Last week I received an early morning distress call from Pippa’s owner. Pippa had vomited four times during the night and had not slept at all - even keeping the family up in the process. The last bout of vomiting had also contained some blood.

Vomiting is a very common symptom in dogs and may have many different causes

Pippa is a five-year-old female Pekingese, and very much a family dog that has hardly ever suffered from ailments, so everyone at home was alarmed and distressed to witness such violent vomiting.

The Pekingese is a small, long-haired, flat-faced dog and a very popular breed in Malta. This dog is an ancient Chinese toy breed also known as the Lion Dog, due to its resemblance to the lion statues found at the entrance of many Chinese imperial buildings. I have always found the Pekingese to be among the most docile of the smaller breeds, and Pippa was no exception – a really sweet-natured dog.

Vomiting is a very common symptom in dogs and may have many different causes. The fact is that dogs vomit very easily when compared to, say, cats, horses and even humans. This is possibly due to their ancestral ‘pack’ origins and instinctive competition to eat – a sort of philosophy of ‘eat now, think later’. So vomiting in dogs should be considered as a form of defence of the stomach against anything it considers undesirable.

The rule of thumb on a normal healthy dog is that any vomiting which is less frequent than once a week could be ignored. Any vomiting that occurs more frequently than that should tell you that something is not quite right with your dog.

In addition, when a dog vomits, even on an empty stomach, precious nutrients are being lost together with liquids and electrolytes, and a relatively healthy dog can quickly deteriorate. Pippa had, in fact, vomited four times in one night, so her owners had good reason to be worried.

In cases of repeated vomiting, first of all it is important to make sure that there is no general illness which may be causing this. In particular, the most important of these are possible kidney and/or liver conditions.

Irritations of the stomach lining due to dogs’ instinctive propensity to ‘eat now’ is a common problem. Dogs are capable of eating anything and everything they might regard as food – including bones.

Dogs also occasionally ingest foreign bodies, such as pieces of toys or small stones. While stones can be very easy to diagnose because they are very visible on X-ray, other foreign objects can be difficult – as in the case of peach stones, which are hardly visible on X-ray owing to their organic woody composition.

If objects such as peach stones are ingested and are small enough to travel down the intestine, this results in intermittent bouts of vomiting, which is generally beneficial for the dog, but terrible for rapid diagnosis.

Perhaps the one that tops my list with regard to difficult diagnoses was an internal hernia which was only resolved during exploratory surgery when we found that the dog’s intestines had become entangled through a tear in an adjacent intestine.

A simple symptom such as vomiting could have a straightforward cause, but it could also have a complicated source. In such cases, if unresolved, it very often becomes a race against time to save the dog.

There are a number of other conditions which could cause repeated vomiting. Megaesophagus is a congenital defect where the pipe taking food down from the mouth to the stomach is wider than it should be.

This means that the food ingested by the dog never makes it to the stomach and in most cases is regurgitated soon after being swallowed. There are also a number of abdominal tumours that can cause vomiting and an ultrasound examination will reveal such tumours.

Perhaps it’s worth mentioning that you should always be vigilant about items that your dog could possibly ingest – be it edible or not. Apart from upholding good feeding principles, you should also avoid allowing small-sized toys, particularly if you know your dog has a habit of carrying things in its mouth.

What is important if and when vomiting does occur, is to gather and observe as much information as possible for your vet, who will ask you for all related information: how many times? How long has it been going on? What came up? Was it related to drinking or eating or both? How soon after ingesting does it happen? Are stools being passed in the meantime? What are they like and when was the last incident?

All this information will help your vet assess how serious the condition may be and will avoid losing valuable time if a serious situation does exist.

Pippa’s blood tests turned out just fine. She had been given a doggy treat she enjoyed tremendously just a couple of days before, so diagnosis was quite straightforward. Pippa’s owner called the next day to let me know that all vomiting had stopped and that Pippa was getting back to normal and showing the first signs of a return of interest in food.

Dr Martin Debattista is a veterinary surgeon.

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