Third Street
Veterinary Hospital, PC
McMinnville, Oregon 97128
Office phone: (503) 472-9418
Chronic
Vomiting in Dogs
Chronic
vomiting is a common problem in dogs.
It may be related to relatively minor causes, such as chronic swallowing
of hair, or it may be due to much more serious diseases.
Because
there are so many causes, there are many tests that may be needed to make an
accurate diagnosis. One of the factors
that determine how quickly these tests must be performed is the condition of
your dog. If the appetite is very poor
or non-existent or if weight loss is occurring rapidly, it is important that a
diagnosis be obtained rapidly. If pain
or a mass is present in the abdomen, tests need to be performed quickly. However, if neither appetite nor weight is
affected, the urgency is much less.
Vomiting
may be due to disease in the stomach or intestines, or it may be due to disease
in many other parts of the body. As a
rule, most of the latter diseases are detected with blood tests. However, few diseases in the stomach are
intestines show up in those tests.
The
sequence of tests will vary from dog to dog.
The urgency issues already discussed are one of the most important
factors that we must consider. However,
as a rule, we recommend blood tests to eliminate the diseases that are not
directly involving the stomach or intestines. If those do not detect the problem, the other tests, listed below,
will be utilized.
The
following tests are performed to evaluate the stomach and intestines. Their pros and cons are listed.
Radiographs (x-rays): Radiographs are made with and without
barium. Those without barium find
foreign materials if they are made of bone or metal or other very hard
substances. Radiographs made with
barium are taken as a series. Barium is
placed in the stomach and radiographs are made every 15-30 minute until the
barium reaches the end of the intestines.
These radiographs permit us to evaluate:
1.
How quickly the stomach empties
2.
If the barium moves completely through the intestines and how quickly that
occurs
3.
If the intestines are dilated
4.
If there are areas in the intestines that are very irritated
5.
If there is a rupture of the stomach or intestines
An
endoscope is a flexible scope that is inserted through the mouth, down the
esophagus, and into the stomach and first few inches of the small
intestines. (It may also be inserted
through the anus and into the colon, but this is generally reserved for dogs
with chronic diarrhea.) This permits us
to look at the insides of the esophagus, stomach, and upper small
intestines. It also permits biopsies to
be taken, which is often the most important part of the procedure.
Endoscopy
requires anesthesia so there is always a small degree of risk involved. However, it does not require a surgical
incision. One of its limitations is
that some tumors of the stomach do not go completely to the inner surface of
the stomach. Since the biopsies are
only made from the stomach lining, it is possible to miss them.
An
ultrasound study is performed with a machine that sends sound waves into the
body. Their reflections are analyzed by
a computer and formed into an image on a computer-type screen. There is no radiation involved. These images allow a trained operator to
visualize the structure of the stomach and intestinal walls. It also permits evaluation of the liver,
kidneys, and other abdominal organs.
Biopsy of abnormal areas of most organs is also possible and can provide
the needed tissue samples for a diagnosis to be made.
An
ultrasound examination usually does not require sedation or anesthesia;
however, the dog must lie on its back for 15-30 minutes. Some dogs will not do that without
sedation. If biopsies are taken,
sedation is usually required to prevent pain and to prevent damage to internal
organs.
Surgical
exploration of the abdominal cavity is generally reserved for those dogs that
cannot be diagnosed with the above tests.
It is the most invasive procedure, but it permits us to see all parts of
the stomach and intestines as well as the other abdominal organs. It also permits us to biopsy specific areas
of any abdominal organ.
In
some cases, surgery is performed as one of the first procedures if an
intestinal obstruction is diagnosed or strongly suspected.