Dry heaving is a moderately common phenomenon in dogs. I|n fact, as a first opinion “GP” vet, I’m probably faced with a dry heaving doggy once or twice a week. In many (but certainly not all) cases, the dog is brachycephalic (flat-faced). More later, on why this is the case! Sometimes the dry heaving is a new, sudden-onset symptom, and in other cases regular dry heaving has been occurring for some time before the dog and owner find their way into the vet clinic. But in all cases, the understandably somewhat alarmed pet owner has the same question: “why is my dog dry heaving?”
As a starting point, it makes sense to first define dry heaving, since this term is a little ambiguous and could be interpreted as meaning different things to different people. In fact, a cursory google search reveals that most sources that seek to answer the question of “why is my dog dry heaving?” don’t even seem to accurately grasp what dry heaving is…Which highlights quite nicely the importance of using trustworthy and authoritative sources when conducting healthcare research (for yourself or your pet) online.
So, to be clear: dry heaving or “retching” is an involuntary, rhythmic contraction of the diaphragm and abdominal muscles, but without the expulsion of stomach contents.
Makes sense? Not really? Let me try again.
Dry heaving is where your (or your dog’s) abdominal muscles and diaphragm contract over and over again, as if to vomit, but without anything being produced. Dry heaving is involuntary, meaning it’s not something the person or animal has any control over.
You could also think of dry heaving as being the body attempting to vomit without success.
One commonly mentioned “cause” of dry heaving is kennel cough, but this is somewhat inaccurate. The forceful hacking cough associated with upper respiratory tract infections (what we colloquially term kennel cough) in dogs may certainly be mistaken for dry heaving by the observer, but the two things are in reality entirely different. Let me explain:
Dry heaving involves contracting of the abdominal muscles and diaphragm in an attempt to expel stomach contents. “Kennel coughing”, on the other hand, involves contracting of the diaphragm and chest wall muscles to sharply intake and then expel air from the lungs. Coughing occurs in response to irritants in the airways (such as mucus, smoke or dust), whereas dry heaving occurs due to nausea, or to irritants in the stomach or upper intestines.
Great, you’re thinking. I now understand in perhaps a somewhat unnecessary level of detail exactly what dry heaving is. But how does this all relate to my doggo? Why is he heaving like a seasick retiree on their very first cruise?
Let’s take a look at the more (and less) common causes of dry heaving in dogs.
Nausea
I’m going to start with a really obvious one. Let’s imagine that your dog has raided the bin or eaten something dodgy on a walk, and has proceeded to vomit until his or her stomach is entirely empty. However, despite being as empty as an estate agent’s soul, your now somewhat regretful four legged family member is still feeling nauseous. In this case, dry heaving is likely to be seen, often accompanied by general malaise and excessive salivation (a classic sign of a doggo who feels decidedly sicky).
Whilst nausea is often a relatively benign symptom in dogs (perhaps most commonly the result of dietary indiscretion), there are certainly more serious possible causes such as liver or kidney disease. As such, it’s always important to see a vet if your pet is nauseous. What’s more, sometimes dietary indiscretion can result in more severe food poisoning symptoms and medical treatment such as anti-sickness medication or intravenous fluid therapy may be required.
Brachycephalic Obstructive Airway Syndrome
Brachycephalic obstructive airway syndrome (BOAS) is one of the more common causes of dry heaving in dogs, and as the name suggests, brachycephalic (flat faced) breeds are affected. Think Bulldogs, French Bulldogs, Boston Terriers, Shih Tzus, Pekingese and Pugs.
These dogs typically have abnormally narrow nostrils (which look more like thin slits than holes, in severe cases), and an overly long soft palate that partially obstructs the airway. Other abnormalities of the nose and throat may also be present. All in all, these abnormalities mean that affected dogs need to exert considerably more effort to breathe, especially during exercise, or in warm weather.
The increased effort needed to inhale and exhale can lead to aerophagia (swallowing air). Swallowed air accumulates in the stomach causing discomfort and activating stretch receptors in the wall of the stomach eventually triggering the vomiting reflex. If food is present, this may lead to actual vomiting. If food is not present, dry heaving is the logical result.
When you think about it, it makes sense that breathing problems and gastrointestinal problems should be linked. In fact, problems involving both the respiratory and digestive systems are so common that we even have a special name for this group of problems: aerodigestive disorders.
The mechanisms for breathing and for swallowing overlap considerably, and a problem with one system can certainly affect the other. Shockingly given how popular these breeds are, it has been suggested that as many as 97% of brachycephalic dogs that see the vet for respiratory problems also have some form of knock-on gastrointestinal problem [1,2], with the most common signs noticed by owners being regurgitation, vomiting and difficulty swallowing.
Esophageal Motility Disorders
Your dog’s esophagus (food pipe) is a muscular tube from their mouth to their stomach. By the way, as a British person it genuinely pains me to spell oesophagus, esophagus (since most of you reading this are American). Are you happy now? Are you???
Esophageal motility disorders are a group of problems where the muscles of the esophagus and/or the sphincter at the bottom of the esophagus (at the entry point to the stomach) don’t work properly. As you might expect, this can result in food sitting around in the oesophagus (sorry, esophagus) for longer than usual, which are result in damage to the oesophagus over time, as well as causing signs such as lip smacking, excessive salivation, retching/dry heaving and regurgitation. Brachycephalic dogs are more likely to have esophageal motility disorders compared to other breeds [3].
Hiatal Hernia
Please don’t think I’m being breedist against the brachycephalics. I’m not! But they certainly are the poster child for an unfair share of medical conditions that result in dry heaving. Hiatal hernia is another classically “brachy problem” for which dogs arrive at the vets with reports of recurrent retching.
A hiatal hernia is basically where the top portion of the stomach sticks up into the thorax, through the hole in the diaphragm that the esophagus (food pipe) traverses. I’ve attempted to illustrate this using Canva and my incredibly inadequate graphic design skills:
Most hiatal hernia in dogs are dynamic, meaning that the stomach doesn’t always sit in this abnormal position, but rather may slide up and down, causing symptoms intermittently. The main signs you might notice if your dog has a hiatal hernia are regurgitation, retching (dry heaving), gagging, excessive salivation and difficulty eating and keeping food down. Most hiatal hernia are diagnosed in dogs less than one year old, but I have certainly also seen them diagnosed in older pets, too.
Hiatal hernias are more common in brachycephalic breeds, partly due to genetic predispositions, and partly because of the increased pressures created in the thorax and abdomen during respiration may “suck” the stomach up into the thorax, exacerbating the problem.
Gastrointestinal Parasites
Gastrointestinal parasites affecting dogs include tapeworms, roundworms, and (if you live in certain areas) hookworms. There are two main mechanisms by which such parasites may cause dry heaving: gastrointestinal irritation, and blockage or obstruction.
Unsurprisingly, having parasitic worms with sharp little “teeth” living in your stomach and/or intestines is kind of unpleasant. Gastrointestinal worms can irritate and inflame the lining of your dog’s stomach and intestines, triggering a vomiting reflex and causing dry heaving even when there is little or no stomach contents present to be expelled.
Less commonly, if very large numbers of worms are present then intestinal blockage or obstruction may occur. Obstruction can obviously lead to dry heaving as the dog’s body attempts to expel the blockage. Intestinal blockages of all kinds are very dangerous, and you shouldn’t hold off on seeking veterinary attention if your pet is repeatedly vomiting or dry heaving.
Gastrointestinal Foreign Body
This one is kind of similar to the second mechanism by which worms can cause dry heaving, as outlined above. Basically if there is a blockage present somewhere in your dog’s gastrointestinal tract (ie, anywhere from oesophagus to anus, if you’ll excuse my French), then you might see dry heaving, as well as repeated vomiting (if your pet is still interested in eating).
Gastrointestinal foreign bodies are incredibly serious and can be life threatening, and you absolutely need to see a vet without delay if you think there is any chance your dog could have swallowed an object or “bulky” food item such as a bone, peach stone, corn cob or similar.
Esophageal Obstruction
Whilst we’ve technically already covered esophageal obstruction above under “gastrointestinal foreign body”, I feel it’s worth zooming in further on esophageal obstruction simply because this type of blockage is especially an emergency.
Not that foreign bodies elsewhere in the gastrointestinal tract don’t require prompt veterinary treatment – they surely do. But if something is stuck in your dog’s esophagus, you need to see a vet now. Signs of esophageal obstruction include dry heaving/retching, gagging, excessive salivation and visible distress.
The reason “stuff” stuck in the food pipe is particularly urgent, is that your dog’s breathing can be affected, which can obviously be acutely life threatening in some circumstances. Some foreign bodies such as bones may also damage the lining of the esophagus, resulting in scars which affect the ability of your dog to swallow food ever again. And obviously, not being able to eat is pretty much incompatible with life eventually, so again, it’s absolutely crucial that esophageal foreign bodies are treated urgently and removed with the utmost of care.
Since esophageal surgery has a very high complication rate, objects such in the throat are typically removed by endoscopy, or an endoscope may be used to push the object down into the stomach, where it can be removed by a safer operation, ideally by a surgeon who isn’t overly squeamish at the sight of stomach contents.
Gastric Dilation Volvulus
The dreaded GDV: feared by veterinarians and owners alike, and a thankfully relatively uncommon cause of dry heaving in dogs, statistically speaking. Gastric dilation volvulus is a life threatening emergency whereby a dog’s stomach rotates along it’s axis causing the “entry” and “exit” points to become blocked. This leads to rapid and excessive build-up of air inside the stomach, as well as cutting off blood supply to the affected portion of the gastrointestinal system. GDVs are rapidly fatal without immediate veterinary attention.
Deep-chested dogs such as Boxers, Bulldogs, Great Danes and the Dogue de Bordeaux are more likely to be affected by gastric dilation volvulus than narrow chested breeds. It is believed that one large meal daily (rather than smaller, more frequent meals), and feeding close to exercise time, are both factors that increase the risk of your dog developing this incredibly serious, life-threatening condition.
Clinical signs of GDV include restlessness/distress, difficult breathing, difficulty swallowing and/or excessive salivation, dry heaving and a bloated appearance.
Cancer
Unfortunately, cancer can also cause dry heaving in dogs, particularly those who are elderly. Tumors that grow in the stomach or oesophagus can cause recurrent retching, which may increase in frequency as the tumour grows. Other signs may include weight loss, difficulty swallowing, vomiting or vomit with blood present.
Frequently Asked Questions
Is is Normal for Dogs to Dry Heave?
No, although in my experience as a veterinarian, many dogs will dry heave at some point in their lives. This may be due to relatively innocent causes such as nausea due to dietary indiscretion, right through to life-threatening emergencies such as gastric dilation volvulus.
Do I Need to See a Vet if My Dog is Dry Heaving?
Yes. Some of the conditions that cause dry heaving in dogs are emergencies, and it is never worth risking a “wait and see” approach! Even when it turns out that the cause of the dry heaving does not need to be urgently addressed, it is still always important to see a vet if your dog is dry heaving to establish the cause and find a solution.
Is Dry Heaving in Dogs an Emergency?
Some of the causes of dry heaving in dogs require immediate and urgent veterinary attention, including esophageal obstruction and gastric dilation volvulus (GDV). If your dog is dry heaving it is important to see a vet immediately. The only exception to this is where a vet has already diagnosed a health condition such as hiatal hernia that causes dry heaving. In this case, it’s still important to follow up with your dog’s vet, but this may be less urgent.
Why is My French Bulldog Dry Heaving?
Like other brachycephalic breeds, French Bulldogs are more prone to a number of issues that can cause dry heaving, including brachycephalic obstructive airway syndrome (BOAS), esophageal motility disorders, hiatal hernia and gastric dilation volvulus. You should seek immediate veterinary attention if your French Bulldog is dry heaving, unless you know for sure that it’s not an emergency (for example, if a vet has already diagnosed your pet with a medical condition such as hiatal hernia, and your dog’s symptoms are occuring at a level that is normal for him).
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Reference List
- Freiche, W. and German, A.J. (2021) ‘Digestive Diseases in Brachycephalic Dogs’, Veterinary Clinics of North America: Small Animal Practice. 51(1), pp. 61-78. Available at: https://pubmed.ncbi.nlm.nih.gov/33187623/ (Accessed 25 November 2023).
- Kaye, B.M., Rutherford, L., Perridge, D.J. and Ter Haar, G. (2018) ‘Relationship between brachycephalic airway syndrome and gastrointestinal signs in three breeds of dog’. Journal of Small Animal Practice. 59(11), pp. 670-673. Available at: https://pubmed.ncbi.nlm.nih.gov/30094894/ (Accessed 25 November 2023).
- 3. Reeve, E.J., Sutton, D., Friend, E.J. and Warren-Smith, C.M.R. (2017) ‘Documenting the prevalence of hiatal hernia and oesophageal abnormalities in brachycephalic dogs using fluoroscopy’, Journal of Small Animal Practice. 58(12), pp. 703-708. Available at: https://pubmed.ncbi.nlm.nih.gov/28963795/ (Accessed 25 November 2023).
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