A Primer on Vomiting

Gross title, I know, particularly for those of you not in a medical profession. It takes a strong stomach to read about vomit (and poop, for that matter), but I hope you will take a few minutes to ponder the following information. It just may prove beneficial in caring for your pet’s health.

“Normal” Versus “Abnormal” Vomiting

It’s normal for most dogs and cats to vomit once or twice a year. The cause may be a passing virus or ingestion of something that the gut deems “unagreeable”. Unexplained vomiting that occurs more than a few times a year, however, I consider to be abnormal and deserving of medical attention.

One would think that stepping out of bed barefoot into a puddle of yuck, or new white carpeting decorated with bile stains would initiate a veterinary visit. Yet many people, vets included, make the mistake of ignoring upchucking as long as the animal appears normal otherwise. They justify the vomiting with excuses such as:

  • He eats too fast. Baloney! The normal stomach expands just fine whether dinner is consumed over seconds or hours.
  • She has hairballs. Clogging of the pipes with feline fur is commonly blamed for vomiting, a fact that causes much rejoicing amongst hairball remedy manufacturers. All cats groom themselves and swallow hair in the process. So it only makes sense that hair is often present in feline vomit. This does not make the fur the bad guy- it’s really nothing more than an innocent bystander. Do hairballs ever cause vomiting? Yes, but rarely, and I’m only willing to buy into this diagnosis when the upchuck contains nothing much more than a big ole’ wad of consolidated cat hair.
  • He vomits because he eats grass. This is a classic “chicken versus egg” conundrum. Do animals vomit because they eat grass or do they eat grass because they feel the need to vomit? Some dogs and cats are grazers. They enjoy munching on greenery and do so without vomiting. This I consider normal. What is abnormal are those dogs and cats who, in response to their nausea or gut discomfort, develop a yen for eating grass, leaves, twigs, dirt, and whatever else Mother Nature is serving. Young veterinarians are sometimes fooled by this. They perform surgery to remove a bunch of foliage from an animal’s stomach, but fail to examine the entirety of the bowel looking for the reason the dog felt the need to eat the stuff in the first place.
  • Vomiting is normal in cats. No, it is not!

Causes of Vomiting

Vomiting is a super non-specific symptom- I could list more than 100 diseases/abnormalities capable of causing dogs and cats to vomit. While it is always tempting to think something must be awry within the gastrointestinal tract (stomach and intestines) when vomiting occurs, one will frequently miss the diagnosis wearing such blinders. Abnormalities within the liver, gall bladder, kidneys, and pancreas commonly cause vomiting as a primary symptom. Vomiting can also also be associated with some hormonal imbalances and in cats, it can be a symptom of heart disease.

These days, one of the most common causes of vomiting in dogs and cats is inflammatory bowel disease (IBD) in which the lining of the stomach and/or intestines becomes infiltrated with inflammatory cells. Although the exact cause of IBD is uncertain, it is thought to represent an allergic reaction within the bowel. Left untreated in cats, IBD can morph over time into a cancerous condition called lymphoma (one good reason to address vomiting sooner rather than later).

Diagnosis and Treatment of Vomiting

The diagnosis of vomiting begins with you providing a thorough history for your veterinarian. Include details such as frequency, time of day, material found in the vomit, anything unusual that might have been ingested, normal diet, and all other symptoms observed. Next comes a thorough physical examination. This may be followed by blood and urine testing (to evaluate liver, kidneys, pancreas, etc.) and/or imaging studies such as X-rays and ultrasound. In some cases, biopsies from the gastrointestinal tract are needed to confirm a diagnosis. Biopsies can be obtained surgically or via endoscopy- a long telescope device that is nonsurgically passed into the bowel. (Those of you over the age of 50 know exactly what I’m talkin’ about!)

If such testing is not feasible, empirical therapy (treatment without a clearcut diagnosis) such as changes in diet and/or medications will be an option. Compared to 20 years ago, vets today have quite the arsenal of safe and effective antiemetics (drugs that prevent nausea and vomiting) at their fingertips. Medications to reduce stomach acid production are also commonly used when trying to resolve vomiting in dogs and cats. All such therapies should be administered only under a veterinarian’s supervision.

If your dog or cat is vomiting more than a few times a year, pick up the phone and schedule a veterinary visit to figure out the cause. As with any medical malady, the sooner the problem is addressed, the better the outcome is likely to be.

Does your dog or cat vomit more than a few times a year?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

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18 Comments on “A Primer on Vomiting

  1. Dr. Nancy,
    I liked your compact answer to the cat hairball problem. I do give my cat hairball remedies and sometimes groom her, but never clipped her. I guess I need to groom her more often which is really a no-brainer!
    In the last few days, one of my dogs has started vomiting up his food.He had sort of gagged a couple of days before this happened and he has also started eating grass which comes up with the vomit. He has DM and has been on Novox for approx 6 months, so the vet is thinking a possible stomach ulcer. I sure don’t want to do much invasive to see what is wrong. Today I have taken him off all his meds, cut back to bland, small amounts of food and made sure he has plenty of water when he wants it.

  2. When a kitty truly is vomiting because of hairballs, the potential solutions include hair ball remedies (flavored vaseline), frequent grooming (by the human) to remove excess hair) and full body clipping to prevent ingestion of all that hair. Hope this helps.

  3. This in interesting to read, Dr. Nancy. since I realize in dogs it can be a serious problem. My dogs also eat grass and I haven’t seen any vomit, so have assumed it’s just something they needed.
    My cats, on the other hand, have always thrown up hair balls. My current cat is a long hair and she regularly(once or twice a month) vomits up a 1/2 to almost 1 inch hair “poop” shaped object. It is always preceded by her cutting back on her food so I know one is coming. It is always just a hair formed long mass with not much of her food included. I have assumed this is normal and am grateful she is able to cough it up verses becoming impacted or? Her vet checks have been normal and thus I still have thought it to just be a part of being a cat and a long haired one at that. Thoughts??
    Thanks for your very informing articles. I never miss one!
    Jan Stice
    Salem,VA

  4. Thank you SO much for this article! Our housemate’s cat vomits at least 5-6 times per week. We have tried and tried to convince her to have a more thorough vet exam on him, but she insists that this is “normal” for him. I’ve forwarded this to her; hopefully it will be enough to convince her to take it more seriously!

  5. With 4 dogs in the house, we seldom know who’s done it if it doesn’t happen in view. I’ve always been told that dogs, like wolves, vomit at the drop of a a hat since that’s part of the regurgitate food for pups process. Nancy’s views change my complacency about vomiting just as dog trainer Pat Miller (Whole Dog Journal) and Karen Pryor showed me that “Alpha/dominance” training was outdated – shame on you Dog Whisperer Cesar.

  6. Great post. I am passin it along to my neighbor with two of four cats decorating her rug -one hairball, the other does need a crate ride.

  7. After reading these posts in my email, I always go to the blog; even if I have nothing to say, I often learn a lot from everyone’s comments. And as to the subject matter here, I always say: “Us dog owners: we’ve not only seen it all, we’ve cleaned it all up!” :-)

  8. Can you discuss the distinction made between regurgitation and vomit.

  9. I knew when my (then) 9 year old Rottweiler began vomiting large amounts of bile and food that something was wrong. It was also coupled with bouts of diarrhea or “cowpie” like stools. After nearly a year of tests and trials with different foods, she’s now on a regimen for suspected IBD (I opted not to have the rather expensive and invasive diagnostics at her age). I’m happy to report she’s been doing well on the regimen and hasn’t had another vomiting incident in about 18 months (she’s an 11 year old now).

    I did keep a detailed daily journal as we went through this whole process. Everything from the time she ate, what she ate, time she vomited, what was in it, BMs, etc. (sorry if you’re eating lunch/dinner while reading this!), and shared that with the vets who were helping us get to the bottom of the problem.

    My mixed breed is definitely a grazer! Fortunately no vomiting issues with him :-).

    Thanks for reminding us that we know our pets best, Dr. Kay.

  10. I wish I had seen this a long time ago. My dog had episodes of vomiting 3-4x a month, but I never saw. I thought it was due to empty stomach. Eventually. SE was diagnosed with stomach cancer. Multiple ultrasounds failed to find it, and we didn’t know until a necropsy. I would have pressed harder sooner. We had told our vet many times.

  11. Thanks for sound information and much needed ‘how-to’ advice on vomiting pets. We see tons of vomiting in cats and dogs – it is the #1 reason folks bring pets into the ER!

    In may cases it is something simple that will pass with minimal intervention, but it can also be a sign of something more serious and deserves some attention and diagnostic testing.

    I am saving this one to hand out to clients and passing along to my pet-loving friends!

  12. Agreed, not exactly something that we all want to have to read about, but we do. I really appreciate this info. Any time our girl vomits i want to rush her to the vet as if she’s dying. The couple of times in all the years where she has, she usually just needs rest and fluids and ends up being just fine. Thanks again for the post. I can see me referring back to it! :)

  13. I think it’s sad when even a vet underestimates the fact that a dog is vomiting. Just recently one of my friend had a dog who had low appetite, was vomiting. First visit? They were given antiemetic, without any diagnosis at all. Of course, the vomiting stopped, temporarily but just throwing medication without attempt to diagnose what’s really going on? Took another vet to eventually find out it was a lymphoma.

    Another friend brought in a vomiting dog and was told that it’s probably allergies and to change food. Again, without any diagnostics whatsoever.

    If my dog is vomiting, I want to know EXACTLY why. I don’t want to guess and I don’t want to throw things on it just to cover up the symptom without taking care of the cause.

  14. My vet thinks my 5-year-old cocker may have IBD. She’s had two episodes of vomiting with a bit of blood in it, and mucousy bloody diarrhea. Both times she had been eating the same food, so I have my fingers crossed that her new food will not cause another recurrence. She also frequently runs outside, eats grass, then vomits back up the grass plus yellow stuff after I get home from work. I think that is due to excitement and maybe being hungry. I hope so, anyway. She will come back inside and eat afterward so I don’t worry too much. The vet is aware of this too, and I note it on a calendar. When any of my guys gets sick I bring the calendar in so the vet can see the history leading up to the bad stuff.

  15. I have had a few dogs who loved to eat grass. One of my dogs now is obsessed, the main attraction of going for a walk is the grass buffet along our street which apparently has even better grass than our back yard. He will pull on the leash to get to his favorite tufts of grass along our route.

    He does sometimes vomit the grass, other times not, and when he does it’s just grass, no food. When his food makes him sick, he vomits the food, as you say, maybe once or twice a year. So, do you think the grass indicates a problem? I think sometimes he gets a bit that irritates his tummy, otherwise it comes out in his poop. I think he eats it because he likes it, loves it, is obsessed with it. He did live on the street for a while, maybe he developed a taste for grass because he was hungry?

  16. My Westie vomits all the time and I have heard other Westie owners say the same thing, It is clear with a little foam. It happens in the morning and it always happens after he has gotten excited. He doesn’t act sick and he doesn’t usually gag – he just stops, opens his mouth and out it comes.