Chronic Vomiting in Dogs: Causes and Treatment

Chronic vomiting in dogs refers to continuous or intermittent vomiting for at least seven days. Unlike acute vomiting, chronic vomiting is a longer-term problem that can have many underlying causes.

Treatment depends on the cause and may include diet changes, medication, treatment of an underlying disease, or surgery.

What Is Chronic Vomiting in Dogs?

Chronic vomiting in dogs refers to continuous or intermittent vomiting for a period of at least seven days. This is different from acute vomiting, or “regular” vomiting, which is a short-term problem.

Vomiting is one of the most common medical issues that affects dogs and is technically defined as the forceful expulsion of stomach contents through the mouth. Vomiting is composed of three stages: nausea, retching, and vomiting.

While vomiting can serve a protective function to eliminate potential toxins in dogs, it is usually a sign that something is wrong with your pet.

Sometimes a dog may vomit once, then return to normal with no change in their energy or appetite. Chronic vomiting is a longer-term problem that may have different underlying causes.

A single bout of vomiting that is not accompanied by lethargy or decreased appetite in a dog who is having normal bowel movements may resolve after a short fast and with a bland diet.

If your dog is experiencing protracted vomiting (multiple bouts of vomiting) with lethargy and/or lack of appetite, it is considered a medical emergency.

What Are the Symptoms of Chronic Vomiting in Dogs?

Your dog may be experiencing chronic vomiting if they have vomiting episodes for seven or more days and/or repeated bouts of intermittent vomiting. Vomiting is a clinical sign of an underlying problem or disease rather than a disease itself.

Vomiting may be associated with signs of nausea, including:

• Drooling or increased salivation
• Decreased appetite
• Lethargy
• Frequent swallowing

Vomiting vs. Regurgitation in Dogs

One of the first steps in determining whether your dog is experiencing chronic vomiting is to rule out regurgitation. Vomiting and regurgitation can look alike but are very different conditions.

In both cases, processed food, stomach acid, and water can come up from the stomach and out of the mouth.

Vomiting is an active process that requires contraction of the abdominal muscles to expel the stomach contents. You will often see your dog's sides heave as they work to vomit. Retching is part of the vomiting process, and your dog will make noise as they open their throat to allow the vomit to come up.

Regurgitation is a passive process. When dogs regurgitate, they simply open their mouth, and food and other stomach contents fall out.

Regurgitation occurs right after a meal, whereas vomiting may occur immediately after a meal or several hours later.

What Causes Chronic Vomiting in Dogs?

Chronic vomiting in dogs can have many possible causes, including gastrointestinal sensitivity, food allergies, frequent diet changes, parasites, foreign bodies, toxins, infections, systemic diseases, medication side effects, and other gastrointestinal or endocrine conditions.

It is important to work with your veterinarian to determine which cause is most likely triggering chronic vomiting in your dog.

Common causes of chronic vomiting in dogs include:

• Gastrointestinal sensitivity or intolerance, or “sensitive stomach”
• Food allergy
• Frequent diet changes
• Stress
• Bilious vomiting syndrome
• Dietary indiscretions, such as repeatedly getting into the garbage
• Gastric foreign bodies
• Parasites
• Toxins
• Infectious disease or an underlying infection, such as an infection of the uterus (pyometra)
• Underlying systemic diseases, such as kidney disease, pancreatic disease, liver disease, or cancer
• Medication side effects
• Addison's disease (a disease of the adrenal gland) or other endocrine diseases, such as diabetic ketosis
• Stenotic pylorus
• Inflammatory bowel disease (IBD)
• Gastric ulcers

Causes of Chronic Vomiting in Younger Dogs

Younger dogs are more likely to experience gastrointestinal foreign bodies, parasites, and dietary indiscretions. Certain underlying genetic conditions, such as a stenotic pylorus, or food allergies may also be diagnosed in a dog's early years.

However, food allergies or intolerance can also develop over time rather than being present at birth.

Causes of Chronic Vomiting in Senior Dogs

Senior dogs are more commonly affected by systemic diseases such as kidney disease and cancer.

How Is Chronic Vomiting in Dogs Diagnosed?

Veterinarians diagnose the cause of chronic vomiting in dogs by taking a thorough history, performing a physical exam, and using diagnostic tests such as a fecal exam, X-rays, and blood work. 

If these first-line tests do not provide answers, more advanced testing may be recommended.

Medical History and Physical Exam

When a dog experiences chronic vomiting, a veterinarian will start by getting a thorough history. It is important to note any patterns seen at home, such as whether vomiting occurs more frequently at a certain time of day or after a meal.

Try to be as complete as possible and share any observations you've made about when the episodes occur and any other behaviors.

Other helpful information includes:

• Type and brand of food
• Your dog's energy level
• Appetite
• Frequency of bowel movements
• What the stool looks like

Stool samples are recommended.

During the physical exam, your veterinarian will likely palpate your dog's abdomen for abnormalities and check their entire body for possibly correlated issues.

First-Line Diagnostic Tests

Initial diagnostic testing may include:

• Fecal exam
• X-rays
• Blood work

Advanced Diagnostic Tests

If first-line tests do not provide answers, your veterinarian may recommend advanced diagnostics, including:

• Abdominal ultrasonography
• Endoscopy
• CT
• Exploratory surgery
• Biopsies

How Is Chronic Vomiting in Dogs Treated?

Treatment for chronic vomiting in dogs depends on the underlying problem and may include diet therapy, oral medications, treatment of an underlying disease, or surgery.

Diet Therapy

Sometimes diet therapy alone can manage chronic vomiting conditions. Several prescription diets are formulated specifically for dogs with sensitive GI tracts that benefit from prebiotics and highly digestible, fiber-rich diets, such as Hill's Gastrointestinal Biome or Royal Canin Gastrointestinal High Fiber diet.

Other diets are made to address food allergies, either with alternate protein sources, such as egg or kangaroo, or by using hydrolyzed protein that has been broken down into small pieces to avoid triggering an allergic response.

If your veterinarian prescribes a prescription diet for your dog, feed that food exclusively for eight to 12 weeks. Do not give unapproved treats that may affect the results of the diet trial. You won't be able to tell if a diet trial is working if your dog is receiving additional food.

Medications

Oral medications may be necessary to manage chronic vomiting. Parasites and other infectious diseases are usually managed with oral medications such as dewormers or antibiotics.

Ulcers may also be treated with medicines given by mouth that protect the lining of the GI tract.

Bilious vomiting syndrome, where dogs vomit first thing in the morning, may be managed with over-the-counter antacids or lifestyle changes. Sometimes management may be as simple as feeding a late-night snack so that your dog's stomach is not empty for a long period of time.

Treating Underlying Diseases

Chronic kidney disease is a common cause of chronic vomiting in senior small-breed dogs. It is often accompanied by increased drinking, peeing, and weight loss.

Prescription diet food can dramatically increase a dog's quality of life by reducing the workload of the kidneys, hence slowing the progression of the disease process.

Other underlying systemic diseases, such as pancreatitis, liver disease, and diabetes, may also benefit from nutritional prescription diets that are specially formulated to spare that organ system and avoid flare-ups of clinical disease.

Surgery for Chronic Vomiting

Certain diagnoses, such as gastric foreign bodies, require surgical intervention. Gastric foreign bodies are non-food items eaten by a dog, such as a ball, sock, or pieces of a toy or bedding.

Surgery may be considered to explore the gastrointestinal tract for problems that may be causing chronic vomiting.

There are many things a dog can eat that do not show up on X-rays. Sometimes these items may be stuck in the stomach and occasionally obstruct the outflow tract to the intestines, leading to bouts of vomiting. These items can be found during exploratory surgery.

Even if exploratory surgery does not reveal a foreign body, biopsies can be taken to look for signs of underlying gastric or intestinal disease.

Recovery and Management of Chronic Vomiting in Dogs

Recovery from chronic vomiting in dogs varies depending on the underlying diagnosis. Long-term management may involve a strict prescribed diet, parasite prevention, medications or lifestyle changes, or postoperative care.

Dietary Management

If the problem is managed with nutrition alone, management requires due diligence to make sure your dog follows a strict prescribed diet. Talk to your veterinarian about which treats are acceptable, if any.

Management After Parasites

If your dog's vomiting was related to parasites, treatment may be curative.

It's important to keep your dog on a quality preventative product monthly to avoid reinfection. Many heartworm prevention products on the market today also prevent common gastrointestinal parasites. Talk to your veterinarian about which product is recommended for your dog.

Managing Underlying Systemic Diseases

Underlying systemic diseases may be managed with chronic oral medications or lifestyle changes.

Follow the instructions set by your veterinarian and check in regularly for recheck visits to monitor your dog's response to treatment and make any necessary adjustments.

Recovery After Surgery

If surgery was required to treat chronic vomiting due to an underlying foreign body or stenotic pylorus, keep your dog calm and quiet during the postoperative two-week period while they heal.

Prevent:

• Running
• Jumping
• Using stairs
• Other activities that put undue stress and tension on the healing incision

Your veterinarian may send your dog home with a prescription bland diet and oral medications after surgery. Give all prescribed medicines until they are gone and closely monitor all intake and output during recovery.

Leash walking is often recommended so that all bowel movements can be observed after surgery.

If your dog becomes lethargic, won't eat, or continues vomiting at any time after surgery, contact your veterinarian immediately.

How To Prevent Chronic Vomiting in Dogs

Some causes of chronic vomiting in dogs can be prevented, such as parasites, toxins, and dietary indiscretions. Other causes are more likely due to genetics and cannot be avoided, only managed.

Ways to help prevent chronic vomiting include:

• Give your dog all recommended regular parasite prevention products.
• Minimize your dog's exposure to toxins and other temptations.
• If your dog gets into the trash, use a trash can with a lid and keep it in a room behind closed doors.
• Avoid letting your dog mouth non-food items or chew on bones or toys without direct supervision.
• Feed a quality, balanced diet.
• Avoid frequent diet changes that can upset your dog's stomach.

Your veterinarian is the best person to discuss your dog's optimal nutrition with. They may refer you to a board-certified veterinary nutritionist if a homemade diet is recommended for a diet trial.

When To See a Veterinarian for Vomiting

If your dog cannot keep any food or water down, take them to an emergency veterinarian. With gastrointestinal foreign bodies, especially if they have moved into the intestines, time is critical.

If your dog occasionally vomits but is otherwise bright and energetic and keeps most meals down, you may be able to schedule an appointment with your veterinarian during office hours for a full work-up.

Vomiting is a sign that something is wrong and should be investigated.