It could be caused by a perforation, but there are others causes of vomiting and diarrhea.
Parvo virus and distemper are the most common viral causes. These are part of the normal vaccination series that usually has 3-4 rounds every 3-4 weeks starting at 6-8 weeks of age. The final round is generally given when pups are 4-5 months of age. Enteric bacteria including Salmonella can infect dogs. Parasites are another common cause of diarrhea.
Puppies as well as adult dogs are not very discriminating about what they eat. Spoiled food, road kill, rodent poison, socks and other clothing...... can cause diarrhea and vomiting with or without blood.
If the vomiting and diarrhea continue, your pup should visit her vet. Take a stool (diarrhea) sample with you. If she has continued to vomit and has black tarry stools (melena), consider taking her to the emergency vet.
Meanwhile, she should not have any food or water. Anything in the stomach tends to stimulate vomiting. If she has not vomiting for 6 hours offer her a very small (teaspoon full) of water or an ice cube to lick/chew. Withholding food and water is used primarily for vomiting, but often helps with diarrhea also. After 12 hours of no vomiting, but some water, soft food is reintroduced slowly. By that time, she should have been to the vet and should follow her/his instruction.
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