What is the difference between vomiting and regurgitation? Knowing the difference between vomiting and regurgitation in dogs is an important piece of information that can lead to a different diagnosis considering that vomiting and regurgitation can be symptoms of different medical conditions. While both vomiting and regurgitation lead to the expulsion of food, there are some key elements that differentiate them. Veterinarian Dr. Eric Weiner shares information about the difference between vomiting and regurgitation in dogs and the treatment of vomiting in dogs.
The Difference Between Vomiting and Regurgitation in Dogs
When a dog comes into my office for evaluation of vomiting, there are automatically a number of questions going off in my head. Throughout the history taking, physical exam and any diagnostics I may recommend, I am trying to fill in the blanks to get the most accurate diagnosis.
This leads to a more specific treatment approach for the individual, allowing for the best chance of success. Vomiting is actually a very vague clinical sign, and can be a result of so many different causes.
For starters, is the dog even experiencing true vomiting, or is it actually regurgitating? Vomiting is an active reflex with stomach contractions. Regurgitation is a passive motion of ingested materials coming up without heaving.
At this point of the exam, I will usually act out the two different motions for the owner. “Is it more like gulp, gulp, gulp, BARF! or more like...blahh.” It’s probably better to see it in person. Anyway distinguishing between the two helps localize the problem and direct me in a direction diagnostically and therapeutically.
Vomiting is usually associated with a problem with the stomach, intestines, or other systemic disease compared to regurgitation, which is consistent with a problem of the esophagus and up. Contrary to common belief, timing of upchucking after eating does not help with the differentiation.
Further differentiation for vomiting dogs includes, self-limiting or life threatening? Has the dog just started vomiting or has it been going on intermittently for months (acute vs. chronic)? Is this a gastrointestinal disease or systemic problem? Is there any history of eating things they were not supposed to? Has there been significant weight loss?
During the complete physical exam I’ll be looking for signs of nausea, such as constant lip licking and drooling. Are there any lesions or foreign objects in the mouth? While palpating or feeling the belly, I will be looking for signs of pain, changes in organ size, and trying to detect things that do not belong (foreign bodies vs masses).
Causes of Vomiting in Dogs
The most common cause of acute vomiting is dietary indiscretion—eating things they shouldn’t. Dogs can get upset stomachs (gastritis) from eating people food, finding random stuff on the floor or in the garbage, or a sudden change in diet or treats.
Some plants and toxins (i.e. chocolate) can also induce vomiting. For a list of toxic plants, please see the references at the bottom. Most cases of gastritis are self-limiting and will get better on its own, but mild medical intervention will help them feel better days sooner.
Another common cause for acute vomiting is GI obstruction. Common offenders are peach pits, corn cobs, chicken bones, pieces of toys, underwear, and the list goes on and on. Clinical signs depend on location and duration of the obstruction and any secondary issues that go along with it. These include dehydration, electrolyte or acid-base disturbances, or gut perforation. Some objects move through on their own, but some do require emergency surgery and hospitalized supportive care.
Another less common cause of GI obstruction includes cancerous masses occluding the inside (lumen) of the gut. These are more common in older dogs, and the most common type in dogs is adenocarcinoma.
Systemic (entire body) diseases must also be explored, especially once the easy stuff has been ruled out. The differential list includes pancreatitis, liver disease, kidney disease, or endocrine diseases, such as hypoadrenocorticism (Addison’s disease) for example. A blood profile will give information on organ function, hydration and electrolyte balance, and show if there is a systemic inflammatory response occurring. Further testing may be warranted to confirm suspected diseases when appropriate.
Treatment of Vomiting in Dogs
Treatment involves supportive care and treating or managing the underlying cause. Empirical treatments include anti-nausea meds, rehydration, and a bland diet. Fasting the pet for 12 to 24 hours after vomiting is often recommended to let the gut reset without giving it more work to do.
Once vomiting has stopped, it is a good idea to start offering a little water and see how that goes. If the dog keeps that down, then offer small frequent meals of a bland diet. If the pet has kept that down and is feeling better, the amount of food offered can be gradually increased. After several days without vomiting, their normal diet can be slowly reintroduced over the next several days.
Empirical management is only appropriate when mentation is appropriate, the physical exam is mostly unremarkable, and there is no history of weight loss.
If there is a history of eating chicken bones for example and the dog has vomited eight times in 24 hours, and has a painful belly, it would be prudent to pursue diagnostics immediately. If empirical management does not work, a further work up is then necessary to pinpoint the problem. Ultimately it is at the veterinarian’s discretion to recommend the most appropriate course of action.
About the Author
Dr. Eric Weiner is a small animal veterinarian practicing in Orlando, Florida. He is a third generation veterinarian as both his father and grandfather are vets. Although he grew up following both of them around and wanted to be a veterinarian himself, he took a bit of a detour and attended Hofstra University originally as a music major.
Eventually realizing his true passion still lays within Veterinary Medicine, he switch majors and graduated in 2010 with a BA in biology and dual minors in biochemistry and music. Dr. Weiner attended Virginia-Maryland Regional College of Veterinary Medicine and graduated in 2015, concentrating in mixed animal medicine and surgery. During his clinical year, his favorite rotation was which ever he was currently on. He especially enjoyed spending time at the Penn Vet Working Dog Center, where he worked closely with search and rescue dogs, diabetic alert dogs, and even cancer detection dogs.
When Dr. Weiner is not working with animals, he enjoys riding his motorcycle and playing baseball. He is married to his high school sweetheart and they are enjoying their brand new baby girl. In addition, they live with their therapy dog Murphy, and two cats, Stella and Luna.