What I Know About Vomiting!

By Jo Marshall, CVT, NREMT
Senior Veterinary Information Specialist

LibertyI consider myself to be an expert in the act of making animals vomit, a kind of PhD in the art of induction of emesis. It is a common thing for me to recommend to our dog owning callers once I have triaged the situation. What brings me to write this is an experience that I recently had with a service dog puppy that I am training for Pets Loyal 2Vet. Liberty is her name and at 5 months of age, she is a challenge to say the least. Everyday we take a walk with one of my other dogs and the two of them run themselves silly. Well, let’s say they run themselves out of naughtiness so we can train a little without all of the attitude that puppies that can possess!

We have lots of wide open spaces around us and spend a significant amount of time in the fields and on the gravel road where it is safe for them to be loose. I frequently call them back to me and then release them again to reinforce their recalls. It so happens that today, Liberty delayed a little on her running back to me and clearly was interested in something in the freshly cut alfalfa field. She suddenly grabbed it and came running to me, but never quite completed her recall and stayed just out of my reach as to prevent me from getting her prize. The prize in question appeared to be a dead rodent – a rather stinky one at that! By the time I tackled her, it had gone down the hatch in one big gulp and all that was left was the stench of something dead and rotting.

Every dog owner knows that feeling of desperately trying to get something out of the dog’s mouth that you feel may cause them harm and catching that last glimpse of it as it goes down! What to do next? It is now time to triage my own dog and determine what would be my next best step to keep her healthy. I didn’t have a clue what it was but I knew it was definitely rotten. What had killed it? The hay field was recently cut so likely it got caught in the mower but the farmer could be putting out poison, although I really doubted that. So what are the risks to be determined on whether or not this dead, rotting rodent is going to harm my dog? Is there poison in the dead critter resulting in relay toxicity for my puppy? Does my dog have any deformities, anatomical challenges or concerns that will result in a worse situation if I make her vomit? Is she conscious? Is making her vomit, likely to worsen the situation?

So let’s break this down one risk at a time:

Dead rotting animal: yep – that has a strong likelihood of making her sick. Vomiting and diarrhea would be the minimum. If it were persistent vomiting and diarrhea, we would eventually face dehydration and electrolyte changes. So this is a yes on this one, time to get the peroxide bottle! Whoa, wait a minute, we still have more to evaluate! This is where I see people call me, after they get the peroxide bottle and prematurely, in a panic, pour it down the dog’s throat, making the whole situation exponentially worse.

So the next step on triage, is there poison in the dead critter? Well, I have no idea! Am I willing to take the chance that she will have relay toxicity, no way! So this makes 2 yes votes for vomiting.

Next concern would be deformities, anatomical challenges or concern that would worsen the situations. Does she have a history of seizures, a stomach that is tacked down to prevent bloat, a mega-esophagus or other health related concern that could make vomiting potentially life threatening? Is the dog a Bulldog, Pug, French bulldog or other breed that has a pushed in face that has the risk of aspirating vomit because of their palate being elongated? Aspiration means the vomit gets in their lungs and causes a potentially fatal pneumonia. Liberty is a Labrador and German shepherd mixed breed and is healthy with no known health concerns so this is the 3rd vote for yes, let’s get the peroxide. On to the next concern!

Is sheconscious? Yep, she is running around and proud of her indulgence! Dogs that are unconscious cannot be induced to vomit. First off, they cannot swallow the peroxide and it gets in their lungs resulting in the potentially fatal, aspiration pneumonia. If by chance, it does get to their stomach. They will aspirate the vomitus because they are not able to get it out of their mouth and when they breathe, it goes into their lungs. We also have this same concern with ingestions of medications that are quickly absorbed and cause the dog to go unconscious after peroxide is given and before they vomit. Again, we have a risk of aspiration when this happens. So for Libby, this is the 4th yes on proceeding with induction of emesis.

Ok, is making her vomit likely to make this worse? What do I mean by this? Is it a sharp object or a large object that could get stuck or cause damage to the esophagus coming back up? Is it something that is corrosive (i.e., battery or concentrated toilet bowl cleaner for example). If it can damage going down, and then double the damage coming back up, then vomiting is the last thing we should be doing. I saw nothing sharp in the critter and it was not big – likely the size of a mole. This should be easy for a 35 pound puppy to bring up. So this is 5 yes votes for vomiting.

NOW it is time to get the peroxide bottle!

How to we induce vomiting? We get so many calls where someone has used salt or some other online remedy for induction of emesis and have caused so much damage in the process. Many of the dogs that have been induced with salt end up with salt toxicosis. Sadly enough, it usually turns out that whatever they ate initially was benign and there was no need to even induce emesis. Unfortunately, they ended up hospitalized for a few days to get their electrolytes back to normal. There is only one thing that we recommend giving to induce emesis in dogs and that is 3% Hydrogen Peroxide. Not salt, not mustard, not dish soap, etc.! We recommend 3% Hydrogen Peroxide that is from a fresh, unopened bottle. Old peroxide does not work well as it can go flat and have no foaming ability.

So for Liberty, I poured 1 tablespoon of fresh Hydrogen Peroxide on a slice of plain old white bread and put it in her food bowl. She is a chow hound so she quickly ate it and then I started to walk her around. The walking gets the foaming going and she successfully vomited up a stinky, dead mole in about 5 minutes. Had she not vomited in 15 minutes, I would have doubled the dose and continued walking her. If she did not vomit after that, my next step would have been to consult our local veterinarian to induce vomiting by another means. We never use peroxide more than twice because of the risk of more serious gastrointestinal irritation. Note: the bread works well with the first dose but rarely do we get so lucky with the second dose. Usually if a second dose is needed, this needs to be given orally with a syringe or other means being careful that the dog is swallowing it and it is not getting into their lungs.

Vomiting your dog can be life-saving in some instances! But all the considerations need to be carefully weighed. Every time a pet-owner calls me regarding an exposure, I weigh all of these considerations and then make my best recommendation for your individual pet, with their specific health concerns and exposure risks because I take your pet’s health as seriously as I take my own pet’s health! We are here 24/7 to help you with your pet and when you weigh the odds and the risks. When the exposure requires veterinary care, our fee covers all follow-up. That means your veterinarian can work with our veterinary staff and toxicology staff to treat your pet, as long as needed 24/7. Trust me, if Liberty, had been poisoned by the rotting, dead thing she ate, I would want the staff I work with to be the first call my veterinarian made for consultation of care – they are simply the best! I am glad to say, Liberty has recovered and is back to her juvenile delinquent ways!

And here is my SPECIAL PSA regarding cats! Cats are an odd bunch and there is no way to safely get them to vomit at home. They have to go into your veterinarian if they need to vomit. Hydrogen peroxide and result in hemorrhagic gastroenteritis or ulcers and bloody vomit and diarrhea.