Tummy Troubles? What to do…

Given the secret lives of pets, and their propensity to vacuum up and swallow anything, digestible or inedible, natural or man-made, palatable or not, it’s not unusual for vets to see pets off-colour with vomiting and diarrhoea. In reality, these symptoms are very non-specific and can result from many diseases, ranging from a simple, 24-hour, tummy bug, that resolves without intervention, through to catastrophic and potentially fatal diseases.  It falls upon a vet’s shoulders to work out which patients need investigation, and which can be sent home on pills.  Here’s some first-aid tips: when to sound alarm bells, and when to feel comfortable with dietary management alone.

Fecal scoring from 1 to 7.  Yes, such a scale exists

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Causes and frequency of tummy upsets in pets

For the pessimists or medico-obsessed, who love filling their heads with uncommon, nasty possibilities:

  • Blockages or perforations of bowel: bones, rocks, sticks, socks, condoms, satay sticks – anything, really
  • Catastrophic events: abdominal trauma, gastric dilation volvulus, intususceptions, torsions
  • Poisonings ranging from insect, tick, toad, and snake venoms, to toxic plants and microbial blooms (rotten things), and man-made agents including insecticides, herbicides, and heavy metals.
  • Organ disease/failure involving liver, pancreas, kidney, gall bladder, and uterus
  • Cancers of the bowel, anywhere from throat to anus, or other abdominal organs
  • Immune system diseases: allergies to food, acute reactions to insect bites, autoimmune diseases
  • Viral diseases: canine hepatitis, parvovirus and distemper; feline panleukopenia
  • Worms: round, hook, tape, whip and heart
  • Protozoal diseases: giardia, coccidia, prototheca
  • Bacterial diseases: Salmonella, Shigella, Campylobacter, Yersinia. Yes, these are transmissible to us.
  • Hormonal diseases: hyperthyroidism, hypoadrenocorticism, hypothyroidism
  • Cardiac disease, rarely, in the cat
  • Neurologic and middle ear diseases including tumours, infections, and neuromuscular diseases

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For the optimists, who want to believe that a vet doesn’t need to be involved:

In reality, outside of tick season, at least 90% of pets presenting with gastroenteric symptoms have no reason to fear.  The majority of cases seen by vets, and countless others that are unnoticed by pet owners or managed at home, are self-limiting – they simply get better by themselves. Vets will often institute treatment (fluid replacement, dietary management, antibiotics, worming, pain relief, surgery) that sometimes saves a life, but more usually just accelerates a pet’s spontaneous recovery.

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WARNING SIGNS A TUMMY UPSET NEEDS MEDICAL ATTENTION

Here’s a few criteria that may help pet owners assess if they should seek veterinary opinion. It must be emphasised that an untrained eye may fail to recognise some of these abnormalities. If there’s any doubt, speak with the vet.

Severe vomiting

Many vomits over many hours, unable to keep even water down, or vomiting that continues even during starvation. While these symptoms don’t necessarily mean the cause is on the nasty list, they’re very likely to cause problems with hydration and/or electrolytes, and may require at least a period on  IV fluids, and possibly investigation. Severe diarrhoea, especially if coupled with sufficient nausea to stop food and water intake, may demand similar IV support.

Abnormal brain or neuromuscular function

Profound depression or weakness; unable to rise and walk; wobbliness or drunkenness; head tilt; agitation; or muscle twitches, tremours or fitting. These could indicate a toxin that  effects both nerves and the bowel, or a gastroenteric disease severe enough to be secondarily affecting nerve function through dehydration,  uraemia, anaemia, electrolyte disturbance or low blood glucose. Either way, it’s an emergency.

Fever

A high temperature is a good, concrete sign that something more serious is going on. Only reliable if taken rectally, you may wish to have a dedicated pet thermometer in your doggy medicine cabinet, to avoid unpleasant confusion.  Normal temperatures range from 38 to 39.2C in dogs, smaller breeds at upper end of scale, while healthy cats can range from 38 to 39.4C.  Seeking cold surfaces, such as tiles, may also be an indicator of a fever, but dry, hot or cold noses are totally unreliable signs of wellbeing.

Blood in vomitus or diarrhoea

Blood in vomit is definitely unusual and a vet should be informed. It may vary from pink streaks to gritty black, like ground coffee. Haemorrhagic diarrhoea seems to be more common in dogs than man or cat, and may or may not indicate something more severe. If there’s a significant volume of blood involve a vet.

Protracted disease

If vomiting or diarrhoea persists beyond a few days, even if your pet seems well enough and is keeping some water and food down, it’s probably best to seek a veterinary opinion.  For chronic diarrhoea, lasting for weeks or months, arriving at the vet with a fresh poo sample will save time.

Gum colour

Become familiar with the normal gum colour of your dog or cat when healthy. When suffering a tummy upset, very pale gums can be associated with haemorrhage, shock or pain, while deep, cherry-red gums can indicate toxaemia. Dry and sticky gums may reflect severe dehydration.

Jaundice

This yellow discolouration of the body tissues is most easily seen when looking at ear flaps or the whites of eyes. This is a concrete signs there is something complex going-on and vet intervention may be life-saving.

Change in abdominal shape

If your dog suddenly looks more bloated or, worse still, seems tight like a drum, get to the vet. It could be gastric dilation volvulus.

Profuse drooling

Severe drooling, that lasts for  an hour or more, is common with blockages of the oesophagus. These dogs usually can’t keep any food or water down for long. Alternatively, some toxins will cause marked salivation; they’re commonly bad tasting, nauseating, burn the mouth or oesophagus, or parasympathomimetics.

Pain

Yelping, crying or whimpering when touched, especially in the abdomen, or adopting unusual postures, such a bowing.

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Dietary management of mild tummy upsets

If a tummy upset seems mild, rings none of these alarm bells, and especially if your pet seems otherwise well, playful and energetic, simple dietary management may suffice. Its free and easy, and unlike the dry toast, rejected by the kid with gastro, a bland diet for carniviores is often well received.

1. Withholding food and water for a short period is important if vomiting is present. This may be  3-6 hours for cats and small dogs, or up to 12 hours for a large breed dog. Resting the bowel will often settle a cycle of vomiting. If only diarrhoea is present, no starvation period is required.

2. Reintroduce liquids only, either water, electrolyte replacers or cooking stock. Small volumes, sipped frequently, is preferable as sudden distension of a stomach with a large volume of water or food may stimulate the vomit reflex.  Ice cubes are a simple solution for slowing a dog’s consumption of water.

3. Reintroduce bland food only. If only diarrhoea is present, you can start at this step. A bland diet for a carnivore is chopped, cooked chicken or fish. No fat, no bone, no skin. Just meat, boiled, steamed or microwaved, served with boiled white rice or potato.  Contrary to popular belief, dry commercial food or kibble is not bland, and is usually high in fat.  Again, if vomiting is present, multiple small meals a day is ideal. Start with a spoonful initially, and gradually increase meal size every couple of hours if kept down.

4. Gradually reintroduce the regular diet after 3-5 days of bland diet, and hopefully normalising stool.  Don’t reintroduce bones for at least a week, as they are a digestive challenge that a fragile, healing bowel may have trouble coping with.

If at any stage during this process there seems to be a setback, such as recurrent vomiting when water or food is reintroduced, it’s probably time to see the vet. This doesn’t necessarily mean it’s something serious; more usually, supportive therapy may be needed, to buy time, while natural healing  does it’s thing.

 

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One Response to “Tummy Troubles? What to do…”

  1. antonia staff says:

    Thaks Matt for a comprehensive view of the topic. It is really helpful. Deno had the runs for a long time and seems to have ceased with human acidophilus. I suspect he has an addiction to chook poo but I would have thought that this was not harmful to a dog? Hope you are well, Antonia PS I was going to send you an indelicate cane toad story regarding a mental health client and a dog and a cane toad. Want it?

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