2/2/24

Causes, Care, and When to Worry 

For pet parents, witnessing your furry friend experience vomiting and diarrhea can be alarming. While these symptoms can sometimes be temporary and harmless, they can also signal more serious underlying health issues. This guide aims to empower you with knowledge about the causes, diagnosis, and treatment options for vomiting and diarrhea in dogs, helping you navigate this concern with confidence.

Beyond Vomiting and Diarrhea - Recognizing Additional Warning Signs:

While vomiting and diarrhea are prominent indicators, several other symptoms warrant close attention:

• Lethargy or Weakness: A significant decrease in energy levels or unusual tiredness can signify more than just a passing upset.

• Loss of Appetite: Reluctance or refusal to eat is a notable change and may point towards discomfort or a deeper issue.

• Abdominal Pain or Bloating: Whining, discomfort when being touched, or a swollen abdomen can indicate pain or internal distress.

• Dehydration: Dry gums, sunken eyes, or reduced skin elasticity are crucial signs to monitor, especially in puppies and senior dogs.

• Fever: A body temperature exceeding 102.5°F (39.2°C) indicates fever and may require veterinary attention.

• Weight Loss: Noticeable weight loss over a short period can be concerning and needs investigation. Long term weight loss can be an indication of a more severe chronic illness.

• Changes in Behavior: Increased irritability, aggression, or other behavioral shifts may reflect pain, discomfort, or anxiety.

• Blood in Vomit or Stool: Fresh blood (red) or digested blood (dark, tarry) warrants may be seen in both acute and chronic cases and could indicate severe disease in some animals.

• Pale Gums: May indicate anemia or significant blood loss, requiring prompt medical attention.

• Excessive Drooling or Panting: Can be signs of pain, discomfort, or nausea.

Unraveling the Cause - Common Culprits:

While the list is extensive, some common causes of vomiting and diarrhea in dogs include:

• Dietary Indiscretion: Consuming inappropriate items like garbage, spoiled food, or even toxic substances can trigger digestive upset.

• Gastrointestinal Obstruction: This can occur due to foreign objects being ingested, tumors, scar tissue formation, or internal hernias. 

• Infections: Viruses, bacteria, and parasites like worms or protozoans can invade the digestive system, leading to irritation and inflammation.

• Toxins: Ingestion of poisonous substances, including certain human foods, medications, and household chemicals, can cause severe vomiting and diarrhea.

• Food Allergies or Intolerances: Reactions to specific ingredients in the diet can manifest as digestive issues in many animals. Food allergies may not always present as acute vomiting or diarrhea, and often can be seen more as chronic intermittent issues.

• Sudden Dietary Changes: A sudden switch to a new food, even high-quality, can sometimes trigger digestive upset in sensitive dogs.

• Lymphangiectasia: Similar to food intolerances, some dogs can be intolerant of fat. When fat passes through the intestines it pools and leaks into the surrounding tissue, causing inflammation and irritation.

• Liver, Kidney, or Pancreatic Diseases: Impaired function of these organs can significantly impact digestion, leading to vomiting and diarrhea.

• Medications: Certain medications can have side effects like gastrointestinal upset.

• Stress or Anxiety: Emotional distress can manifest physically, including through digestive issues.

• Inflammatory Bowel Disease (IBD): A chronic condition causing inflammation of the intestines, leading to recurrent vomiting and diarrhea.

• Cancer: Tumors in the digestive tract can disrupt its normal functioning and cause vomiting and diarrhea. Not all cancers present as visible masses, some can be microscopic, hiding within the walls of the intestines.

• Metabolic Disorders: Conditions like Addison's disease or thyroid issues can manifest with digestive symptoms like vomiting and diarrhea.

• Pancreatitis: The pancreas is an important organ for the digestion of food, secreting powerful digestive enzymes to break down proteins, fats, and carbohydrates. Inflammation of the pancreas can be life-threatening due to how irritating these enzymes can be, going beyond just simple intestinal upset.

• Vascular Accidents: Strokes or other vascular events can sometimes manifest with digestive symptoms.

Remember, this list is not exhaustive as vomiting and diarrhea by themselves are very vague symptoms. A thorough history along with diagnostics recommended by your veterinarian will help to rule out some of the more common causes, and often pinpoint the exact cause.

Reaching a Diagnosis - The Detective Work Begins:

Diagnosing the root cause of vomiting and diarrhea involves a multi-step approach:

• Thorough Medical History: Your veterinarian will gather detailed information about your dog's diet, recent activities, potential exposure to toxins, and any previous health issues.

• Physical Examination: A comprehensive physical examination will assess your dog's overall health, checking for abdominal pain, dehydration, fever, and other abnormalities such as enlarged lymph nodes.

• Fecal Examination and Testing: Infectious organisms can sometimes be seen in a fecal sample but keep in mind that they can also be missed due to small sample size or intermittent shedding. Giardia, tapeworms, and roundworms are often seen under the microscope or with special testing. Parvo testing is important in any young or unvaccinated dog. More specific testing for atypical infectious like fungus may be necessary in some cases.

• Blood Tests: 

  • Systemic blood work (complete blood count and chemistry panel) can assess overall health, organ function, and check for signs of infection or inflammation. Normal blood work can help to rule out anemia, liver disease, and kidney failure. Unfortunately normal bloodwork does not rule out cancer and there are no reliable markers for cancer in the blood of animals.

  • Vitamin B12 and B9 testing is often performed to rule out vitamin deficiencies and give further evidence of underlying intestinal issues. Both of these vitamins are absorbed in the intestines an low levels may be due to decreased intestinal absorption.

  • Pancreatic function and inflammation can be evaluated via the blood to look for pancreatitis and exocrine pancreatic insufficiency.

  • Cortisol testing is often performed to rule out Addison’s disease, a condition where animals are unable to produce enough stress hormone for normal daily life. This leads to chronic intermittent intestinal issues as cortisol is required for normal healthy intestinal function.

• Urinalysis: To evaluate kidney function and hydration levels. Occasionally infectious organisms can be detected in the urine, such as with leptospirosis and certain fungal diseases.

• Abdominal X-rays: X-rays can be an important imaging test and are can reveal foreign body obstructions, large masses, and fluid build-up within the abdomen.

• Abdominal  ultrasound: Ultrasound uses sound waves to non-invasively image the abdominal organs such as the stomach, pancreas, liver, and kidneys. Masses, abscesses, and severe inflammation can often be detected using ultrasound, although microscopic disease will often be missed with ultrasound because it may not disrupt the normal architecture.

• Endoscopy and tissue biopsy: For direct visualization of the inside of the digestive tract and collection of tissue samples for biopsy. The goal of biopsy is to rule out uncommon causes of chronic signs, such as deep-seated infections and cancer. Inflammation within the intestines without finding another definitive cause often leads to the diagnosis of idiopathic inflammatory bowel disease.

• Food Trials: If a food allergy is suspected, a specialized elimination diet may be implemented.

• Surgical biopsy: If lesions cannot be sampled using endoscopy or ultrasound-guidance, surgery may be necessary. Disease on the outer layer of the intestines cannot be sampled using endoscopy and surgical biopsies given greater information than endoscopic biopsies.

Supportive Care - Tailoring Treatment to Your Dog's Needs:

Treatment options depend on the identified cause and your dog's specific condition, although some supportive treatment options can be used regardless of underlying cause:

• Dietary Management: Some dogs with dietary indiscretion will be improved by a bland diet and gradual reintroduction of appropriate food to restore gut balance.

• Fluid Therapy: To prevent or correct dehydration, especially crucial for puppies and senior dogs.

• Medications:

  • Antiemetics: Drugs like Cerenia and ondansetron aim to control vomiting and nausea.

  • Probiotics: Beneficial bacteria to restore gut flora and support digestion.

  • Fiber: Fiber can be used as a bulking agent but can also support the beneficial bacteria in the intestinal microflora, similar to probiotics.

  • Antiparasitic treatments: Drugs like fenbendazole and pyrantel are used to eliminate common intestinal parasites. Atypical or resistant infections may require more intensive therapies.

  • Anti-diarrheals: These medications can be used supportively in some cases, although they do not generally treat the underlying cause of the diarrhea.

  • Specific treatments for IBD, cancer, or other diseases: These may involve immunosuppressive drugs, chemotherapy, antibiotics, or other specialized medications based on the diagnosis and severity.

• Home Care: Close monitoring of your dog's hydration, activity level, and appetite is crucial alongside gradual reintroduction of food according to your veterinarian's instructions.

• Hospitalization: For severe cases requiring intensive care, intravenous fluids, medications, or supportive treatments, hospitalization may be necessary.

Preventing Recurrences - Proactive Steps for a Happy Gut:

Once your dog recovers, preventive measures can help minimize the risk of future episodes:

• Maintaining a Healthy Diet: High-quality dog food appropriate for your dog's age, breed, and activity level is essential. Avoid table scraps and other unhealthy treats.

• Regular Deworming and Flea/Tick Control: This helps prevent infections from parasites that can contribute to digestive issues.

• Managing Stress: Techniques like regular walks, playtime, and positive reinforcement can help reduce stress-related digestive upset.

• Close Monitoring: Keep a health diary noting your dog's stool consistency, behavior, and any signs of discomfort. This helps identify potential problems early on.

• Regular Veterinary Checkups: Scheduled checkups allow your veterinarian to monitor your dog's overall health and detect any potential issues before they escalate.

Conclusion:

Vomiting and diarrhea in dogs can be unsettling, but understanding the potential causes and available treatment options empowers you to act confidently. Remember, early diagnosis and appropriate treatment are crucial for your dog's well-being. Always consult your veterinarian for personalized advice and prompt intervention whenever your furry friend experiences these symptoms. By working together, you can ensure your dog enjoys a happy and healthy life with a comfortable digestive system.