Ask Your Vet: Chronic Vomiting by Stefanie Wong, DVM

Does your pet vomit on a regular basis (once to several times a week)? If so, this is not normal behavior and may be an indication that your pet has an underlying illness. There are many different causes for chronic vomiting in pets. Here, I’ll outline some of the more common disease processes, and how we treat them.

First of all – timing is very important. For example, if your pet is vomiting primarily in the early morning before being fed, they may have a condition called bilous vomiting syndrome. This is a condition that can be seen if there is too long of a wait time between feedings. Let’s say your pet is fed at 5pm, and isn’t getting breakfast again until 7am. Over that 14-hour period, bile within their gastrointestinal tract may start to build up in and irritate the stomach – which can trigger vomiting. If we suspect bilous vomiting syndrome, the first thing we will recommend is that you feed a snack at bedtime. This is best done by taking a portion of what they are being fed for dinner and offering this right before they’re about to go to bed (i.e. if they get fed ½ cup at dinnertime, only feed ¼ cup at 5pm, and then feed the other ¼ cup right at bedtime).

Another possibility is your pet may have a food allergy. Food allergies can cause a large range of symptoms, from increased itching and scratching with ear and skin infections, to diarrhea and vomiting. Most often, animals may be allergic to the grains within the food (why we often recommend grain free) and proteins such as chicken or beef. What we typically recommend first is to try a diet change – for more information on food allergies and which diets are best, click here.

Inflammatory Bowel Disease (which we also refer to as IBD) is another common reason for chronic vomiting, diarrhea and/or weight loss. Any one or sometimes all three of these symptoms can be seen with this disease process. This is seen when the immune system deposits inflammatory cells within the walls of the intestine. The intestine (as a result of this inflammation) becomes thickened and is unable to absorb and digest nutrients appropriately. We are able to view and measure the thickened intestine by performing an abdominal ultrasound. Treatment for IBD is often a combination of diet change, vitamin B12 supplementation and (if necessary) steroids to decrease inflammation.

It is important to note that another condition that mimics and looks and acts just like IBD is a disease called small cell lymphoma. This is a cancer that deposits lymphocytes into the walls of the intestine, also causing thickening and thereby decreased absorption/digestion of nutrients. The only way to definitively be able to tell the difference between IBD and small cell lymphoma is by obtaining samples of the intestines themselves – this can either be done by endoscopy or surgery.

There are many more causes than I outlined in this article for chronic vomiting, however this covers the most common issues involving the stomach and intestines. It’s important to know that vomiting can also come from issues involving other internal organs. One of the first diagnostic tests we will recommend if your pet comes in for chronic vomiting is a blood work panel (to make sure there are no issues with the other body systems – for example, liver and kidneys). If there is no apparent cause found on blood work, then we will often move into a more in-depth examination of the stomach and intestines.