Gagging and Dry Heaves (Unproductive Vomiting) in Dogs

Key Takeaways

Gagging (retching), or dry heaving in dogs describes an active process that appears like the initial stages of vomiting.

• Gagging is either non-productive, or produces small amounts of white froth and bile

• Multiple underlying conditions, primarily affecting the respiratory and gastrointestinal systems, result in gagging

• Investigation involves physical examination, blood work, and diagnostic imaging such as X-rays, endoscopy, fluoroscopy, CT and MRI

• Treatment aims to manage the underlying cause and may include medication and/or surgical intervention

• Prognosis varies significantly

• Some triggers of gagging are mild and resolve spontaneously or are simple to treat such as nausea or kennel cough

• Some cases occur suddenly and are life threatening such as bloat or laryngeal obstruction

• Other causes are progressive such as collapsing trachea, and are sometimes fatal

A Closer Look: What is Gagging and Dry Heaves in Dogs?

Cause and prognosis of gagging in dogs varies widely. It is a common presentation, often seen alongside other symptoms as part of many different conditions.

Mild cases are often self limiting, require no treatment and have an excellent prognosis whereas other cases are indicative of life threatening disease. Dogs with symptoms of persistent, unexplained gagging require prompt veterinary attention. Severe gagging, non-productive retching, and difficulty breathing indicate an emergency and require immediate veterinary attention.

Possible Causes

Diseases that result in persistent gagging generally affect either the respiratory or gastrointestinal system.

Inflammatory causes include

• Gastritis • Esophagitis • Laryngitis • Bronchitis • Gastric ulcer

Congenital causes include

• Brachycephalic obstructive airway syndrome (BOAS)

• Collapsing trachea • Vascular ring anomaly

Infectious causes include

• Kennel cough • Upper respiratory infection

Non-specific causes include

• Gastric dilatation volvulus (GDV) aka Bloat • Megaesophagus

• Geriatric Onset Laryngeal Paralysis Polyneuropathy (GOLPP)

• Nausea • Nerve damage • Injury

Obstructive causes include

• Tumors • Foreign bodies • Salivary mucocele (sialocele)

• Esophageal stricture

Immune mediated causes include

• Myasthenia gravis

• Systemic lupus erythematosus

Risk Factors

The severity of gagging varies in dogs depending on the underlying condition.

Gastritis resulting from a dietary indiscretion usually presents with a mild, self limiting form of gagging which resolves spontaneously. BOAS often presents with chronic, intermittent acid reflux that results in gagging. These cases often don’t resolve but symptoms wax and wane.

Severe, sudden onset gagging is seen in acute conditions such as GDV or foreign body obstruction and are often life threatening without emergency treatment.

Progressive conditions, such as GOLPP, result in gradual worsening of symptoms and are sometimes fatal.

Testing and Diagnosis

Investigation of gagging in dogs involves detection of the underlying disease and may include:

• Physical examination

• Blood work

• Biopsies

• Bacterial culture

• Virus isolation (specialized bloodwork)

• Diagnostic imaging

Treatment similarly depends on the underlying disease but options may include a combination of medications, surgical interventions, and dietary and lifestyle changes.