Vomiting is one of the most common reasons a dog ends up on the consult table, and one of the easiest to mishandle. It is a presenting sign, not a diagnosis. The skill is not knowing every cause — it is having a repeatable structure that turns “the dog is being sick” into a ranked differential list and a proportionate plan.
Step 1 — Is it actually vomiting?
Before anything else, separate vomiting from regurgitation. Vomiting is an active process with prodromal nausea, retching and abdominal effort. Regurgitation is passive, often happens minutes to hours after eating, and points you toward the oesophagus rather than the stomach and intestines. Owners use the words interchangeably, so ask about effort, timing and the appearance of the material.
Step 2 — Sick or not sick?
The single most useful triage question: is this a bright, otherwise well dog with self-limiting signs, or a systemically unwell patient? The answer changes everything about urgency and work-up.
- Red flags that escalate the case: lethargy, repeated unproductive retching (think GDV), abdominal pain or distension, haematemesis, known toxin or foreign-body access, and dehydration.
- Reassuring features: bright demeanour, normal hydration, a single dietary indiscretion, and signs that are already settling.
Step 3 — Localise: primary GI vs secondary
Vomiting is either a problem with the gut itself (primary) or the gut reacting to something systemic (secondary). Holding both columns in mind stops you from anchoring on gastroenteritis and missing the kidney, the liver or the endocrine cause.
- Primary GI: dietary indiscretion, foreign body, inflammatory disease, parasites, neoplasia.
- Secondary / systemic: renal disease, hepatic disease, pancreatitis, hypoadrenocorticism, diabetic ketoacidosis, and a long list of toxins and drugs.
Step 4 — A proportionate diagnostic plan
Match the work-up to the patient. A bright dog with a single episode may need nothing more than history, a careful exam and symptomatic care with a clear safety-net. A flat, dehydrated or painful dog warrants minimum database bloods, imaging to rule out obstruction, and inpatient support. Let the “sick or not sick” answer drive how far down the list you go.
If you remember one thing: vomiting is a sign to be explained, not a box to be ticked. Structure beats recall.
This is a placeholder draft to shape the site’s clinical content. The framework is sound but each section is meant to be expanded with worked examples, dose-specific advice and references before publishing.