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Hematemesis (Vomiting Blood) in Dogs

By: Dr. Bari Spielman

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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.

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