Vomit, Regurge & Gag, Oh my!
Anyone who lives with Frenchies, knows they are prone to some strange gastrointestinal issues, besides the room-clearing gas, that is. They vomit, regurgitate and gag more often than most dogs, and frenchie fanciers just get used to it. They give the actions all sorts of names, like â€œurpâ€, â€œspewâ€, â€œgagging foamâ€, etc. They even come to think of it as normal. But is it? Even veterinarians can be stumped by these strange symptoms and what could be causing them, because quite honestly, it could be any one of numerous underlying causes for most of these issues. And in the case of some dogs, it may be â€œnormalâ€.
This article will provide some basic information about vomiting/regurgitation along with a description of the brachycephalic issues that may cause or worsen this problem. In addition, I’ll give you some guidelines about when you should consult a veterinarian. Here are a couple of definitions to help you decipher between vomiting and regurgitation.
Regurgitation is a rather passive and apparently effortless process in which food or liquid is expelled from the throat and/or esophagus, without ever having made it as far as the stomach. Whatever comes up appears unchanged from what went in, and the dog doesn’t appear to feel ill at all (and may re-consume whatever was just regurgitated). Vomiting refers to the forcible expulsion of food in variable stages of digestion from the stomach, and is accompanied by retching and usually by other signs that the dog knows that something is about to come up (salivation, pacing, swallowing). So when a dog tosses its kibble, observe not just the process, but also the product carefully so as to determine which has occurred.
There is a phenomenon in Frenchies that I have heard referred to as “urping” or “spewing,” and generally is applied to a Frenchie’s shooting warm clear liquid up via its mouth and/or nose. Afterward, the dog will often look shocked and scared, and may gag. If this occurs in your Frenchie with any regularity (one isolated event is not necessarily a reason to run to your vet, but no one would blame you), I believe you should seek veterinary advice. Other Frenchies gag and will spit up a frothy foam and/or bile; I have even seen this ringside. Again, if this happens with any regularity, seek help. Some Frenchies develop a â€œrattlingâ€ sound in the back of their throat or nose, as if they need to cough up phlegm. If this is a chronic or intermittent situation with your Frenchie, seek help. Certainly if any of these conditions occur daily, weekly or even bi-weekly, alone or in conjunction with another, please see your veterinarian. One piece of advice: when you do see your vet, donâ€™t try to give a name to what your frenchie is doingâ€¦ and donâ€™t call it vomiting or regurgitation unless you are sure it is exactly that. These are 2 very different things and can lead to very different diagnoses. Just try to give your vet the best description of the event and answer their questions honestly and he/she will try to determine which one is occurring. If you ever have any doubts as to what is â€œnormalâ€, take your dog to the vet; at least you will have peace of mind. If you have a digital camera that takes video clips, you might try to film one of these episodes to show your vet.
Here are a handful of possible causes for the above symptoms, and some basic definitions and information. You may want to discuss any or all of these with your vet if your Frenchie is having these issues.
Obviously, with the breed of dog we choose to own, this MUST be at the TOP of our list. This is a condition (which I am sure most of you are extremely familiar with) where flat-faced dogs can have one or any combination of the following: elongated soft palate, stenotic nares, everted laryngeal saccules, hypoplastic trachea, and/or laryngeal/tracheal collapse. The stenotic nares, elongated soft palate, and hypoplastic trachea are congenital (present at birth), and if they are allowed to go uncorrected will cause the secondary changes of everted laryngeal saccules and, finally, tracheal and/or laryngeal collapse. Brachycephalic syndrome can cause vomiting, regurgitation and gagging. In my personal experience, this seems to be characterized most often by ‘spitting up’ of a frothy foam.
There are several esophageal disorders that can cause regurgitation, and even vomiting or gagging. I will attempt to highlight just a few that may be more common in our Frenchies.
1) Megaesophagus is generalized dilation of the esophagus due to lack of peristaltic activity. It can be congenital or acquired; acquired is generally later onset and may be either idiopathic (i.e., having no known cause) or as a secondary side effect of another disease, such as myasthenia gravis. It is thought to have hereditary components. The most common sign of this is regurgitation (of undigested food). Your veterinarian will diagnose this with radiographs and barium swallows and other tests.
2) Hiatal Hernia. The esophageal hiatus is the opening in the diaphragm through which the esophagus passes before it enters the stomach. A hernia in this site occurs when there is a protrusion of the esophagus, lower esophageal sphincter, and/or part of stomach through the esophageal hiatus into thoracic cavity. Sliding hiatal hernias are most common, which means the herniation is intermittent. The most common form is congenital with a breed predisposition for brachycephalic dogs. Diagnostics are again similar to other esophageal diseases and they may be managed by surgical or medical means. Your veterinarian will decide what is best for your dog.
3) Vascular Ring Anomalies are likely to have a hereditary basis. They are a congenital defect most often due to the persistence of an artery (the right aortic arch) that normally is lost during fetal development. The PRAA (persistent right aortic arch) forms a ring around the esophagus, entrapping it and causing it to be narrowed so that food cannot easily pass through the constricted area. Symptoms are usually exhibited early in life (less than 6 months or so) and the diagnostic road is similar to that of megaesophagus.
4) Esophagitis is an inflammation of the esophagus and is usually secondary to gastroesophageal or gastrointestinal acid reflux. Endoscopy, biopsy and/or radiography can be useful to help diagnose this disease. It can be mild to severe, but is often able to be medically managed.
The last topic I will address in relation to a chronic vomiting or gagging frenchie is food allergies and/or inflammatory bowel disease. This is a condition where your dog is actually allergic to some ingredient(s) in its daily diet or treats. This can result in continual or intermittent vomiting of food or bile. Usually this would be in conjunction with abnormal bowel movements as well, but not always. This would certainly be something to consider when ruling out reasons why your frenchie is having trouble.
Many of the above described issues can be medically managed with a combination of acid reflux drugs (i.e. Pepcid, Prevacid, Tagamet) and drugs which coat the stomach and esophageal lining (Carafate, etc). This is the reason why so many Frenchie owners will see and improvement if they blindly place their dog on these medications. But I would urge you to try and find out why your dog is doing this, especially if you are entertaining thoughts of breeding this dog. Certainly these represent only a handful of the reasons why a dog could exhibit vomiting, regurgitation or gagging, but they do seem to be among the more common reasons. I do hope this has given you some food for thought and perhaps you may even have a Frenchie now who can benefit from this information. Remember, if you think your frenchie exhibits any of these signs more often than you think they ought to, please take them to your vet, as it may not just be â€œnormalâ€.