Acid Reflux in Dogs

Canine acid reflux occurs when stomach or intestinal fluids flow back into the oesophagus, causing irritation and discomfort.

What is canine acid reflux?

Acid reflux in dogs is similar to acid reflux in humans. It occurs when gastric or intestinal fluids rise from the stomach and enter the oesophagus. These fluids can cause inflammation, irritation and damage to the oesophageal lining.

A muscular opening called the lower oesophageal sphincter is located at the base of the oesophagus. In a healthy dog, this usually prevents stomach contents from travelling back up. If the sphincter relaxes or does not close properly, fluids or food may enter the oesophagus.

Acid reflux is also known as gastroesophageal reflux. It may be a short-lived reaction, but recurring symptoms can be associated with an underlying gastrointestinal problem. Severe or repeated reflux can cause painful inflammation of the oesophagus, known as oesophagitis.

Possible symptoms

A dog with acid reflux may appear well between episodes. Possible signs include:

• Licking the lips or repeatedly licking the air
• A reduced appetite or reluctance to eat
• Vomiting bile
• Grinding the teeth or snapping the jaw
• Pain or whining when swallowing
• Regurgitating food
• Repeated swallowing or gulping
• Weight loss
• Restlessness or signs of discomfort
• Occasional coughing

Vomiting and regurgitation

Bile is usually yellow or yellow-green and may be vomited when a dog's stomach is empty. Regurgitation differs from vomiting and often brings up undigested food with little warning or abdominal effort.

Repeated vomiting or regurgitation can lead to dehydration, nutritional deficiencies, weight loss and oesophagitis. Not every dog with reflux will vomit or regurgitate, so other signs such as lip licking, discomfort when swallowing and reluctance to eat should not be ignored.

Coughing

Reflux may cause short bouts of coughing as a dog attempts to clear irritating fluid or food from the oesophagus. However, a persistent cough can have many other causes, including respiratory or heart disease, and should be assessed by a veterinary surgeon.

Eating grass

Some dogs eat grass when they feel nauseous or have an upset stomach, but grass eating alone does not confirm acid reflux. Contact your vet if your dog is frequently eating grass and retching or has other symptoms such as regurgitation, excessive lip licking, reduced appetite or weight loss.

Possible causes

There are several reasons why a dog may develop reflux. A veterinary assessment is important because the symptoms can also be caused by other illnesses.

Anaesthesia

Anaesthetic medicines can relax the oesophageal sphincter and increase the risk of stomach contents entering the oesophagus. The risk may be greater if the dog's head is positioned lower than the stomach during a procedure.

An anaesthetised dog cannot swallow normally and is also at risk of inhaling vomit or regurgitated fluid into the lungs. This is one reason why owners must follow their veterinary practice's fasting instructions before anaesthesia.

Food intolerance or allergy

Some dogs may experience gastrointestinal symptoms in response to particular foods or ingredients. Food allergy cannot be diagnosed from reflux symptoms alone. Your veterinary surgeon may recommend a properly controlled elimination diet if a food reaction is suspected.

Chronic vomiting

Repeated vomiting caused by illness, medication or another gastrointestinal problem can damage the throat and oesophagus. This may make the tissues more sensitive to further episodes.

Abnormal stomach acid or delayed digestion

Problems affecting stomach acid, digestion or the movement of food through the digestive system may contribute to reflux. Fatty foods, some medicines, inflammation and other gastrointestinal conditions can also play a part.

Hiatal hernia

A hiatal hernia occurs when part of the stomach moves through an opening in the diaphragm towards the chest. It may be present from birth or develop following trauma. This abnormal positioning can increase the likelihood of reflux.

Diagnosis

Your vet will consider your dog's symptoms and medical history. Tests may include blood tests, urine tests and diagnostic imaging to look for an underlying illness, foreign body, hernia or other abnormality.

In some cases, an oesophagoscopy may be recommended. This involves passing a small camera into the oesophagus while the dog is under anaesthesia so the veterinary surgeon can look for inflammation, bleeding or damage to the lining.

Acid reflux and GERD

Gastroesophageal reflux may be a short-term problem lasting a few days or weeks. Gastroesophageal reflux disease, commonly called GERD, describes persistent or recurring reflux.

It can be difficult for an owner to distinguish occasional reflux from GERD because the symptoms may be similar. The duration and frequency of the symptoms, together with the results of veterinary investigations, help determine the diagnosis.

Both reflux and GERD may respond well to treatment, particularly when the underlying cause is identified before serious damage to the oesophagus develops.

Treatment

Treatment depends on the cause and severity of the reflux. Any underlying illness, hernia, tumour or foreign body will need to be addressed.

Mild cases may be treated at home using veterinary-prescribed medication and temporary dietary changes. Some dogs may need treatment for an infection or another illness contributing to the reflux.

Do not give your dog human antacids, acid-reducing medicines or other medication unless instructed by your veterinary surgeon. The correct treatment and dose depend on the individual dog and the cause of the symptoms.

Honey

Honey is sometimes suggested for soothing an irritated throat, but it does not treat the cause of acid reflux. It is also unsuitable for some dogs, including those with diabetes or those requiring strict calorie control.

Ask your veterinary surgeon before giving honey or any other home remedy, particularly if your dog is unwell, taking medication or has an existing medical condition.

Feeding a dog with acid reflux

Your veterinary surgeon may recommend a temporary or permanent change of diet. The most suitable food will depend on the cause of the reflux and your dog's other health and nutritional needs.

A vet may recommend a complete, balanced and easily digested diet with an appropriate level of fat. Home-prepared ingredients such as chicken, turkey, fish, rice, pumpkin or sweet potato are sometimes used for short periods, but these foods do not provide a complete long-term diet on their own.

Always seek veterinary advice before making a significant dietary change. A qualified veterinary nutritionist should formulate any home-prepared diet intended for long-term feeding.

Foods and ingredients to avoid

• Fatty or oily foods: These can delay stomach emptying and may make reflux worse in some dogs.
• Spicy or heavily seasoned foods: These may irritate the digestive system and may contain ingredients which are unsafe for dogs.
• Known allergens: Avoid ingredients to which your dog has a veterinary-confirmed allergy or intolerance.
• Excessive table scraps: Rich or unfamiliar foods can cause gastrointestinal upset.

Meal size and timing

Some dogs may benefit from smaller, more frequent meals because large meals can place additional pressure on the stomach. A consistent feeding schedule may also help.

The timing of the final meal should be discussed with your vet. Some dogs vomit bile when their stomach is empty for too long, while others may experience reflux after eating close to bedtime. Advice therefore needs to be tailored to the individual dog.

Softer or moist food may be easier for a dog with an inflamed oesophagus to swallow. Your vet can advise whether this is appropriate and recommend a nutritionally complete option.

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