Your dog stands up and quietly deposits his dinner from three hours ago on the rug. You panic—both for your dog and the rug!—but your dog seems fine otherwise. This type of throwing up is called “regurgitation.” It’s not vomiting.
When your dog vomits, he actively brings up food from his stomach. That means the food must pass through the gastroesophageal opening and go all the way up the esophagus. His sides move in and out, he makes the classic retching noises that can wake you up from a sound sleep. There is often bile mixed in the partially digested food.
With regurgitation, the food he ate has not passed into his stomach. For a variety of reasons, it is sitting in the esophagus, undigested. This type of throwing up has little warning before it comes up. You might hear a quiet burp as he lowers his head. There are no strenuous abdominal contractions.
Why Is My Dog Throwing Up Undigested Food?
Regurgitation is a classic sign of megaesophagus, a GI motility disorder. In this condition, the muscles and nerves of the esophagus are not normal, so the important motility required to move food along is absent. As food sits in the esophagus, the esophagus will stretch over time (hence, “mega” esophagus). Other causes include abnormalities of the vessels of the heart that block the progression of food and anything that blocks the opening of the esophagus into the stomach.
Some endocrine disorders like hypothyroidism are connected to regurgitation, as is myasthenia gravis, an autoimmune disease associated with muscle weakness. But not all dogs who gulp food voraciously are ill. If your dog throws up infrequently, you can chart the occasions to see if there is a trigger, such as eating too fast.
Puppies Throwing Up
Primary megaesophagus is a congenital problem noted in puppies when they switch over from nursing and liquid food to solid foods. You will notice failure to thrive and gain weight as well as regurgitation. A serious problem can develop from aspiration pneumonia as the affected dogs seem hardly aware that food is coming back up. Aspiration pneumonia is a life-threatening concern.
Megaesophagus has been shown to be of genetic origin in Wire Hair Fox Terriers and Miniature Schnauzers. Other breeds prone to this condition include German Shepherd Dogs, Great Danes, and Labrador Retrievers.
Diagnosis
Diagnosis depends on history and radiographs. If a plain X-ray is not definitive, a contrast study with barium may be recommended.
Treatment
Dogs with megaesophagus can be managed but are not cured.
You may hear of sildenafil (Viagra) being used as an off-label treatment for megaesophagus in dogs. A 2017 study published in The Veterinary Record showed sildenafil “could represent a novel therapeutic tool for the treatment” of idiopathic/congenital megaesophagus, but a 2022 study published in the American Journal of Veterinary Research, was less positive, concluding that: “There were no differences in esophageal clearance times or quality-of life-scores between sildenafil and placebo.”
Basically, treatment for megaesophagus in dogs requires your commitment. Any underlying conditions such as endocrine disorders need to be dealt with, but often the esophagus will not totally recover.
That means daily, lifelong care by you. You must be observant for the slightest sign of aspiration pneumonia as that is often the cause of death.
Some dogs will do fairly well with a certain texture of food, such as a slurry or multiple small “meatballs.” The diet must be high quality and high calorie, so you don’t need to feed large meals.
Most often these dogs need to be fed elevated and kept elevated for at least 15 minutes after eating. The simplest way to feed your dog is with a step stool, with him on his hind legs and his food bowl on a higher step.
Many families choose to go with a Bailey chair. These chairs keep your dog upright to eat and for the “holding time” postprandial (the immediate time after eating). You can purchase one or make your own via plans.
