Vomiting & Diarrhea
Vomiting and diarrhea are one of the most common reasons that owners contact animal hospitals. In theory, the ability to vomit and the creation of diarrhea are both extremely important mechanisms that the body uses to protect itself. Vomiting and diarrhea both allow the body to rid itself of toxins, parasites, bacteria, foreign material and gastrointestinal irritants. Unfortunately, both of these body protective mechanisms can also cause a dog to become dehydrated. They can also be a clinical sign of a more dangerous disease processes.
This discussion will help you recognize the severity of the problem and help you decide when you should contact the veterinarian.
Vomiting can be a symptom of a disease or it can be a primary disorder. As a primary disorder, it is related to something in the gastrointestinal system causing the vomiting reaction. Vomiting actually occurs when an internal mechanism triggers receptors in the stomach and/or the intestines sending a message to the vomiting center in the brain. This center is called the central triggering zone (CTZ). The CTZ then sends a chemical message to the stomach to start reverse peristalsis (vomiting). The "something" in the stomach can be almost anything, an ingested irritant such as chemicals, plants, drugs, or foreign material. It can also be caused by inflammation, irritable bowel syndrome, inflammatory bowel disease, ulcers, bacteria, virus, and parasites. When vomiting is a symptom of a disease, the vomiting is actually triggered by the CTZ. With systemic disease the CTZ is stimulated by metabolic toxins caused by the specific disease process. Examples of diseases that do this are: diabetes, hyperthyroidism, pancreatitis, liver disease, gall bladder disease, as well as others. Since there are so many things that can cause vomiting, we have to decide when is the vomiting dangerous for my dog? The criteria for deciding if your dog needs professional help is based on how frequently the pet is vomiting. Most healthy, normal dogs will vomit occasionally
We place vomiting into 2 syndromes: Acute and Chronic.
Acute vomiting:
If a dog vomits frequently during a 24 hour period there most likely is a fairly significant problem. If the vomiting persists for more than 36 hours
a dog will then become clinically dehydrated and needs help. Most importantly, a dog that vomits very frequently during a 24 hour period (especially if they are unable to hold down water) needs help in the first
24 hours. A dog that vomits 2-3 times over 24 hours and are able to hold water down, can wait to see the veterinarian. The most important thing to
remember is that if a pet can't take in and keep water down, it will
become dehydrated. Once dehydration begins, other body systems start to
become affected. It is best to seek help before dehydration becomes a
problem. This type of vomiting is usually caused by gastrointestinal
irritants, ulcers, pancreatitis and viruses.
Chronic vomiting:
When dogs vomit infrequently, but over long periods of time,(vomiting 2-5 times a week)it's referred to as chronic vomiting. Intermittent vomiting generally causes weight loss and loss of body condition over time. This type of vomiting is usually related to systemic diseases such as inflammatory bowel disease, diabetes, hyperthyroidism, liver disease, and many others. These problems are more insidious in nature, sometimes not being recognized until the pet begins to lose body condition. In order for a veterinarian to diagnose the cause of both acute and chronic vomiting, diagnostic tests need to be performed. Typically, the tests performed are, a fecal evaluation (to diagnose intestinal parasites), abdominal radiographs (to look for foreign material and gas patterns), and blood tests (to diagnose metabolic diseases). In some cases, abdominal ultrasounds and endoscopy may need to be performed as well. The treatment of vomiting, depending on the cause, is primarily based on maintaining hydration status then treating the cause. In the cases of viral infections, the treatment is strictly supportive as the body fights off the disease. If your pet begins vomiting, the best advice is to initially provide gastrointestinal rest. This means, that if your dog vomits, take away ALL food and water for 4-6 hours. If your dog continues to vomit, seek help. If your dog improves, provide small amounts of water frequently and a bland diet for a day or two. If the vomiting becomes chronic in nature, seek veterinary advice. It is important to remember that dogs do sometimes eat things they shouldn't. If foreign material becomes lodged in the small intestine, it becomes a life threatening situation. If there is any question that your pet has eaten something it shouldn't, then it's best to see the veterinarian and have a radiograph taken to be sure your pet is not in danger.
Diarrhea can also be a primary disorder or a symptom of a disease process. Diarrhea is actually a mechanism by which the body rids itself of toxins, by adding fluids into the digestive system and increasing the intestinal motility. This works by effectively diluting out the toxin and moving it through the system as fast as possible. It is a very effective protective mechanism that the body possesses to protect itself.
Diarrhea is also classified as acute and chronic, as well as small intestinal vs large intestinal (colon).
Acute diarrhea starts very quickly, with the dog having very frequent bowel movements. This can lead to dehydration. Chronic diarrhea starts and lasts for a long time (weeks to months). It can be very frequent bowel movements or simply diarrhea with normal frequency. Small intestinal diarrhea is watery feces and tends to be explosive type. It can be a normal or dark in color. Large intestinal diarrhea is characterized by soft "pudding" like stool, with increased frequency. The color can range from normal, grey, yellow or even black in color. Sometimes the color will help diagnose the causative disease. For instance, grey colored feces can be caused by liver disease whereas black colored stools many times are indicative of upper gastrointestinal bleeding (ulcers).In order to diagnose the cause of diarrhea; the veterinarian will characterize the diarrhea with the owner's help. Diagnostic tests can then be formulated to pinpoint the cause. The most common diagnostic tests performed are fecal exams, blood tests and abdominal radiographs. Some specialized tests may need to be performed in the cases of long term chronic diarrhea. These include testing for pancreatic disease (TLI, PLI), for bacterial over growth (B-12,folate levels),fecal digestive and pathogen profiles, and occasionally, abdominal ultrasound and colonoscopy with biopsies.
If your dog gets diarrhea, the best thing to do is to skip a meal.
Provide water and observe him to insure that the dog is maintaining proper
hydration. Start a bland diet, such as boiled chicken and rice or potatoes, for a few days. Any dog that has diarrhea should have a fecal exam done, so you should bring a fecal sample to the veterinarian. Parasites are a very common cause of diarrhea. If the diarrhea becomes persistent, then you should seek veterinary advice. If your dog is suffering from vomiting and diarrhea at the same time, it can become dehydrated very quickly. Both of these problems cause large amounts of fluid to the leave the body quickly. It is very difficult for a dog to maintain hydration when vomiting and diarrhea are happening at the same time. Most of the time they will need some veterinary assistance, especially if the fluid lose continues for more than 24 hours. In order to prevent your dog from vomiting or developing diarrhea, it is best to maintain a steady diet with minimal changes. A dog's digestive system doesn't appreciate changes. Be careful about what types of treats you are giving to your dog as well. Keep all non-edible objects away from your dog. Make sure your dog is not ingesting large pieces of toys, bones, stuffed toy, blankets, clothing, towels or rocks. Keep all chemicals and drugs out of reach as well. Never give your dog any medication without contacting your veterinarian first for advice. Use monthly heartworm preventative to prevent intestinal parasite infections. It would certainly be wise to have yearly fecal exams done on your dog's feces.
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Dr. Ellen Leonhardt
Animal General
East Norwich
(516) 624-7500
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