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Wednesday, July 20, 2011

Reasons Regarding Regurgitation

Please excuse my alliteration in the title, but it just sounded fun.  Here's an email from Stefanie....

I have recently taken on a second foster dog. She is only about a year old and is a border collie cross. A high energy dog - which is fine - I'm learning how to channel her energy. I've noticed though that she will glurp out water as she is walking or running around. She also even glurped (my non-technical term for regurgitation) out dog food and water about 6 hours after her last meal. It's not a lot and while she has actually vomited a couple of times - it's been different objects she's chewed on around the house - it's more the regurgitation that has me puzzled.
Is regurgitation a few times a day enough to warrant a vet visit? She doesn't have any other symptoms other than what I've described - still has plenty of energy and is bright-eyed. I am fostering for a rescue so ultimately the decision to take her to the vet is at their discretion, but your advice on when to have her examined is greatly appreciated.
 
I would most certainly take her to the vet, and plan on having x-rays taken.  As you've indicated, regurgitation is different than vomiting.  The former is passive, with the stomach or esophageal contents spilling out because of a lack of tone in the sphincters or muscle walls.  Vomiting is active, involving contractions of the abdomen and stomach.  There are very different indications for each, so we can't treat them similarly.
 
The biggest concern I would have for chronic regurgitation would be megaesophagus.  This condition occurs when the esophagus is significantly dilated for some reason.  Anything swallowed can sit in this expanded area rather than passing into the stomach, and after a period of time can suddenly "glurp" back out.  In younger dogs this is most commonly caused as the result of a birth defect where a vascular arch near the heart stays around the esophagus, essentially causing a stricture and eventually dilation of the esophagus.  There are causes of megaesophagus that are more acquired than a vascular abnormality, but they are not as common.  A hiatal hernia or problem with the cardiac sphincter of the stomach (the one between the stomach or esophagus) could cause similar problems.  But I would consider megaesophagus until shown otherwise.
 
Megaesophagus is a big concern, as there is a high risk of food or water running backwards through the esophagus getting down the trachea and into the lungs, causing what we call aspiration pneumonia.  This kind of pneumonia can be life-threatening and the risk shouldn't be ignored, even if it hasn't happened yet.  Even if it's not megaesophagus, anything being regurgitated can be aspirated into the lungs and therefore should be checked out.
 
There is no cure for megaesophagus, so efforts are put to management.  I have known dogs successfully managed for many years, but it involves being very careful about feeding and drinking.  These dogs always need to have elevated bowls so they do not have their heads down while they are trying to swallow.  Essentially we are letting gravity work with us rather than against us.
 
So see a vet about this before something worse happens.  Good luck, Stefanie!
 
By the way, I love the word "glurp" and may use it myself, if you don't mind!

14 comments:

  1. I am having this same regurgitation problem with my 12 year old male mixed breed ( Golden retr/ tibetan mastiff?). He has always lived in one house. A year ago my ex and I separated. He ONLY has this problem when he comes to stay with me, in a different house. NEVER when he goes back to his original house. He is calm and happy here. I watch him carefully and he does not roam outside and eat anything foreign. If he had the condition you describe, WHY would it only show up here, in this house? Is it possible for him to be allergic to something here? This has stymied three vets who have seen him. Please help.

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  2. An allergy may be a possibility, but something in the environment is unlikely to cause this symptom. If you are feeding a different food or different treats, a food allergy could be an issue. If you have plants in the house or yard that he is chewing on this could also be a cause. Otherwise I'd really have to look at his history, what has been tried, and any lab tests to figure it out. But if three other vets can't figure it out, I probably wouldn't be much help.

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  3. 3224No different foods, no plant chewing. I have not gone the xray route yet, but all of his blood work for normal checkups are always fine, in fact I am always told he is in remarkable shape for an older dog! I have some control over the problem by : now mixing his food in a blender to smoothie consistency, changing to 4 smaller meals a day, feeding in raised dishes, and putting a heavy mug in the center of the dish ( to slow down eating). Though none of these things are done back in his 'original' home and he does fine there! Research on line has indicated that the condition of megaesophagus ( which this could be?) can be exacerbated by stress, one type being separation anxiety. Though he is a completely mellow and adaptable dog, this seems the only possible explanation. ( though he does NOT do this when at a boarding kennel during our vacations, even new kennels...) THANKS so much for answering.

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  4. I have got a 2yr old border collie with this problem at the moment. She has been very flat and is regurgitating her food usually within a couple of minutes of eating. She has been eon hills i/d gastrointestinal food. She also has dilated cardiomyopathy which was diagnosed 3mths ago, and is currently on vetmedin. She has been to the vets, and has seen 4 vets and none can figure out what is wrong with her. Could it be this megaesophagus? What is the prognosis for this? She has had blood tests taken all normal, and has had bloods taken for myasthenia gravis - negative. Anything you can do to help would be greatly appreaciated.

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  5. Amy, talk to your vet about this. She may need specialized diagnostics such as endoscopy or upper GI barium x-rays. Megaesophagus has a guarded prognosis and is all about the care and precautions you use.

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  6. My large mixed breed (shep lab x?) will be 10 this November. He has been treated for diabetes for 2 years. He began almost constant regurgitation 5 days ago. Nothing stood out on the x-rays. The vet gave him Cephlexin, Prednisone and cough tablets 4 days ago. On the 3rd day the vet replaced the Prednisone with Sucralfate. There has still been no improvement and now there is noticeable weight loss. As I attempt to research I'm drawn back to megaesophagus. Any advice is greatly appreciated.

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  7. Megaesophagus can be difficult to diagnose because the disorder often doesn't show up well on x-rays. But it doesn't typically come on that rapidly and aggressively. An endoscope may be necessary.

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  8. I have a five year old Saint Bernard pure bred. She regurgitates about every two or three weeks for no apparent reason. She has no other symptoms. My vet doen't seem to be too worried. Is it possible that some dogs just have an overly sensitive stomach. She has always had food allergies and our brands are getting very limited. We are running out of brands. But the food we found has worked the best so far. No more diarrhea. But the occasional regurgitation.

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  9. There are definitely some dogs with sensitive digestive tracts, but I would still recommend expressing your concerns to your vet and have a more detailed discussion.

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  10. My dog (currently 1.5yrs old - Jack Russell) started regurgitating shortly after he had been neutered (about 6mths old at the time). It started with water and progressed to regurgitating many times a day - both food and water. He had x-rays done (plain film) which did not reveal anything concerning - no evidence of megaesophagus but I understand it does not always show. The vet prescribed Pepsid AC, Metoclopramide and a month long tappered course of Prednisone. Within a day of being on the Prednisone, the regurgitation stopped completely. Once the course was complete he would regurgitate but with substantially less frequency which eventually tappered off to once every month/month and a half usually after gulping a lot of water and/or trying to play after drinking a lot of water. He has been like that since June 2015. However, this month, after receiving his vaccines, he's started regurgitating again - almost once a day (although not every day). Usually only water but occasionally a couple pellets of undigested food. I'm not sure if this is related to the vaccines but I'm treating it as esophagitis (we assume this is what he has...likely mild and likely related to GERD). He has always been a "burpy" dog - he burps after eveey meal and almost every time he drinks water. He eats and drinks from elevated dog bowls and I am conscientious of how quickly he eats and drinks (we had issues with this when he was younger. Still drinks quickly sometimes - I've taught him the command "slow"). I have heard him whimper a handful of times when he drinks water. No other symptoms of GERD or anything else actually.

    I've restarted him on the Pepcid and Metoclopramide but am hoping to avoid another course of steroids.

    Of note, he has also been on plenty of antibiotics and Apoquel (related to allergies) and I've just read that swallowing pills and not washing them down with water may contribute to esophagitis. Oops. That will be another change to make.

    Any ideas? How long should I try to Metoclopramide/Pepcid before giving in to another course of steroids? Could this still be megaesophagus? I am assuming that if it was, it would not have disappeared with steroids...

    Thanks so much for the helpful article!

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  11. My 11 year old yorkie was hospitalized a month ago with pancreatitis and the past 2 nights around midnight has regurgitated. Is this common after pancreatitis? He acts fine and is eating and pooping like normal.

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    1. Pancreatitis shouldn't cause this. I would contact your vet to make sure he isn't having a relapse.

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  12. hi
    I have a 7 months old golden ret pure bred.recently since the padt 1.5 weeks he has been demanding and drinking a lot of water at a stretch and after which he regurigates his recent meal
    Please do suggest the problem with him
    Thanks in advance

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    Replies
    1. You should have him checked by a local vet, as there is no way for me to properly diagnose him. This could be a number of things from the serious (megaesopahgus) to the mild (filling the stomach too quickly). You'll need to have a visit to your vet.

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