Graphic by Mihails Zuravlovs.

Vomiting, called emesis, is common in dogs and cats. Sometimes, vomiting is a normal part of being a dog or a cat; other times, it is the symptom of significant disease. Making a distinction can be difficult.

When a pet who has been vomiting regularly is brought to our clinic, we will ask about the time, amount and apparent contents of the vomit; whether your pet is still eating; and any correlation to feeding. A puppy that vomits foamy and phlegmy material that is sometimes yellow in color during the night or early morning can have what is called empty stomach vomiting.

In this situation, the vomiting might just result from the normal intestinal activity of a hungry puppy, as the gall bladder secretes bile into the intestines when there is no food to be digested. Feeding this puppy before bedtime or early in the morning is all that is needed, in most cases.

Another puppy might be bringing up food when it vomits. This could stem from internal parasites like roundworms. We will ask you if you see any worms, so close observation on your pet’s bowel movements is needed, especially for outdoor pets and when you go for a walk.

Pups that are ill and not eating, sometimes with blood in the vomitus, are clues in the history that it is more than empty stomach vomiting or worms. These pups might have the more serious disease called parvovirus, or a foreign body stuck in the intestines.

Internal parasites (worms) like this roundworm can cause vomiting. This parasite can also cause diarrhea. The proper name for this worm is an “ascarid.” It is most common in puppies and can infect the pup in utero, in the milk while nursing, and in the feces. We diagnose them by looking for the eggs in the feces, although often you will see them in the vomitus. Courtesy of Long Beach Animal Hospital.

The same applies to vomiting in adult dogs. In the history, we will ask about how much time your dog spends both indoors and outdoors. Vomiting adult dogs that spend a majority of time outside or go to dog parks commonly have dietary indiscretion. This is a polite way of saying they are eating some grass, junk, rotten food or garbage outside.

An indoor dog that is vomiting during the holidays brings up a suspicion of a toxin or pancreatitis, which is a much more serious problem than dietary indiscretion. Cats that are not eating and vomiting around the holidays bring up a suspicion of a foreign body, likely tinsel, stuck in the intestines. As a reminder, lilies are extremely toxic to cats.

Foreign bodies can cause vomiting. They sometimes show up on a radiograph, like this piece of cloth in the stomach circled in red (st: stomach; sp: spleen). Many foreign bodies do not show up on a radiograph, and we need ultrasound to detect them. Courtesy of LBAH.

An intestinal mass can cause vomiting. They usually do not show up on a radiograph, so ultrasound is used to make the diagnosis. Courtesy of LBAH.

The duration of vomiting is important. A dog or a cat this is vomiting for several days brings up the suspicion of a foreign body or a chronic disease like inflammatory bowel disease.

We might even ask if you brush your longhaired cat, since hairballs can be the cause of vomiting in this case.

Maybe you have changed the food recently, your pet might be on medication, or you may have given your dog or cat something to treat diarrhea.

In each of these scenarios, there is information regarding timing, amount, consistency, duration, and other GI signs that would give your vet a preliminary clue about the cause of the vomiting. The more you can tell your vet about the vomiting while the history of the instances is being recorded, the sooner the cause can be found or treated.

You will learn more about the diseases that cause vomiting next week when I talk about diarrhea, since many of them are the same and many pets that are vomiting have diarrhea simultaneously.