Expert: Charlotte Sherrell, DVM - 9/5/2008

Question
Dr. Sherrell,
I adopted a one-year old Silky Terrier about three months ago.  The dog came to us with little background information, but quickly received a clean bill of health.
Several weeks after he arrived at our house, he began vomiting-- always yellowish liquid.
At first he would vomit once a week. When the vomiting became more frequent, we called the vet. It was determined he was probably eating grass on his walks. As the vomit did contain a blade of grass at times, and as he was not vomiting his food, this made sense. We tried to watch him carefully on walks to avoid his eating grass, leaves, and sticks. The vomiting continued.
At this point, he might vomit twice during a week, or he might vomit daily. We contacted the vet again.
The dog then had fecal testing, urine testing, blood work and an exam. All results were normal.
The vet said the dog could have an acidic stomach, and recommended feeding more frequently to avoid an empty stomach. In addition to the regular morning and evening feedings, we were to add a very small mid-day and bedtime feeding. The dog was also given four days of Cerenia. With this new plan we were vomit free for the four days of Cerenia plus three additional days.
Then the vomiting returned. The vet did another fecal test, just to be sure. Again negative.
The dog only vomits the yellowish liquid, never food. The dog only vomits when we are at home, never when he is home alone. When he vomits at 4 a.m. I lower him off the bed onto the hardwood floor, and then he is immediately ready to go back to sleep. When he vomited at 6 a.m. he was then immediately ready for breakfast which he ate without problem. He may vomit in the late afternoon. He only vomits once a day. Sometimes he'll skip a day or two before vomiting again. Sometimes he will vomit daily. Twice he has vomited while running around the house with a toy in his mouth. While there is sometimes a blade of grass in the vomit, this is not always the case. The dog looks and acts healthy. He is a delightful little guy. He has not acted sick for one minute of one day! Even immediately after vomiting, he is ready to go.
The vet recommends changing his diet, but has no specific requests. If that doesn't work, x-rays are being suggested. The vet leans toward some type of upper GI issue, maybe reflux, maybe size of the throat.
I am looking for any wisdom or ideas you might provide. The vet bills are quickly rising, and we seem to have no answers.
If the little dog was an outside dog, I would have no idea any of this were happening. I only know because I must wipe the puddles from my hardwoods after the vomiting.
Is there a specific dog food you would recommend? (Despite the fact that the dog had turned one before we got him, he had been fed Puppy Chow by his previous owners. We are feeding him Nutro Max Mini Chunks.)
Any ideas on why the dog didn't start until several weeks after arriving at my house?
Why would he always vomit liquid, but never food?
We already adore this dog, vomiting and all, and would greatly appreciate any insights.
Thank you for your time.
Mary Margaret

Answer
Margaret -

Have the radiographs done to further examine the problem.  Without further diagnostics it will be hard for your vet to properly determine why your dog is vomiting. Megaesophagus is something to consider but usually cannot be diagnosed without a radiograph. Periodic vomiting is often a symptom of this disease of the esophagus even though it is more common in larger breeds.  

Good Luck -

Charlotte Sherrell, DVM