If your dog vomits blood, you are rightfully concerned. The medical term for this is "hematemesis" and how serious it is depends on various factors such as the amount vomited, its frequency of occurrence and its presentation.
Generally, blood in the vomit means there's bleeding somewhere along the esophagus, stomach or the first part of the small intestine.This article will look at some common causes of blood in the vomit in dogs, but if your dog is vomiting up copious amounts of blood, stop reading and please see your emergency vet.
Minor Cases of Blood in Vomit
Generally, small amounts of bright red blood that looks like small streaks or small red blood clots or flecks, may simply be seen in any dog as a result of vigorous vomiting explains Michael D. Willard, a board-certified veterinarian specializing in internal medicine. The blood in this case simply comes from gastric mucosa which is superficially traumatized by the retching. Generally, this type of vomit doesn't need immediate vet attention as it's self-limiting.
Exclude Other Possibilities
When assessing blood in the dog's vomit, one should also exclude the consumption of something colored red or something that would leech the color red once ingested. In some cases, one assumes the blood comes from the digestive tract, when it may instead come from elsewhere such as the mouth. Checking the dog's mouth is a good idea to look for signs of a bleeding mouth or gums. Eating sharp bones may sometimes scrape the mouth, and if swallowed, the sharp pieces may cause erosion in the esophagus, stomach and intestines. Also, swallowing blood from a nose bleed or licking blood from a bleeding wound may also cause presence of blood in vomit.
Recognizing Digested Blood in Vomit
Dog owners readily recognize blood in the vomit that appears red, but many may not be aware that vomit that appears the color of chocolate or coffee grounds is suggestive of the presence of partially digested blood. This is indicative of the dog bleeding somewhere in the upper digestive. Since the blood is digested by stomach acids, its color will change from its familiar bright color to a less familiar darker color.
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Blood Coagulation Problems
The presence of large amounts of blood in the vomit can be suggestive of serious problems with the coagulation of blood.This may include thrombocytopenia, von Willebran disease and disseminated intravascular coagulation. These coagulatory conditions may also simultaneously cause bleeding from other areas such as the nose, and under the skin, causing pin-points areas (petichiae) or purple blotches (ecchymosis.) It's important to rule out the possibility the dog ingested rat poison which causes coagulation problems and internal bleeding.
Bleeding Stomach Ulcers
A common cause of vomiting blood is the presence of bleeding ulcers which may derive from stress, the administration of nonsteroidal anti-inflammatory drugs and the administration of steroids, especially dexamethasone. Steroids should never be given together with nonsteroidal anti-inflammatory drugs. Mast cell tumors are also a culprit and present as skin lesions which release histamines known for causing excessive secretions of stomach acid.In some cases, the blood in the vomit may come from the esophagus, in cases of gastroesophageal reflux.
Presence of Stomach Tumors
In elderly dogs, the presence of stomach tumors known as leiomyoma and leisomyosarcoma can cause quite some bleeding considering that they tend to ulcerate. These tumors can be easily treated surgically and have a good outcome. They are not easily visible by ultrasound, so they are sometimes discovered through exploratory surgery.
Watch for Blood in Stools
Concerning is when the vomiting is accompanied by dark stools, that appear pitch black, the color of tar. This is indication of presence of digested blood in the stool in the upper digestive tract, something referred to as "melena." If you are not sure if your dog's stool is just dark or actually has blood in it, there's a simple test you can do at home. Place the feces on absorbent paper and watch if a reddish tint leeches out from the feces, suggests Dr. Willard.
Some Other Causes
Liver disease has been associated with blood in vomit, but there are often other signs. HGE, also known as hemorrhagic gastroenteritis affects the whole digestive tract and may cause both blood in vomit and bloody stools. This is often seen in young, small breed dogs. More rare cases of vomiting blood include hypoadrenocorticism (Addison disease), presence of gastrinomas, small tumors on the pancreas, known for producing gastrin which increase gastric acid secretions. In some cases, foreign objects may cause blood in vomit, but not commonly.
[adinserter block="5"]You vet will likely check your dog's gums for signs of anemia. If you suspect, blood in stool, a stool sample may help determine if there is any accompanying blood in the feces. Blood tests may look for signs of anemia and hypoalbuminemia. If your vet suspects a coagulation disorder, he will check the platelet count and clotting factors. Serum gastric concentrations may be helpful as well in some cases. Ultrasound is sometimes performed when faced with diagnostic challenges or severe cases. Additional tests that may turn out helpful is endoscopy to check the esophagus, stomach and duodenum. It's important not to give carafate prior as this may affect the visibility as it covers erosion and ulcers. Exploratory surgery is necessary at times.
Treatment is Based on Findings
Because there are several causes of blood in vomit, the treatments will vary. In severe cases, the dog may need to be hospitalized and given fluids, and possibly, blood transfusions. In the case of excessive reflux of bile, the drug metoclopramide or cisapride can be helpful. Antiacids such as the H-2 receptor antagonists cimetidine, ranitidine and famotidine help reduce acid secretions. Proton-pump inhibitors such as omeprazole (Prilosec), help inhibit gastric acid secretions. Sucralfate works well to coat ulcerated areas allowing them to heal. Surgery may be needed for any tumors.