Delayed Gastric Emptying in Dogs

Delayed gastric emptying or gastric motility issues are becoming more frequently seen and diagnosed in our canine companions.  They seem to be acquired more often than not and some are actually conditions which are secondary to underlying gastrointestinal diseases.  

Delayed gastric motility is one of the three classifications given to the condition and comes with its own set of possible causes.  The appropriate treatment of delayed gastric emptying will depend on the most accurate diagnosis possible for the symptoms.

Delayed gastric emptying can be defined quite simply as the delayed movement (also referred to as gastric motility) of food through the host’s digestive system.

The symptoms of delayed gastric emptying can vary somewhat from dog to dog and from the various classifications of the condition, but here are some of the symptoms you might see in your canine companion:

• Chronic vomiting after eating - In dogs, a meal should be digested and the stomach should be empty about 6 to 8 hours after eating. any vomiting of undigested food longer than 12 hours after the consumption of a meal should raise gastric alarms
• Stomach distention (swollen stomach)
• Lack of appetite (anorexia)
• Belching
• Eating of non food items (called pica)
• Loss of weight

Types 

Delayed gastric emptying is one of three classifications of gastric motility issues:

• Accelerated - This is the least significant of the three and is usually related to medications or surgery
• Retrograde Transit - This one may be related to gastroesophageal issues like reflux or esophagitis or entero-gastric (vomiting and bilious vomiting syndrome)
• Delayed Transit - This one could be related to a multitude of conditions like megaesophagus or functional delayed gastric emptying (gastric dilatation, gastritis, ulcers, electrolyte disturbances), ileus (could be postoperative, drug induced or megacolon)

Because of the variety of conditions which could be at the root of delayed gastric emptying, this third classification is the one most veterinary professionals are seeing in their practices and the one which needs the most accurate diagnosis for the appropriate treatment.  Here are some of the causes your vet will be considering as he searches for the cause:

Primary Condition

The cause could be idiopathic (meaning there is no known cause) or it could be the result of electrical misfirings in certain muscles in the gastric system.

Secondary Condition

Most gastric motility disorders are secondary to other conditions like:

• Some blood disorders like low potassium or elevated urea or other imbalances in nitrogenous waste components in the blood
• Nervousness, stress, pain, fear or trauma
• Certain drugs for other health conditions
• Stomach diseases which include inflammation and blockages, stomach ulcers and parvovirus infection
• Stomach surgery
• Bloat or gastric dilatation (the canine’s stomach fills with gas or fluid due to an electrical misfire in certain gastric muscles)
• Esophageal reflux
• Abnormal functioning of the autonomic nervous system

When your veterinary professional is searching for the correct diagnosis so that your canine companion can be treated appropriately, he will need a detailed history from you about the eating and eliminating habits of your dog.  Dietary regimens, exercise routines and locations where it is done along with a complete a health and vaccination history that you can provide will also be helpful.  

Your vet will perform a physical examination and will have to rule out as many of the possible underlying conditions as quickly as he can.  His first step after the examination will likely be radiography (x-ray) of the abdominal area to rule out any blockages or foreign body presence which could initiate GI disease.  Other imaging modalities may be utilized if he feels more information is needed.  The vet will need some blood work and urine and fecal analysis to determine if there are any imbalances or abnormalities.  If he finds food present in the gastric system longer than 10 to 12 hours, delayed gastric emptying is certainly a strong possibility.

After the results of the vet’s testing are compiled, a diagnosis will be rendered and an appropriate treatment plan will be developed and initiated.  If delayed gastric emptying is found in your canine companion, here are some of the treatment options which your veterinary professional may employ: 

• Many veterinary professionals will recommend dietary changes to resolve the delayed emptying issues
• In the event that recommended dietary changes are not successful at resolving the problems, then gastro prokinetic therapy will become very important; in this treatment, a gastroprokinetic drug or other agent will be used, improving the motility of the gastrointestinal system by increasing the frequency of small intestine contractions or by strengthening them (doing so without interruption of the normal rhythm)
• The addition of a particular gastroprokinetic agent or drug will be determined by the location within the gastrointestinal tract which has been determined to be delaying the emptying
• Some of the medications which could be used for gastroprokinetic purposes are Cisapride, Metoclopramide, Ranitidine, Nizatidine, Misoprostol and Erythromycin
• If an obstruction is found, stomach surgery will be needed to remove it and make appropriate repairs to the surrounding tissue

If your canine companion presents with dehydration, your vet will need to address this need first, usually as an outpatient.  You should expect some steps toward rehydration which will generally be IV fluids as a means to assure the appropriate hydration and proper balancing of electrolytes in your pet.

The recovery and prognosis of your canine companion will be dependent upon the cause of the delayed gastric emptying found and the response of the various treatment options available for that cause.  For those canines who do respond to the dietary or gastroprokinetic treatments, you should expect the healing process to take several weeks. Continued dietary regimen changes and adjustments should help to manage the condition in the future. 

For those canines who do not respond to the dietary or gastroprokinetic treatments, further examination for mechanical obstructions will be required.  If your canine companion is found to have an overall abnormal function of the autonomic nervous system (known as “generalized dysautonomia”), the prognosis is more grave.