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Dr. Kara
Dr. Kara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 21098
Experience:  Over 20 years of experience as a veterinarian.
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I think my 3 year old German Shepherd has acid reflux. She

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I think my 3 year old German Shepherd has acid reflux. She vomits usually in morning and has done since puppy but just brings up bile. Is this possible?
Assistant: I'll do all I can to help. Hopefully it didn't make a mess. Did the Shepherd eat anything unusual?
Customer: No but it is usually before she has eaten
Assistant: What is the Shepherd's name?
Customer: Millie
Assistant: Is there anything else important you think the Veterinarian should know about Millie?
Customer: No she is quite well, but this has been happening since puppy

Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

Customer: replied 2 months ago.
Hello and thank you

I am sorry to hear that Millie is vomiting yellow, bile material in the early mornings.

Yellow in the vomit means that the small intestine is refluxing bile into the stomach so that when she vomits you see the yellow color. That isn't normal as bile doesn't belong in the stomach, and it does mean that there is some reverse motility, but it isn't specific for any particular disease process.

In many cases vomiting is triggered by eating something they should not, too much table food, too many treats or something they find outdoors, esophageal reflux, or a dietary allergy or sensitivity.

More serious causes of vomiting include viral or bacterial infections, chronic pancreatitis, inflammatory bowel disease, internal organ failure (kidney or liver disease), a full or partial gastrointestinal obstruction or even infiltrative cancers such as lymphoma.

Rarely a parasite called a stomach worm (Physaloptera) can lead to intermittent vomiting. These are difficult to diagnose because they rarely shed eggs, so we can try simply worming her with a gentle wormer called Pyrantel and see if that helps. This is easy to do and inexpensive so well worth trying.

If that doesn't work and since she seems to feel well otherwise some dogs seem to vomit more on an empty stomach so feeding her small meals several times a day, and maybe a snack before bedtime, may be very helpful.

It may also be helpful to put her on an acid reducing medication as too much stomach acid, especially on an empty stomach, is very irritating and predisposes to vomiting.

I recommend giving her a dose before bed so that it is in her system in the morning. You can give either:

1) Pepcid ac (famotidine) at a dose of one 10mg tablet per 15 to 40 pounds (7 to 20 kilos) of body weight every 12 hours

OR

2) Prilosec (omeprazole) at a dose of one 20mg tablet per 30 to 80 pounds (14 to 40 kilos) of body weight every 24 hours

These are both acid reducers and either one could help her vomiting. They are quite safe and can be used long term if necessary.

You might also consider feeding a low residue, low irritant easy to digest food. Both Science Diet and Royal Canin make sensitive stomach formulas you can purchase at the pet store.

If she continues to vomit even with the acid reducers, runs a fever (more than 103F rectally), has a tense painful belly or if she refuses to eat she should see a veterinarian for an examination, and some diagnostic testing. I would start with a complete blood count and biochemistry profile, a specific test for pancreatitis called canine specific pancreatic lipase, as well as fecal checks for parasites.

It has been my pleasure to help you today, and I hope that I have earned my 5 star rating. Please remember to rate my service by selecting the 5 stars at the top of the screen (rating me now does not close your question). You are welcome to ask follow up questions about my response here until you are satisfied, simply use the reply box and let me know. Thank you!

Customer: replied 2 months ago.
Bit concerned that I have now been charged for a £15 phone call that’s not going to happen and I still have not had an answer to my questiin

My apologies! Please scroll up to see my full written response.

You DO NOT need to accept a call if you are good with my written response.

I am sorry about the offer of a phone call. That is an automatic, site generated offer that many licensed veterinarians are unable to fulfill. Many states/province licensing boards do not allow veterinarians to communicate via phone calls, unless they have previously physically examined a pet. The states and Province I am licensed in have that restriction. I could lose my license for communicating with you by phone. If you would like we can continue via this venue. You are welcome to reply and ask any follow-up questions regarding my written response and I will be happy to respond to them here.

The phone call deposit can be refunded if you would like.

I can forward this to customer service to address your concerns when you are done asking me any questions you might have. If you do not hear from them here is the phone number for customer service: Phone: 0***-***-**** (UK)

Also because you are in the UK you might find the acid reducer Ranitidine easier to buy over the counter.

The dose is 1mg to 2mg per kilo of body weight every 8-12 hours. That's one 75mg tablet per 35 to 75 kilos of body weight every 8-12 hours.

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