Help! My Senior Dog Threw Up — Now What?
After practicing as a veterinarian for more than 25 years and being chief of staff at Animal House of Chicago, I have treated my fair share of senior dogs for episodes of vomiting. The cause of the vomiting has ranged from something simple, like the dog eating too many dog treats, to something more complex, like a senior dog with liver or kidney disease.
Senior dogs, like puppies, are not as resilient and may become more significantly and more rapidly affected by vomiting compared with adult dogs.
Is It An Emergency?
Vomiting can be more dangerous in senior dogs because they may already have other health issues. Keep a closer eye on your senior dog and take him to your vet if he continues to throw up, because vomiting can severely dehydrate dogs.
Vomiting is the forceful expulsion of stomach contents through the mouth. The difference between regurgitation and vomiting is that in regurgitation, the food that is expelled comes from the mouth or esophagus versus the stomach. Vomiting involves the forceful contraction of stomach muscles; regurgitation does not. Both vomiting and regurgitation can occur right after eating or drinking, or up to several hours later. If your dog is bright and alert, and only vomits once, it may not be necessary to call your veterinarian. Many dogs will vomit after eating grass, for instance.
If your dog vomits more than once or appears sick, call your veterinarian. Your veterinarian will ask you a series of questions to determine how severe the vomiting is. It will be helpful for your veterinarian to know when the vomiting started, how many times your dog has vomited, what the vomit looks like, and if your dog is uncomfortable. Call your veterinarian immediately if:
- There is blood in the vomit.
- Your dog acts like he wants to vomit, but nothing is expelled.
- Your dog appears bloated or has a swollen abdomen.
- You suspect your dog may have eaten something toxic or poisonous.
- Your dog has a fever or is depressed.
- Your dog’s gums are pale or yellow.
- Your dog appears to be in pain.
- Your dog also has diarrhea.
Never give your dog any medications, including over-the-counter human medications, unless advised to do so by your veterinarian.
Causes Of Vomiting
Conditions in senior dogs that may cause vomiting include:
- Bacterial infection of the gastrointestinal tract
- Diet-related causes (diet change, food intolerance, ingestion of garbage)
- Foreign bodies (i.e., toys, bones, pieces of chewies) in the gastrointestinal tract
- Intestinal parasites
- Acute kidney disease/failure
- Acute liver disease/failure
- Gallbladder inflammation
- Post-operative nausea
- Ingestion of toxic substances
- Viral infections
- Certain medications or anesthetic agents
- Car sickness
- Infected uterus (in non-spayed females)
The Diagnosis Puzzle
Many things cause vomiting in senior dogs. It is important to determine the cause so the appropriate treatment can be given. Your veterinarian will combine information from you, the physical exam, and possibly laboratory and other diagnostic tests to determine the cause of the vomiting.
When senior dogs vomit, their abdominal muscles contract very strongly multiple times before the food is actually ejected from the mouth. It may appear as though the whole body is involved in the effort. Often they will go through this process several times in a row.
How suddenly the symptoms appeared is a good clue to what the cause of the vomiting may be. If the symptoms appeared suddenly, the condition is called “acute.” If the symptoms continue over a long period of time (weeks), the vomiting is called “chronic.”
In senior dogs where the vomiting can be associated with other diseases, your veterinarian will often recommend a variety of lab tests. A fecal flotation is a test to check for parasites such as intestinal worms or protozoal parasites like Giardia. If a bacterial infection is suspected, a fecal culture and sensitivity are performed. In cases of certain viral diseases, such as parvovirus, other tests on the feces may aid in the diagnosis. If the dog is showing signs of illness, a complete blood count and chemistry panel are often recommended. Special blood tests may also be conducted if certain diseases are suspected. Radiographs (X-rays) are appropriate if a tumor, foreign body or anatomical problem is suspected. Other diagnostic imaging such as a barium study or ultrasound may also be helpful. Examinations using an endoscope to evaluate the stomach or intestinal tract may be indicated. For some diseases, the only way to make an accurate diagnosis is to obtain a biopsy and have it examined microscopically.
Treatments Must Address The Cause
Because there are so many causes of vomiting, treatment varies. In many cases of vomiting in dogs, food is withheld for at least 24 hours while small amounts of water are provided frequently. Then, a bland diet such as boiled chicken and rice is offered in small amounts. If the vomiting does not recur, the dog is slowly switched back to his normal diet or a special diet over the course of several days.
For some cases of vomiting, it may be necessary to modify the diet permanently. Special or prescription dog food may need to be given as a way to avoid certain ingredients, add fiber to the diet, decrease the fat intake or increase digestibility.
If intestinal worms are present, the appropriate de-wormer will be prescribed. Few de-wormers kill every kind of intestinal worm, so it is very important that the appropriate de-wormer be selected. In most cases, it is necessary to repeat the de-worming one or more times over several weeks or months. It is also important to remove the worm eggs from the environment. The fecal flotation test looks for worm eggs, and if no eggs are being produced, the test could be (“false”) negative even though adult worms or larvae could be present. For this reason, in some cases, even if the fecal flotation test is negative, a de-wormer may still be prescribed.
If dehydration is present, it is usually necessary and beneficial to give the animal fluids either via intravenous or subcutaneous route. Oral fluids are often inadequate during vomiting or diarrhea because they may be vomited up or pass through the animal too quickly to be sufficiently absorbed.
Antibiotics are given if the vomiting is caused by bacteria. They may also be given if the stomach or intestines have been damaged (e.g., blood in the stool or vomit would indicate an injured intestine or stomach) and there is a chance that the injury could allow bacteria from the digestive tract into the bloodstream.
In some cases, medications may be given to decrease vomiting. As a general rule, these drugs should not be given if the dog could have ingested a toxin or may have a bacterial infection. Therefore, it is always important to have an accurate diagnosis before use of these drugs.
Treating Senior Dogs With Extra Care
At Animal House of Chicago, we commonly see that senior canine patients who present vomiting as one of their clinical signs may be suffering from old age, chronic changes in kidney/liver function, or neoplasia. These conditions may be more complicated to treat and may only be controllable and not 100 percent curable.
Treatment options may vary from at-home therapy to veterinary care. You can baby your dog as you would a sick child and give him homemade food such as boiled potatoes, rice and well-cooked, skinless chicken. However, in certain situations with our senior pets, your dog may require fluid therapy, antibiotics, a change in dog food, anti-emetics (drugs to help control vomiting) or other medication. It is best to follow your veterinarian’s recommendations regarding appropriate treatment.
At any given time, Animal House of Chicago is treating several dogs for chronic liver and kidney failure with fluid therapy, dietary modifications and Eastern and Western medical protocols. We are aware that although we may not be able to cure the diseases, we can try to maintain the highest quality of life for the greatest amount of time.
By: Dr. Byron de la Navarre
Feature Image: James Johnson/iStock/Thinkstock