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Last night she vomited up some bile and now she refuses to…

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Last night she vomited...

Last night she vomited up some bile and now she refuses to eat or drink anything A 4 month old puppy

Veterinarian's Assistant: I'll do all I can to help. Hopefully it didn't make a mess. Did the puppy eat anything unusual?

No, just her normal diet

Veterinarian's Assistant: OK. The Expert will know what to do. What is the puppy's name?

Fox

Submitted: 5 months ago.Category: Dog Veterinary
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Answered in 4 minutes by:
3/17/2018
Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago
Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,981
Experience: Over 20 years of experience as a veterinarian.
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Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago

I am sorry to hear that Fox is vomiting yellow material and has lost her appetite.

Yellow in the vomit means that the small intestine is refluxing bile into the stomach so that when she vomits you see the yellow color.

That isn't normal as bile doesn't belong in the stomach, and it does mean that there is some reverse motility, but it isn't specific for any particular disease process.

Bile is very irritating to the stomach and esophagus, and that along with whatever led her to vomit in the first place is likely also playing a part in her loss of appetite.

She is likely dehydrated because she is vomiting, but if even water is making her vomit you need to take it away from her for now.

In most cases vomiting is triggered by eating something they should not, too much table food, too many treats or something they find outdoors.
More serious causes of vomiting in puppies include viral or bacterial infections, a dietary allergy or sensitivity, congenital internal organ failure (kidney or liver disease), or a full or partial gastrointestinal obstruction.
In a young dog, especially one that hasn't finished her vaccine series, a viral infection such as Parvo virus or a foreign body leading to a partial or full gastrointestinal obstruction would be the most likely cause of her symptoms and either one can be deadly. Not all dogs with viral infections run a fever initially, sometimes they are too weak to mount a fever response. Worms can cause loose stools, but rarely cause vomiting and lethargy.
Because she is young, this has been going on for more than a day, and especially if she is lethargic ideally she would see a veterinarian now. Young puppies dehydrate easily and she needs fluids.
If that isn't possible for whatever reason there are some things we can try at home, but we cannot replace in clinic intravenous fluids and injectable medications so if she isn't responding quickly she should see a veterinarian promptly.
To try and settle her stomach you can give either:
1) Pepcid ac (famotidine) at a dose of one quarter of a 10mg tablet per 5 to 10 pounds of body weight every 12 hours
OR
2) Prilosec (omeprazole) at a dose of one quarter of a 20mg tablet per 10 to 20 pounds of body weight every 24 hours
These are acid reducers and may help her feel less nauseous and hopefully stop the vomiting and improve her appetite. They are quite safe and can be used for several days if necessary.

I would pick up all food for now and water for a couple hours to allow her stomach to settle after the acid reducers.

In a couple hours when you give her water make sure it is in small amounts only. If she drinks too much too quickly that can lead to vomiting. To get some electrolytes in you can also offer her a 50:50 mix of pedialyte and water.
If there is no vomiting for 12 hours offer a bland diet of 1/3 boiled, minced, white skinless chicken or boiled, lean hamburger and 2/3 boiled, white rice mixed with some low salt chicken or beef broth to make it easy to lap up and swallow and get additional fluids into her. If she refuses that, you can offer a little meat baby food. If she refuses both then she needs hands on veterinary care as soon as possible.
But if things go well and she does eat the bland diet and doesn't vomit feed her the bland diet for 3 to 4 days then slowly start to mix back in her regular puppy food, a little more at each meal. It should take about 5 to 7 days to slowly convert her back to her regular diet.
If she continues to vomit even with the acid reducers, runs a fever (more than 103F rectally), or has a lower than normal temperature (less than 99F), has a tense painful belly, or if she refuses to eat even after the acid reducer is given she should see a veterinarian for an examination, diagnostics, injectable anti-nausea drugs, intravenous fluids and supportive care.

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Customer reply replied 5 months ago
I actually still had the vomit in the trashcan from last night and checked on it, the vomit was actually a regurgitation and not bile. There was an undigested peanut in the mix that she must have picked up and the rest was just chewed up dog food. What does this change and what can I do?
Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago

Did you see this happen?

Whether the food is digested or not doesn't necessarily mean regurgitation rather than vomiting.

Dogs that vomit soon after eating may vomit food that looks undigested/whole.

If she seems to be regurgitating (passive outflow with no retching or effort) rather than vomiting (active retching with abdominal contractions) then this can be an early sign of a gastrointestinal blockage or rarely a condition called megaesophagus.

I would try my recommendations and see how she comes along, but if she's not perking up quickly or vomits/regurgitates again then an exam is warranted.

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Customer reply replied 5 months ago
I saw it happen but I was very tired and only half awake. It was hours after she had eaten her food. But there was no bile like I had previously told you.
Customer reply replied 5 months ago
She also has diarrhea but there is no blood in it.
Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago

No worries, I understand it may be hard to remember something that happened late at night.

It sounds like she definitely has abnormal motility, and isn't digesting things as she should. That happens with gastrointestinal inflammation and upset.

Bile being present or not she is showing signs of significant upset if she vomited, has diarrhea and is refusing to eat and drink.

If she's not fully vaccinated this may be viral in origin, or perhaps she ate something you don't know about. If she ate a lot of peanuts then she may have a full or partial obstruction. Given her age, persistence of symptoms and refusal to eat/drink anything the best step would be a veterinary exam now, but if that isn't possible you can try the things I recommended.

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Customer reply replied 5 months ago
She is fully vaccinated but I'm currently unable to get her a veterinary exam
Customer reply replied 5 months ago
How can I know if she has parvovirus? Would she vomit again? She has been vaccinated for it
Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago

If she is finished with her Parvo virus puppy vaccines it is unlikely that this is Parvo virus. Most fully vaccinated dogs are protected.

But without in clinic testing we cannot say for sure that this is NOT Parvo virus.

Treatment for viral infections is supportive care (antinausea injections, injectable antibiotics to prevent secondary bacterial infections, intravenous fluids), so at home try to provide similar supportive care such as an oral acid reducer, bland diet with lots of fluids added and rest. If she isn't responding you must find a way to have her seen by a veterinarian.

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Customer reply replied 5 months ago
Should I implement treatment without a clear diagnosis of viral infection?
Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago

We would use the same supportive care for any patient with nausea/loss of appetite until we achieve a firm diagnosis. None of the things I recommended would hurt her, but if she has an obstruction or she is extremely nauseous they may not be enough to help her. It is fine to try the things I recommended, because they won't hurt her no matter what the cause of her symptoms may be.

But I want you to be aware if she is not responding she must be seen.

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Customer reply replied 5 months ago
Could I find the treatment at a local pet store?
Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago

The acid reducers and Pedialyte I recommended are human medications that you can purchase at the drug store.

The bland diet mix ingredients (beef or chicken, rice) are available at the grocery store.

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Customer reply replied 5 months ago
If she isn't vomiting anymore but still is acting lethargic and refuses to eat, does that give you any more of a clue of what her issue may be?
Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago

No, it does not.

If she isn't eating that means she is nauseous, she just isn't actively vomiting because she doesn't have anything in her stomach.

The fact that her symptoms continue and that she is lethargic is very worrisome though, and so we want to address that nausea and hopefully get her eating and drinking.

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Customer reply replied 5 months ago
Understood. Also, when she yawns I can see that the back of her throat is discolored. Does that mean anything?
Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago

No, not necessarily. Some dogs have darker or lighter pigmentation in their mouths/throats. If the tissue was raw/bleeding that would be concerning.

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Customer reply replied 5 months ago
I have a 5ml oral tube for the pedialyte and water. How much should I give her? Also what signs should I continue to look for in order to determine whether she has parvovirus or another issue?
Customer reply replied 5 months ago
She just drank water but not in her normal bowl next to her food and she is showing signs of wanting foods that she doesn't normally eat.
Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago

How much to give depends upon how much she weighs.

A normal dog needs to take in roughly 1-2 ounces of fluids (from eating and drinking) per pound of body weight per day.

One that is sick, has vomited or had loose stools, will need more to replace lost fluids.

You likely will not be able to force the amount of fluids she needs orally, bu whatever you can get in should help.

5mls = 1 teaspoon, there are 6 teaspoons per ounce.

If she weighs 10 pounds she would need 10-20 ounces, or 60 to 120 teaspoons per day.

Try to give her some fluids every hour or two. Perhaps 4-5 of the 5ml measured tube.

I am glad she is drinking. If she continues to do so you won't need to force fluids.

Offer her a small amount of the bland diet mix instead of her usual diet and see how that sits with her.

If she eats well feed her small amounts every couple of hours, adding warm water or broth to get enough fluids in.

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Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago

Signs of trouble that indicate she is beyond home care are if she continues to vomit even with the acid reducers, runs a fever (more than 103F rectally), or has a lower than normal temperature (less than 99F), has a tense painful belly, or if she refuses to eat even after the acid reducer is given, or has large quantities of bloody diarrhea.

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Dog Veterinarian: Dr. Kara, Veterinarian replied 5 months ago

We've been chatting for 2 &1/2 hours now. I need to log out for a bit. If you have further questions you are welcome to leave them for me & I can address them when I come back online later today.

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Customer reply replied 5 months ago
Ok thank you
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