Nausea

IMG_4296.JPG

I received a welcomed call from my older son while sitting in the BirchBark booth at the Human Race this year.  Knowing the next day was Mother’s Day I suspected an early well wishing… instead it was concern about his dog.   His 1.5 year old Daschund cross had been up and coughing since 5 AM and was bringing up clear foam.  After a visit to the emergency room in San Francisco and multiple phone calls later, we were able to determine Andy had kennel cough- but a case severe enough to affect the health of his esophagus (tube from the mouth to the stomach) and raise concerns about chronic disease that might take a life time of additional medical care. Luckily, his infectious disease had just irritated his esophagus and he has made a full recovery.

Nausea is an interesting part of disease in cats and dogs and can manifest for many reasons, ranging from motion sickness to severe disease in the intestines.  In Andy’s case his throat and esophagus were irritated enough to cause him to bring up not just his food, but his spit- particularly since his cough would trigger nausea that brought up both food and phelgm.  The mechanism of nausea remains somewhat of a mystery- but multiple parts of the brain linked to the intestines, balance center and emotional centers influence nausea.  

Any damage to the intestines- virus, chemotherapy or inflammation affect nausea. Motion sickness like the effects of a roller coaster alter the balance center and create nausea.  The scene in the movie “Stand By Me” where a taunted child seeks revenge by inducing mass vomiting is an example of emotional or sympathetic nausea.

AdobeStock_122249770.jpeg

Documenting nausea in veterinary medicine is a little more challenging since our patients don’t cross their arms across their belly and moan.  We look for drool, hard swallowing, lack of appetite and the obvious one: vomiting.  Seeking out grass and eating it is often considered a sign of nausea and an attempt to purge some discomfort from the belly. 

Reasons for nausea in pets include:

  1. Irritation to the throat (like Andy with his kennel cough)
  2. Malfunction of the esophagus which should propel food into the stomach automatically. If it is irritated, has muscle abnormalities or is blocked by foreign material or stricture- then pets may “regurgitate” which is different from vomiting in that it involves bringing up food or saliva without contraction of the abdomen.
  3. Stomach or intestinal disease such as viral infections, bacterial infections, inflammation or chemotherapy.  This is by far the most common category for nausea in pets.
  4. Obstruction of the intestines or outflow of the stomach which can be from a foreign body, twisting or telescoping of the intestines or stomach (bloat) and in rare cases parasites.
  5. Motion sickness or vestibular (balance) disease which creates a sensation of the world spinning.

Most important If your pet is unable to keep water down then a visit to the emergency is indicated so the possible causes can be explored and medication can be administered to relieve nausea.

Andy.JPG

When your pet has signs of nausea, consider the recent history- in Andy’s case we knew he had recently moved to a new part of the city and visited new dog parks with new canine friends. We also knew the stress of moving may have contributed to his getting kennel cough.  If your pet has recently consumed a large bone or tends to destroy toys- cats that play with string or chew rubber bands- those can all be a source of obstruction in the esophagus or farther down the intestines.  If your pet has not been vaccinated then infectious disease goes high on the list. 

We all want to be the best advocates we can for our pets- so when in doubt seek out advice or make a call to your local emergency clinic to help get guidance for your situation.

Blog Post Author: 

Merrianne Burtch, DVM, DACVIM