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vomiting, diarrhea, and other digestive upsets

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Kirsten:
Among mammals dogs have one of the most durable and self-repairing digestive systems available.  There are a few conditions that would be considered emergencies and I'll go over them, but most digestive symptoms that you see will correct themselves if given a few days of rest.

Emergencies are:
1.  A blocked digestive tract.  This can cause tissue death within the digestive tract which eventually causes septicemia and death or the tract could rupture, again causing death.  This includes the dreaded "Bloat."  Signs of some sort of blockage include:
   a.  food goes in, but poop does not come out the other end.  Diarrhea still counts as poop coming out.
   b.  eventually, food stops going in (dog loses appetite).
   c.  abdomen may swell and or become taut.
   d.  dog expresses discomfort about abdomen and may be tender when you press gently on it.
   e.  normal gut sounds cease.  If you put your ear to your dog's abdomen right now and listen for several seconds, no matter how long ago he ate you should hear some pinging and gurgling of his gut moving.  Note:  this sound may not be present right after vigorous exercise, but should always be present in a healthy, resting adult dog.  It will get louder when he is hungry and you may be able to hear it without putting your ear to his side, but it should always be present when he is relaxed and at rest if you listen for it.
   f.   dog expresses general signs of illness, such as a change in demeanor (perhaps depression or anxiety), he whines, hides, or generally stops acting like his usual self.

2.  An internal injury.  There might be signs of blood in the digestive tract IF it is the digestive tract that is bleeding.
     a.  material in the vomitus that looks like coffee grounds.
     b.  material in the feces that looks like thick, black, gooey tar or like coffee grounds.  If it looks like red blood and is a tiny amount, it is most likely a minor injury to the rectum, especially if the feces are hard (this happens with constipation and is not life threatening).  Digested blood turns black.  It will not be a tiny amount, it will be a lot.
     c.  if the internal injury is not in the digestive tract, you might see swelling and signs of feeling ill (see 1(f) above).  When Cole's spleen ruptured, his abdomen was swollen and soft and I could see he was miserable and felt sick. 

All internal bleeding is an emergency (except a tiny injury to the rectum from straining to poop or constipation).

Vomiting and diarrhea by themselves will not kill or cause permanent damage UNLESS you allow the dog to become dehydrated or they go on for a really long time (many days or weeks).  However, they may be symptoms of something else, so check the dog's vital functions.  Learn how to check a dog's vitals so you can report useful information to your veterinarian if you consult him over the phone, or if it becomes necessary to go in to see him.

1.  When did the dog last poop, pee, eat, drink?
     a.  did he do these things the way he usually does?
     b.  were the color and consistency of urine and feces normal?
          1.  darker urine may indicate dehydration.  Learn what the normal color of your dog's urine is so you notice when it is the wrong color.
          2.  oranger urine may indicate blood, possibly from infection or crystals forming in the bladder.
          3.  abundant pale yellow urine is preferred.  Yes, in males it sometimes comes out in a continuous stream and sometimes spurts out rhythmically. 
          4.  learn to recognize your dog's normal volume of both urine and feces.  Decreased volume of urine may indicate a UTI (urinary tract infection) or crystals or dehydration.
          5.  fecal output has a wide range of "normal."  There are a wide range of possible colors which depend partly on what he ate and partly on how he processed it.  His own body will input yellow and red bile, so even if he ate brown kibble, it is possible for it to come out looking pretty yellow on the other end.  Think about it.  When you eat vanilla ice cream, it does not come out as white poop on the other end.  That's because your body adds bile and a bunch of bacteria which wind up turning most things brownish.  Same with a dog.
          6.  fecal texture can vary throughout the day and is likely to become softer or even liquidy during vigorous exercise or stress, then return to normal when the dog has rested a few hours.  On a long walk his first poop may be solid and normal and a later poop may be very soft, like soft serve ice cream or apple sauce.  This is normal.
          7.  what he eats comes out in the poop.  If he ingests a foreign object, it might turn up in a poop.  Like a piece of bright blue fabric from a toy, or a used-to-be white sock.  As long as it doesn't cause a blockage, injure the soft lining of the digestive tract or include a chemical that is dangerous, a dog is capable of passing a lot of foreign objects straight through without harm.  Socks are ridiculously easy for average sized dogs (60 pounds) to pass through.  If you feed him white rice, white rice will come out in the poop.  This is important to note because tape worm segments look similar to white rice.  So if you feed your dog rice and then take him to the vet, notify the vet that there is white rice in there so he doesn't have to poke around in poo checking for tapeworms on a wild goose chase.

=====

What do you do when your dog is vomiting or has diarrhea?

If there are no other symptoms.  If he is eating, drinking, pooping, and peeing normally.  If his attitude (behavior, demeanor) are otherwise normal.  If he is an otherwise healthy adult dog (not a baby puppy).  Then it is extremely likely he will self repair if you do nothing but give good nursing care for 24-48 hours.

You can fast him (withhold food) for up to 24 hours, but ONLY for an otherwise healthy ADULT dog.  This is NOT true with cats!!!!  It is not true with baby puppies!!!!  Both of those creatures can suffer liver shutdown with fasting, but not with an otherwise healthy adult dog.  He'll be fine.  It might help him a lot to reset his system.

You can switch him to a bland diet for 24-48 hours.  There are different recipes for bland diets.  You can discuss this with your own vet the next time you see him for a regular visit, but here is my preferred recipe:

Chicken and rice
Measure out a cup of instant rice in a microwave safe bowl.  Add one or two chicken breast(s).   Add however much water the rice package says you need for a cup of dry rice.  Cover with plastic wrap leaving a small corner open or stab it with a fork to make some steam holes.  Microwave on high for 10 - 15 minutes, checking periodically.  Check for doneness on the chicken.  For those who are not used to cooking chicken, the inside flesh should be white, not pink.  The juice coming out of it when you slice it should be clear, not pink.  Do not add salt or any other seasoning.  Break up the chicken into bite-sized chunklets after cooking (it's easier to do cooked), cool thoroughly, and serve the chicken and rice mixture.  If you over cook it, the chicken will shrivel, turn greyish and become tough.  Dogs still love it.  With this method, the chicken flavors the rice, and the water from the rice helps to keep the chicken moist so it is less likely to turn rubbery if you are a vegetarian hopeless about cooking meat (as I am).

You can flush the dog's digestive tract (empty it out so he can start over) by feeding him fiber.  The easiest way to do that is to give him some canned pumpkin.  Do not use pumpkin pie filling, which has a bunch of extra stuff in it.  Make sure it contains only pumpkin.  Many dogs love pumpkin and will eat it readily.  You can use it for vomiting, diarrhea, AND constipation.  It helps to make soft poop firmer and hard poop softer.  It's amazing.

Consider keeping some unflavored pedialyte on hand or at least know where to get it (many grocery stores will carry it, possibly in the baby section).  Mix it half with water and try to encourage a dog with diarrhea or vomiting to drink that instead of water.  Your body loses certain important chemicals through vomiting and diarrhea that can be replaced with pedialyte.

If your dog is reluctant to drink, or is not drinking enough, consider putting a few spoonfuls of milk in the water.  This will encourage some dogs to drink more.  Similarly, sodium free meat or chicken broth may encourage some dogs to eat.

Kirsten:
Back to vitals.....

2.  the dog's TPR (temperature, pulse and respiration). 
     a.  average normal temperature is 101.5 F, give or take one degree.  Take your dog's temperature periodically when you know he is healthy so that you learn what normal is for him.  It could be a degree lower than the average which would mean 102 is a fever for him even if it isn't for the average dog.
     b.  typical pulse is 60-140 beats per minute at rest, but will vary with fitness and size of dog (lower pulse for larger/fit dogs).  Take the pulse periodically when you know your dog is well to learn what is normal for him.
     c.  typical respiration is 18-24 breaths per minute, not counting panting.  Again, this varies with size and fitness.  Learn what is normal for your dog.

3.  Capillary refill.  If you press on a pink colored area on your dog's gums gently but firmly with the pad of a finger, you will squoosh all the blood out of the tiny blood vessels near the surface.  This will turn pink tissue white.  Capillary refill time is the time it takes for those tiny blood vessels (called capillaries) to refill with blood and turn the tissue back to pink.  It does no harm to the dog.
     a.  https://www.youtube.com/watch?v=txwp7AQCYCY  (I can't access this with sound to check accuracy, so can someone check it for me?)
     b.  http://www.infovets.com/books/Canine/B/B105.htm

4.  Mucous membranes.  You find this in the lining of the eyelids and on the gums.  If you want to know if your dog is "pale" check these areas.  If it's grey, it might indicate something causing anemia, such as a parasite problem or shock.  Learn what is normal for your dog.  If he has black gums, you might have to rely on gently rolling his eyelid down and looking there.  Please don't do the capillary refill test on an eyelid (only on gums).  Mucous membranes should be lightly pink and moist, not dry, sticky, red or grey/white.  Learn the normal appearance of your own dog's mucous membranes so you can recognize when they are not right.

5.  Skin pinch (hydration) test.  http://www.peteducation.com/article.cfm?c=2+2116&aid=1161
     NOTE:  There are some areas on a dog where the skin is just plain more loose and it will not snap back even when the dog is well hydrated.  This will also vary by breed and by fitness.  Some dogs are naturally "wet" (have loose skin) and some are "dry" (have snug skin).  In this case the terms "wet" and "dry" (used by breeders) are not in reference to the dog's hydration but his skin structure.  Practice the pinch test when you know your dog is well hydrated and find the spot where you need to go to test when you wonder if he's well.  The back of the neck does not work great on my dogs, but I do well with the forehead between the ears or the skin on the front of the paw.  On a typical human a good place is the back of the hand, so you can try it out and see what it should look like and also learn how to check your own hydration.




See also:  http://www.vethelpdirect.com/vetblog/dog-examining/

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