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The top three presenting complaints for dogs in every small animal veterinary clinic are ear infections, itchy skin, and vomiting.
Working up the vomiting dog is a diagnostic challenge for veterinarians for several reasons, including:
1. The physical exam of a vomiting dog is often totally normal, especially if Fido feels icky because he licked something yucky in the back yard but is otherwise fine.
2. Most foreign objects that can fit down the throat of a dog are either too squishy or too small in relation to the size of the dog to be felt just by the veterinarian squeezing on your dog’s tummy, especially if said foreign object is still in the stomach, safely tucked away under your dog’s rib cage.
3. Routine blood tests can detect conditions that may cause nausea leading to a vomiting dog – damage to the kidneys, liver, pancreas for instance – but blood tests alone cannot detect a problem that is occurring purely within the stomach or intestines. If your vomiting dog ate something funky in the yard, blood tests will likely be totally normal.
4. X-rays are great at taking pictures of bones and super dense foreign objects like rocks or metal, but not so good with soft tissues or soft squishy foreign materials inside a vomiting dog.
WE RECOMMEND BLOOD TESTS AND SURVEY X-RAYS ON ALMOST EVERY VOMITING DOG, because by ruling out bad organ disease with blood tests, and obvious foreign objects with routine x-rays, we can eliminate some dangerous, treatable problems that might, untreated, rapidly kill your beloved pet.
Yes, it’s true, nine times out of ten, those expensive tests will be totally normal, but the one out of ten dogs with an abnormal test might die without a rapid diagnosis.
Medicine is an inexact science.
Better we run a test and your dog is fine, than NOT run a test and miss something easily treatable.
Luckily for our patients, most vomiting dogs get better with help. Here’s the scenario we most often end up seeing (telling the tale using 20/20 hindsight, after a vomiting dog has already recovered):
The stomach of a dog often knows when something bad is inside it, and dogs are designed with a defense mechanism where they throw up repeatedly until the stomach is FOR SURE empty. So if Fido eats some yuck from the back yard, he’ll vomit 15 times over 3-4 hours until only white foam or little puddles of yellow bile are coming up, then he’ll gack a few more times, empty, just to make for SURE sure all the bad stuff is gone.
Eventually, he stops throwing up, but he’s had an exhausting day. He’s a little shaky, a little tired, and just wants to sleep it off. He feels crummy for 24 hours, moping around and not wanting to eat, then he finally starts to feel a little better and picks at his (bland, veterinary prescribed) food for a few days before returning to normal. Sometimes he might even develop diarrhea as whatever it is that made him sick completely works its way out of his system. This is the story that happens MOST of the time.
Dogs with foreign bodies in their intestines often present exactly the same way, they just don’t get better, and continue to vomit, and vomit…
Assuming most vomiting dogs present looking normal, feeling normal, with normal blood tests and normal x-rays, how on earth can veterinarians tell the difference between the dog who licked yuck in the back yard and will be fine 24 hours later, vs. the dog who ate Barbie’s head and might die?
Sometimes it’s the duration of vomiting that clues us in – vomiting once, we might not worry as much as vomiting that continues for 12 hours and even water comes right back up. Sometimes we make Fido drink barium, a benign substance that happens to light up like a Christmas tree on x-rays, to confirm or rule out foreign bodies. Sometimes we recommend endoscopy, which is to anesthetize Fido and feed a camera down into his stomach to take a look around.
Most times, when a veterinarian is presented with a normal looking vomiting dog who ends up having normal blood tests and normal x-rays, we often send home and/or administer medications we think might help settle his stomach, then we cross our fingers and hope he gets better. This explanation is often unsatisfying to the pet owner who expects a concrete diagnosis, but it’s often the best a veterinarian can do to say “try this and call me in the morning”.
The grand, overall message of this post should hopefully be coming clear. If your veterinarian can’t even tell what’s wrong with your dog or predict his outcome after a physical exam, blood tests and x-rays, there’s no WAY you can tell what’s wrong or predict how things will go at home.
Instead of trying to predict your dog’s future, here’s what we recommend.
Write yourself a list, including:
1. EVERYTHING you can think of that Fido might have put in his stomach: food, toys, bones, rawhides, everything.
2. Any recent changes to his diet.
3. Whether or not you have rodent poison out, a puddle of antifreeze in the garage, any other potential toxins, plants, cleaners, whatever.
4. How much of exactly what kind of people food he’s eaten in the last week. Be honest, we’re not going to yell at you, we just need to know.
5. Previous history of similar episodes, treatments that were performed and outcome – records from your last veterinarian are incredibly helpful here.
Then when you’ve got your list of symptoms, timeframe, potential exposure and recent changes, call your veterinarian and they’ll help you work through whatever ails poor Fido, come what may.