Why Jack's vomiting needed to be investigated!

Jack came to see us because he had been vomiting intermittently during the past two weeks, but then vomited 4 to 5 times on the day he was brought in. He had refused breakfast and was looking a little under the weather. On examination all his vital signs were normal, so he received an anti-nausea injection and was sent home for further observation.

When we phoned the owners the next day, they reported that Jack seemed worse, he didn't want to move much at all and appeared to be quite uncomfortable. They mentioned he may have eaten some wood recently and we became concerned about the possibility of an intestinal obstruction. The owners were unsure when he last defecated as well - further worrying us about the possibility of an obstruction. We decided to do some abdominal x-rays on Jack to check for any obvious blockages that would require surgery. Unfortunately x-rays will not detect all obstructions, as an item such as a sock or piece of plastic or corn cob (all common things we remove from dogs' intestines!) may not show up clearly. Jack's x-rays showed some excessive gas within the intestines, which in some cases indicates an obstruction, but in other cases just indicates that the bowel has stopped contracting normally. Apart from the gas, there were no other obvious abnormalities.

We needed more information to decide whether Jack had an obstruction requiring surgery so two further tests were done: a blood test and a contrast x-ray study. Jack had a blood test to check whether any other organs in his body were affected, such as the liver or kidneys, and the blood test would also show up whether he had high levels of inflammatory cells which might indicate a more serious problem. The other thing we would find out from a blood test was whether Jack had pancreatitis or not. Pancreatitis is an inflammation of the pancreas, the organ which is responsible for producing all the enzymes which break down your food so you can absorb the nutrients. Most dogs that develop pancreatitis show this problem by vomiting repeatedly, which was something that Jack was doing so we were keen to ensure he didn't have pancreatitis. Thankfully everything on the blood tests came back as normal, except for a mild increase in his inflammatory cell numbers.

Now that we knew Jack didn't have a pancreatitis or other internal organ problem, we turned our attention back to investigating the possibility of an obstruction further. Jack was fed a product called ‘BIPS'. BIPS are tiny beads that show up as a bright white colour on an x-ray. As they pass through the intestine, we can monitor their passage with x-rays to make sure they are travelling through without any problems. Jack's BIPS all managed to pass through without any trouble so we were confident that there were no obstructions present in his intestines.

Jack improved dramatically with supportive care consisting of an intravenous drip and some pain relief and was back with his family the next day. The most likely cause of his vomiting was a severe gastroenteritis, which may have been caused by a virus, bacteria, or toxin. Jack continued to improve at home and has made a full recovery at the time of writing.

A note on vomiting in cats and dogs:

Vomiting is a very non-specific sign in animals, and can be caused by a multitude of factors. Depending on how sick your pet is, the vomiting will be managed in different ways. For instance, if your pet is vomiting daily but still remains bright, active and keeps its appetite, we will treat it less intensively than the pet that is very lethargic and has stopped eating.

In Jack's case, because he was not eating and was very lethargic at home, we needed to rule out the more serious causes of vomiting such as pancreatitis and an obstruction. If not diagnosed swiftly and treated accordingly, these conditions are both life-threatening. Jack was lucky not to have either of these problems, but if your pet is vomiting and lethargic or inappetent, we strongly recommend it is examined as soon as possible to ensure it receives adequate treatment.