Dear Dr. John,
Our older dog is almost 12 and a mixed breed Shepherd. In the last year or two he has gotten quite thin. Our vet ran bloodwork and fecal exams and came up with nothing. We have recently changed to a sensitive stomach diet, and he is eating very well yet not putting any more weight on. My concerns stem from the most recent display of gagging a few times a day and having some bile vomit on half of the mornings. Could he have something stuck in his throat? Should we be concerned with the possibility of cancer? Can my dog have reflux? He has started to do is lick his lips a fair amount. W.D.
Dear W.D.,
Older dogs sometimes naturally get thin almost as if nature meant it to be, so they carry less weight around on older bones and joints. Yet weight loss should never be taken lightly. Parasites and stomach and intestinal issues must always be considered and be diagnostically ruled out.
The next steps might be to radiograph or ultrasound the dog’s abdomen for subtle changes that might be a clue. Endoscopy might also be needed to diagnose reflux because dogs can get GERD. Bilious vomiting can occur because of acidity in the stomach. Try feeding a small amount before bedtime as that sometimes works because the morning vomiting is due to the empty stomach. The reflux can also cause the gagging and even the lip licking, but the latter can also be a sign of nausea and that may need further exploration. I have a patient now who was doing a lot of lip licking, and it was due to nausea as a result of early intestinal cancer. The dog is doing well on anti-inflammatory medication and an anti-nausea drug. In no way does that mean that your dog might have cancer.
As for the possibility of something being stuck in his throat, I doubt that is the case. Dogs with that usually are gagging all the time and paw at their mouths or rub their face on the ground a lot. If any of this continues, start with a thorough oral examination and then the suggestions of radiographs, ultrasound, or endoscopy might be needed to come up with a definitive cause of these signs.
Dr. John de Jong is President of the World Veterinary Association. He owns and operates the Boston Mobile Veterinary Clinic and can be reached at 781-899-9994.