When Vomit Isn't Vomit

Story at-a-glance -

  • When your pet throws up, she may be vomiting – or she may actually be regurgitating. These are two different problems, with different causes and treatments.
  • It’s important to your pet’s diagnosis to know whether he’s vomiting or regurgitating, so if you can tell the difference when it happens, you’ll be that much ahead of the game when you visit your vet. You can also consider videoing the “event” to show to your vet.
  • Vomiting is an active process, whereas regurgitating is passive. When your pet is preparing to vomit, there are usually a number of signals to let you know what’s coming. In cases of regurgitation, it happens without warning.
  • There’s a difference between the appearance of vomitus, regurgitus, and a third variation -- expectorate.
  • The causes of chronic vomiting or regurgitating are also different. Vomiting is usually tied to the diet, dietary indiscretion, possibly a toxin or foreign body, or a developing condition like inflammatory bowel disease. Regurgitation happens for reasons unrelated to the diet or health of the lower GI tract.

By Dr. Becker

Today we're going to discuss the difference between vomiting and regurgitating.

Now, I'm sure some of you are thinking, "Oh, that's a pretty gross and disgusting video topic." But the fact is many people don't know exactly what's happening when something suddenly flies out of their pet's mouth. Having this information can be extremely helpful in determining whether you should see a vet, and what to tell him or her at your appointment.

Since your dog or cat isn't apt to vomit or regurgitate on cue at the vet's office, knowing what she was doing before you get there is beneficial in diagnosing the problem.

Also, if you can manage it, taking a video of your pet during one of her episodes, and taking it with you to your vet appointment can be really beneficial. It may seem strange, but it can actually help your vet arrive at a definitive diagnosis in much less time than it might otherwise take.

How to Tell the Difference Between the Two "Events"

Most veterinarians, when presented with the "vomiting pet," first have to determine whether the animal is actually vomiting, or is instead regurgitating. Deciding which it is very important, because the problems have different causes, and of course, different treatments.

If your pet is about to vomit, he feels nauseous. His abdominal walls are beginning to contract. He may drip or drool saliva, or begin licking his lips right before he retches. Often there's a heaving motion, where your pet's abdominal muscles begin to contract several times before he actually empties the contents of his stomach onto your floor.

If your pet regurgitates, chances are he'll simply open his mouth and out will come part of a meal, or the water he just drank. There's usually no warning with regurgitation -- for him or you. It's passive, whereas vomiting is an active process.

Regurgitation is less common than vomiting in cats.

Vomitus, Regurgitus, or Expectoration?

Contrary to what many pet owners believe, the timing of a meal and an episode of vomiting or regurgitation isn't an indicator of what is happening, nor is whether the food looks digested or undigested. These things don't make much difference when you're trying to decide which of the two problems your dog or cat is having.

What lands on your floor, or hopefully, right outside your front door if you're lucky, is either vomitus or regurgitus, and believe it or not, yes … those are actually words!

When a pet vomits, the stuff she brings up comes from her stomach and sometimes the first part of her small intestine. If there's yellow or orangish-colored bile or digestive fluid, you know your pet is vomiting. But not all vomitus contains bile. So, if you don't see any, it doesn't mean that your pet didn't vomit.

Regurgitus, on the other hand, reappears from either the esophagus or the pharynx (the back of the throat), which is why sometimes it's shaped like a tube. It's typically a mixture of food, saliva, and sometimes mucus – but not bile.

A third variety of this lovely subject matter is when a dog or cat expectorates. Many pet owners can confuse this event with vomiting. When an animal coughs -- a few times or several times -- and then produces a blob of mucus, she is expectorating, which is very different from regurgitating or vomiting. The key with expectoration is that there's always a cough involved.

Common Causes of Regurgitation

A disease of the esophagus is the most common cause of regurgitation in a pet, and is either the result of an obstruction or a motility problem. The esophagus can be obstructed by a foreign body, stricture, vascular abnormality, or, less commonly, a tumor.

Motility disorders or problems with the muscle contractions of the esophagus can be either congenital or acquired. An acquired motility disorder can be caused by esophagitis (inflammation of the esophagus), hypoadrenocorticism (which is the fancy name for Addison's disease), lead toxicity, organophosphate toxicity, myasthenia gravis (a neuromuscular disorder), and possibly hypothyroidism. Megaesophagus or an enlarged esophagus can also cause regurgitation in many pets.

Though uncommon, regurgitation can also be caused by pharyngeal dysphagia, which is a swallowing disorder. Pets with this condition can have difficulty or pain when swallowing, causing them to cough or gag when they try to swallow. So you'll see pets drop food from their mouths while eating. Pharyngeal dysphagia can be the result of a neuromuscular disorder, a tumor on the pharynx, an anatomic abnormality, or trauma.

Different Problems Requiring Different Treatments

As you can see, vomiting and regurgitation are actually quite different problems. The reasons pets vomit, which I've discussed in dozens of other videos and articles here at the Mercola Healthy Pets site, are wide-ranging, but are much different than the reasons a pet regurgitates.

In an otherwise healthy pet, the tendency to vomit is usually tied to the diet, dietary indiscretion, possibly a toxin or foreign body, or a developing condition like inflammatory bowel disease. Regurgitation happens for reasons unrelated to the diet or the health of the lower GI tract. The diagnosis and treatment of the two problems are quite different as well.