and looks like poop is very serious. It is called retrograde peristaltic contents and comes from the small intestines. When the intestines work backward, the prognosis is not good. Dixie did that a bit before she died. We certainly did not want that for Stella. Stella got IV, antibiotics and motility drugs. Her radiographs showed a really enlarged stomach. Fearing a bloat, emergency surgery and possible death, I got out a stomach tube to see if it would pass. Because Stella came in on my day off and I had missed lunch, I had my allotted two EL Fudge cookies. I guess I got a little close, because Stella tried to snatch my cookie out of the corner of my mouth. That changed all of the prognosis for the better. She still needed fluids, but I suspect she ate something that was poop-like that made her sick.

We did see a case of gastric dilatation and volvulus or bloat with a twist at the ER. The dog was severely affected within an hour of starting vomiting. (The vomiting attempts continued, but there was nothing produced which is classic for GDV.) The prognosis was so poor (and the surgery and treatment so expensive) that the owners chose euthanasia without treatment. It was a good decision on their part. Any time there is pain with the vomiting, it is an emergency.

It is important to check the vomit. Disgusting though it may be, flecks of blood, coffee like bits of digested blood, pieces of plastic, parasites, toxins or pieces of pills may provide a lot of clues about the cause of the vomit.

Vomiting can be serious. If they vomit more than seven times in an hour or more than a day, they need to be seen. If they are very young or older, they will need to come in even before that. Puppies can have parvovirus which is deadly if not treated. Projectile vomiting can be a sign of an obstructed GI tract. If they are sick (lethargy or depression), it means there is a bigger whole body problem. Vomiting combined with diarrhea can lead to severe life threatening dehydration.

Three hospitalized dogs with vomiting this week. One looked like it would die from the shock and bloat, but did fine with fluids and treatment. Two looked better than they were. We gave them a few days of feeling better, but ultimately their deaths contributed to what I would consider a bad week.