Dr. Dana Brooks, an internist at Seattle Veterinary Specialists in Kirkland, answers a reader's question.
Question: My 6-ish-year-old female beagle has had a problem with vomiting immediately after drinking water. We've tried withholding water immediately after she eats, giving her room-temp water. It was worse when she was on dry food. She is now on a 100 percent wet limited-ingredient diet, and our vet put her on phenobarbital for lambic epilepsy. It was better for a while, but now she's vomiting regularly again. I don't know what to have her tested for. Our vets are stumped. Poor thing always acts like she's starving.
Answer: The first question is whether this is truly vomiting or if it could be regurgitation.
Vomiting is when the food/water comes from the stomach and is usually accompanied by nausea and retching/dryheaving. You may also see bile (yellow or green liquid).
Regurgitation is a more passive event and the food/liquid is coming from the esophagus. These dogs will often just extend their neck and the ingesta comes out without much warning. It may be very slimy or foamy. Sometimes these dogs will also make a loud burping sound when they regurgitate.
Assuming obvious metabolic diseases (kidney or liver failure) have been ruled out with blood tests, the next diagnostic step depends on whether this is actually vomiting or regurgitation. Based on your description, I suspect this may be regurgitation, which points to an esophageal disorder.
The esophagus is the muscular tube that transports food from the mouth to the stomach after we swallow. It does this with coordinated muscle contractions that efficiently propel food to the stomach.
Causes for regurgitation include megaesophagus (flaccid dilation of the esophagus with no contraction), esophageal dysmotility (poor muscle contraction without the dilation), foreign objects in the esophagus, or strictures (a narrowing from scar tissue that causes obstruction). In most cases, foreign objects and strictures allow liquids but not solids to pass, which does not appear to be the case with your beagle.
A radiograph (x-ray) of the chest will usually identify megaesophagus showing a dilated, air or ingesta filled esophagus (the esophagus is not normally visualized on X-ray).
If this is not found, a swallowing study can be done with fluoroscopy, which involves administering barium as a liquid or mixed with food and watching with moving X-rays how it is propelled to the stomach.
If no problems are found, or if you are more convinced this is truly vomiting, and abdominal ultrasound or gastroscopy (examination of the inside of the stomach with a fiber-optic endoscope) would be recommended.
While you are awaiting the next tests, try giving all food and water from an elevated dish. You can buy dog dish stands at most pet stores, place the bowls on a step stool, box or the stairs. After food and water, keep your dog upright for 10-15 minutes. You can just keep her in a sitting position or hold them vertical -- but do not let her walk around or lie down.
The purpose of this is to let gravity help the food/water to go down to the stomach. If this results in improvement, esophageal disease is likely.
Dr. Dana Brooks
Brooks is a internal-medicine specialist at Seattle Veterinary Specialists in Kirkland. She graduated from Mississippi State University College of Veterinary Medicine in 1991 and completed her residency at Michigan State University Veterinary Teaching Hospital in 1995. She worked in the Northeast until 2007, when she joined SVS. Her special interests include hormonal and immune-mediated diseases as well as endoscopy. She lives with two black cats named Jasper and Logan.
Published on December 14, 2011.Home » News & Blog » Veterinary Q&A: Problems drinking water