Vomiting or Regurgitation — An Important Distinction
Vomiting is a symptom that commonly affects both cats and dogs. In fact, I performed a little puke clean up in the back of my car this morning. Apollo gets car sick at times; guess I wasn’t taking those turns as gently as I thought.
Even though vomiting is very common, one of the first things that a veterinarian has to do when faced with a "vomiting" pet is determine whether or not that is truly what is occurring. Vomiting can easily be confused with regurgitation, and making the distinction between vomiting and regurgitation is crucial. Not only are their causes very different, but so are the treatments that are most likely to help.
Of course, it is ultimately the veterinarian’s job to determine whether a pet is vomiting or regurgitating, but it is very helpful if pet owners know what distinguishes the two conditions so they can accurately describe what they are seeing at home.
Vomiting is an active process. It involves contractions of the abdominal wall (i.e., retching) prior to the actual event and the sensation of nausea, which is often associated with excess salivation, licking of the lips, and drooling. Regurgitation, on the other hand, is passive and may occur just after a pet changes position (e.g., lowers his head). Whenever I hear an owner say something like, "He didn’t even seem to know that it was going to happen," or, "He just opened his mouth and out came food," I start thinking regurgitation versus vomiting.
Where the material comes from is also important. Vomitus (love that word) originates in the stomach and sometimes the first part of the small intestine. If you see bile, a yellow or orange digestive fluid that is produced by the liver and delivered to the small intestine, you know your pet is vomiting, but an absence of bile doesn’t eliminate vomiting as a possibility.
Regurgitated material travels backwards from either the esophagus or pharynx into the mouth or nose. Regurgitus (yes, it’s actually a word) sometimes exits the body in the shape of a tube because of the time it spends in the esophagus and typically contains food, saliva, and some mucus but no bile.
Not to confuse matters, but another symptom that is sometimes called “vomiting” by owners is expectoration. If your pet coughs a few (or more) times and then gags up a glob of mucus and associated nastiness (expectorus?), he may well be expectorating rather than vomiting or regurgitating.
If you get the opportunity, take a video of your pet during one of his "episodes" before your appointment and bring it with you. The first time one of my clients did this I couldn’t help thinking, "Dude, that’s a little weird," but we reached a definitive diagnosis in about half the time it sometimes takes, which made everyone involved very happy.
Dr. Jennifer Coates
Image: Vitaly Titov & Maria Sidelnikova / Shutterstock