Vomiting

Updated: 2/14/21
Dog vomiting

Background

Veterinarians make a distinction between vomiting and regurgitation. Vomiting refers to the forceful expulsion of contents from the stomach. Regurgitation, on the other hand, is the passive return of contents from the esophagus. Food that is regurgitated never makes it to the stomach.

Vomiting can be acute (sudden) or chronic (long-term). Acute vomiting lasts less than 3-4 days and has no other signs present. Chronic vomiting refers to vomiting lasting longer than 5-7 days or intermittent vomiting that does not respond to medical treatment. Chronic vomiting can occur more than once or twice a day and be accompanied by other clinical signs, such as blood, abdominal pain or fever.

Signs

Vomiting

  • Abdominal contractions before expelling the stomach contents
  • Possible yellow staining due to bile
  • Nausea (pets that have nausea may drool, for example)

Regurgitation

  • Little to no abdominal contractions
  • Mucus covering the typically undigested, regurgitated contents
  • Falling of contents from the mouth (as opposed to a forceful expulsion)

Possible Causes

Vomiting

  • Bacteria Salmonella is a type of bacteria that can cause inflammation of the intestines.
  • Bloat Unproductive vomiting is the hallmark of bloat. Bloat is the term used to refer to two stomach disorders called gastric dilatation (GD) and volvulus (GDV). Bloat is a life-threatening condition in which the stomach fills with gas and then twists on itself. The gas-filled stomach can obstruct blood flow.
  • Blockage or obstruction Blockage of obstruction of the gastrointestinal tract is an emergency condition that can be caused by a foreign body, folding of the intestines, bloat, or constipation. Common signs of GI obstruction include pain, vomiting, and diarrhea.
  • Cancer or tumor Cancer is a disease in which abnormal cells grow and reproduce, often in a mass called a tumor. These abnormal cells have the ability to spread to surrounding tissues or other areas in the body. Tumors of the digestive system, pancreas, or even the central nervous system may be an underlying cause of chronic vomiting.
  • Constipation/obstipation Constipation is a common issue in animals in which defecating is infrequent or difficult. Straining to defecate commonly causes vomiting in cats. Obstipation occurs when the animal is unable to defecate.
  • Diabetic ketoacidosis Diabetic ketoacidosis is an increased acid level in the body due to ketone bodies in the blood in diabetic animals.
  • Food intolerance/allergy Allergens are substances that, when inhaled, ingested, or absorbed into the body, stimulate the immune system, resulting in inflammation. Pets can have allergies to substances in the air or in food.
  • Gastrointestinal blockage
    – Ingestion of foreign object
    – Abnormal stomach emptying
    – Tumor
    – Intussusception
  • Hiatal hernia A hernia is when a body part, such as an organ or tissue, protrudes from the lining that normally encloses it. Hiatal hernias occur when a portion of the stomach slides up into the chest.
  • Histoplasmosis Histoplasmosis is an infection caused by the fungus Histoplasma capsulatum typically found in soil containing bird or bat manure.
  • Hyperthyroidism Hyperthyroidism is when the thyroid gland, which controls metabolism, is overactive and leads to an increased level of thyroid hormones.
  • Hypoadrenocorticism (Addison’s disease) Hypoadrenocorticism, is the underproduction of hormones from the adrenal gland, which controls the levels of sodium and potassium in the blood.
  • Inflammatory bowel disease Inflammatory Bowel Disease (IBD) is characterized by clinical signs such as vomiting, diarrhea, and weight loss alongside inflammation of the intestinal tract.
  • Kidney disease Kidney disease is the decreased ability for the kidneys to filter waste products from the blood.
  • Liver and gall bladder disease Cholangiohepatitis is inflammation of the bile ducts and liver.
  • Pancreatitis Pancreatitis is inflammation of the pancreas.
  • Parasites Parasites in the stomach or intestines can be a cause of vomiting or other clinical signs in pets. Roundworms, for example, are a type of intestinal parasite typically passed to a developing fetus through the placenta or to a puppy through its mother’s milk. Stomach worms are another type of parasite that can cause stomach inflammation. Tapeworms, caused by eating an infected animal or fleas, can lead to poor food absorption or diarrhea.
  • Pythiosis Pythiosis is an infectious disease that affects the gastrointestinal system caused by the water mold Pythium insidiosum.
  • Reaction to medication
  • Viruses (Canine Parvovirus, Canine Distemper Virus, Feline Parvovirus)

Regurgitation

  • Abnormal narrowing of the esophagus (stricture)
  • Abnormal opening between a bronchus and esophagus
  • Bloat
  • Cancer
  • Cleft or short palate
  • Cricopharyngeal achalasia
  • Dysautonomia
  • Esophageal diverticulum
  • Foreign body
  • Gastric dilation
  • Gastroesophageal intussusception
  • Gastroesophageal reflux
  • Glycogen-storage diseases
  • Granulomatous disease
  • Hiatal hernia
  • Hypoadrenocorticism
  • Hypothyroidism
  • Megaesophagus (enlarged esophagus)
  • Muscle disease (myopathy)
  • Myasthenia gravis
  • Nervous system disease (neuropathy)
  • Parasitic infection
  • Persistent right aortic arch
  • Poisoning
  • Rabies
  • Tumor

Diagnosis

Your veterinarian will try to determine if your pet has vomited or regurgitated since they require different types of diagnostic testing and treatment. If vomiting is suspected, your veterinarian may order an abdominal x-ray. If regurgitation is suspected, your veterinarian may order a chest x-ray of the esophagus.

Treatment

Successful management of vomiting requires treatment of the underlying condition or disease.

In cases of acute vomiting, pets may be kept off of food or water, known as NPO, (“nothing through the mouth ”) for 12-24 hours.

If your pet has vomited more than three to four times within a 24-hour period, if vomiting is intermittent for 2 weeks, or if your pet has vomited and is showing additional signs of illness, seek immediate veterinary care.

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