Chronic Vomiting in Pets
Written by Shula Berg BVSc CertAVP(GSAS) GPAdvCert(SASTS) MRCVS
Clinically reviewed by Elizabeth McLennan-Green BVM&S CertAVP(SAM) MRCVS
Table of Contents
Vomiting is the active process of bringing up food or fluid from the stomach. Vomiting regularly for more than two weeks is considered chronic and, unlike an acute bout of vomiting, is more likely to be caused by an underlying problem.
Vomiting can be caused by conditions affecting the stomach or intestines, as well as more systemic conditions such as endocrine disease or organ dysfunction. Common conditions affecting the stomach and intestine that cause vomiting include enteritis (chronic inflammation), ulceration, and obstruction.
Vomiting is always accompanied by contraction of the abdominal muscles, and may be preceded by signs of nausea such as lip-licking and gulping. A passive process in which food or fluid is emitted from the mouth with little to no warning and no abdominal contraction is known as regurgitation. Regurgitation often occurs shortly after eating. It is important to differentiate between vomiting and regurgitation as they have different causes and treatment.
Coughing may sometimes be mistaken for vomiting. Coughing tends to occur in bouts, and causes a longer period of hacking/retching, followed by a relatively small amount of emission from the mouth. Coughing causes clear or white froth, foam or fluid to be brought up, but not food.
When approaching cases of chronic vomiting, the animal's age and breed, any known concurrent disease, and their vaccination and worming status will help to guide investigations. Other important information includes the duration and progression of symptoms, the nature and timing of the vomiting, whether diarrhoea is present and any recent dietary changes. You may also be asked if your pet has other symptoms, is a scavenger, or could have had access to anything toxic.
A thorough clinical exam and history taking is always the first step in diagnosis. Further testing will then be required, including some or all of the following:
General Blood Tests
These are used to provide an overview of organ health, as well as checking electrolytes (such as potassium) and often lipase (suggestive of pancreatitis). If results suggest a systemic disease is present, more directed blood tests may be required.
Intestinal-Specific Blood Tests
Measurement of three specific parameters, known as folate, TLI and B12, provide more precise information about gastrointestinal function and nutrient absorption. Deficiencies can be indicative of a disease process but also require treatment.
Ultrasound and/or x-rays may be required to assess organ shape and size, examine the gastrointestinal system, and screen for signs of obstruction (such as with a foreign body). Not all foreign bodies will be evident on x-ray, and if there is a high suspicion, exploratory surgery may be recommended. Sedation or anaesthesia is often required for imaging, especially if the abdomen is uncomfortable.
Ultimately, endoscopic or surgical biopsies of the stomach and intestines may be required for diagnosis, especially to differentiate between severe inflammatory disease and cancerous changes.
Treatment depends largely on the results of investigations. Any underlying disease identified should be treated first, as this may lead to resolution of the vomiting. If the patient is dehydrated due to repeated vomiting, hospitalisation and intravenous fluid therapy may be recommended.
If an obstruction or foreign body is suspected, exploratory surgery may be advised to diagnose and treat the problem.
Non-specific medication for vomiting includes anti-emetics (prevent nausea/vomiting), pro-kinetics (encourage movement of the intestines), and antacids (reduce the amount of stomach acid produced). These may be used as sole treatment or alongside other treatment.
A prescription exclusion diet is used to diagnose and manage food responsive enteropathy. This diet is fed for 4-6 weeks but improvement may be seen as early as 2 weeks. If chronic enteropathy is suspected, parasite treatment and an antibiotic trial may also be used.
The prognosis for chronic vomiting is variable, depending on the cause. Pets vomiting due to gastrointestinal obstruction can usually see complete recovery after surgical resolution of the obstruction. Pets who are systemically well and respond well to a diet trial can usually be managed very successfully long term.
Please note that the content made available on this webpage is for general information purposes only. Whilst we try to ensure that at the time of writing all material is up to date and reflects industry standards, we make no representation, warranties or guarantees that the information made available is up to date, accurate or complete. Any reliance placed by yourselves is done so at your own risk.
Page last reviewed: 16th January 2024
Next review due: 16th January 2026