I think I am old enough now that I can use the phrase, “You remember the good old days.” If you listen to the “older than me timers” you could feed your dog scraps, bones, pork or anything else lying around. They wouldn’t get sick and still live forever. And that’s a long time. I am not sure how true all this is, but I still hear it said by many of our charming senior clients. These days, we get several calls about vomiting or diarrhea patients every single day. Our patients compared to the past seem to have a much more “sensitive constitution,” as my grandma would have said.
There is good news and bad news with these symptoms, which often go hand in hand. Fortunately, the vast majority of our cases are nothing more than an upset stomach for some very simple reason. Unfortunately for us as veterinarians, vomiting and diarrhea are such vague signs that they can be associated with hundreds of diseases, from benign to deadly. Fortunately, we don’t have to work up every case with blood work, radiographs (x-rays), ultrasound, ct scan, exploratory surgery, etc. to diagnose a cause. Unfortunately, sometimes we do. Fortunately, most vomiting and diarrhea cases are really easy to treat, oftentimes with things you can do at home and with over-the-counter medications you may already have. Unfortunately it may take a few days to get things under control. Fortunately, most of these cases will be normal very quickly. Unfortunately, our patients can’t tell us where or why their belly might ache, which if they could, would be really fortunate…..for me.
The obvious causes of vomiting and/or diarrhea usually come up early in our conversation. Causes such as: “I switched dog food brands two days ago,” “my dog got into the trash yesterday,” “I fed him a plate of spare rib bones,” all are simple to diagnose and very straightforward to treat. IMPORTANT: A dog’s pancreas is set up to digest very lean meat, not fats such as pork. I have had dogs die from pancreatitis (swollen, inflamed pancreas) after getting one hot dog or a tablespoon of bacon grease to “flavor” their food.
Viral cases, which are very common, are not so easy, but may sound like: “My dog was fine yesterday, was at the kennel a week ago, now won’t eat, is quieter, vomited a few times yesterday and just doesn’t seem right.” There aren’t tests to diagnose these types of viruses, and just like people, they can just show up out of nowhere. Typically there are a few days between exposure to a virus and the onset of clinical signs which usually last only a few days. They may have a fever (above 103) for a day or two during this period. These dog gastrointestinal (GI) viruses are contagious among dogs, but don’t affect humans or vice versa. That is to say they are species specific. However, you can carry a dog virus home with you on your shoes and give it to your dog.
If all signs point to a regular GI virus, we have a very standard approach to treating these cases. We like to discontinue food for a day to let the stomach rest and settle down. We offer water but in small amounts several times a day. Ice cubes work well for this. We start them on a bland food diet for a few days. Bland foods include things like rice mixed with boiled chicken or hamburger (rinse off the grease), low fat cottage cheese, or scrambled eggs. A dollop of yogurt can help re-colonize the gut with good bacterial organisms too. Dog food is the equivalent of pizza and chili. If you have the flu and someone offers you pizza and chili, bad things are going to happen. Bland foods are like broth and crackers. Occasionally we use antispasmodic prescriptions to decrease the vomiting. If diarrhea is present (often shows up a day or so later) there are doses of Imodium that your veterinarian can suggest to help with that.
We call day three “hump day,” meaning that symptoms should be improving by then. If symptoms persist or worsen, we work the animal up completely. At least once a year, for a period of several weeks we will get a dramatic increase in the number of GI calls and we know something is “going around” (sounds like people!). If you have multiple pets, don’t be surprised if a week later it starts in someone else.
All of the above holds true unless we get a “red flag” on a case. Some of our red flags include abdominal pain, anemia, dehydration, amount of weakness, blood, and sometimes just a “gut” feeling that things aren’t right. We have to be ever diligent for that one patient that is different. These cases are much more serious and include things like pancreatitis, kidney/liver disease, diabetes, cancers, foreign body obstructions (plastic toys, socks, balls, bones, etc), or hormonal diseases. Red flag cases are worked up right away, as one day can make a difference in the outcome. (If they could only talk.)
Our classic foreign body case presents a little differently. Usually it is a young, very happy (use your own adjective here), outgoing, rambunctious, playful (often retriever), is eating very well, but the food comes back up undigested every time they eat. They usually feel pretty good even for a few days while this goes on. Then the abdominal pain sets in and they start walking hunched up. (If they could only talk.) Time for radiographs and get the surgery room ready!
If you have ever had a dog with explosive diarrhea you can appreciate the volume of liquid in the intestines. Remember, the intestine is a long tube that in a large dog could be more than 15 feet long. It’s no wonder that diarrhea can just keep coming. Also noteworthy is that a dog with an obstruction of the upper intestine, can still have normal bowel movements for a couple days. Generally speaking, if a dog is eating, keeping it down and having normal bowel movements, then the “tube is open.” In contrast, if they just emptied their entire GI tract with diarrhea, it will take a couple days for the next bowel movement to show up.
Most of these symptoms and diseases are also found in cats. However, there is one special variation on the vomiting theme in the cat world. It is mandatory in felines, that in the very wee hours of the morn that they wretch, moan, yowl and finish with a hurled up wad of hair that I guarantee no matter how hard you try to avoid it, will squish between your toes. We always say that the only good hairball is the one you find. Consider them cured.
Whenever I clean up the pile of vomit or diarrhea from one of our rug rats, it helps to remember our client in Middlebury with two Great Danes who both had explosive diarrhea for an entire night and destroyed a room because they had a “sensitive constitution.” Puts it in a little perspective I guess.
Jeffrey Vogl, DVM | Ask the Veterinarian