Hematemesis is the act of vomiting blood. Hematemesis may involve the vomition of new or recent blood, which is bright red. It can also involve the vomition of old, partially digested blood, which has the appearance of brown coffee grounds. There are a variety of causes of vomiting blood and the effects on the animal are also variable. Some are subtle and minor ailments, while others are severe or life threatening.

General Causes

Clotting disorders (coagulopathies) that cause bleeding into the gastrointestinal tract

Gastrointestinal tract ulcerations, primarily of the stomach, esophagus or upper small intestine (duodenum)

Bleeding tumors of the stomach, esophagus and upper small intestine

Bleeding in the stomach or esophagus from the presence of foreign bodies

Administration of medications that are irritating to the stomach

Ingestion of foreign material or bones that lacerate the lining of the esophagus or stomach

Vomiting blood that has been swallowed, such as from bleeding in the mouth, from a nose bleed (epistaxis), from blood that was coughed up from the lungs (hemopytsis), or licked from the skin

What to Watch For

Blood in the vomitus. Fresh blood is usually bright red. Old, partially digested blood is brown and has the appearance of coffee grounds.

Anorexia

Diarrhea

Digested, dark black blood in the feces (melena)

Fresh, red blood in the feces (hematochezia)

Possibly abdominal pain

Paleness or pallor of the gums with severe blood loss

Rapid breathing with severe blood loss

Weakness, collapse, and shock with severe blood loss

Signs of bleeding at other sites in or on the body

Diagnostic Tests

Complete blood count (CBC)

Biochemical profile

Urinalysis

Coagulation (clotting) profile

Abdominal and chest (thoracic) X-rays or radiographs

Abdominal ultrasonography

Upper gastrointestinal contrast study

Endoscopy of the esophagus, stomach and small intestinal tract

Examination of other sites of bleeding, such as examination of the mouth, chest x-rays, x-rays and scooping of the nose, etc.

Treatment

The vomiting of blood that represents bleeding within the gastrointestinal tract is a serious condition. It generally warrants hospitalization, the performance of numerous diagnostic tests, and at the very least, supportive care. Symptomatic therapy may include the following:

No food or drink given by mouth (NPO)

Intravenous fluid and electrolyte therapy

Blood transfusions as needed

Gastric acid blocking agents and gastric protectant drugs to treat for gastrointestinal ulceration while awaiting test results

Determining the underlying cause and instituting specific treatments for the cause

Home Care

Call your veterinarian immediately if there is blood present in the vomitus, and administer all medications and dietary changes as directed by your veterinarian. Avoid drugs that might damage the gastrointestinal tract, such as corticosteroids and other anti-inflammatory drugs.