You may suffer from acid reflux, but did you know the same can happen for your furry friend? Acid reflux in dogs is a very real problem. Integrative veterinarian Dr. Julie Buzby shares why acid reflux occurs, what symptoms to watch for, and the medications, foods, and natural remedies used for acid reflux treatment in dogs.
Humans and dogs have such a special bond. It’s almost as if we can sense what the other is feeling sometimes—both emotionally and physically. Of course, I want all of my patients to remain healthy. But I will admit I am slightly intrigued when an owner brings in their dog for symptoms they have noticed in themselves as well.
Could Rusty have acid reflux in dogs?
Such was the case with Rusty, a 4-year-old English Bulldog. I greeted him and his dad in the exam room, and dad cut right to the chase. “Can dogs get indigestion?” he asked. “They can,” I responded, “in a way. What’s going on?”
Rusty had been having some digestive issues. He was more gassy than usual (really saying something for an English Bulldog), and had vomited bile a few times. His dad also noticed he seemed uncomfortable after meals. Sometimes he was even refusing food, which was very out of character for him.
“I feel bad for him,” his dad told me. “He looks like I feel when I have acid reflux.”
“You may not be too far off base,” I said. “We can see acid reflux in dogs, and he’s certainly displaying some of the symptoms we look for.”
As we continued to talk about acid reflux, I reviewed some of the diagnostic tests I would recommend. And then I discussed the potential treatments for acid reflux should our suspicions prove to be correct.
What is acid reflux in dogs?
Acid reflux in dogs (i.e. gastroesophageal reflux) occurs when stomach acid moves into the esophagus and causes pain and irritation. This may occur for a short period of time or due to an inciting event. But in other situations, it may occur long-term. In that case, you may see it referred to as gastroesophageal reflux disease (GERD).
Let’s take a look at the relevant anatomy to get a better idea of how acid reflux occurs in dogs.
In many ways, dogs’ gastrointestinal tracts are similar to people’s. When dogs swallow food, it travels down their esophagus, the tube that takes food into the stomach. The contents of the stomach are very acidic, which facilitates digestion of the food. Then as the food enters the intestines, it mixes with other digestive enzymes.
The lining of the stomach and intestines are specifically designed to handle that acidic fluid. The esophageal lining, however, is not.
At the base of the esophagus, right where it attaches to the stomach, is a sphincter. When functioning properly, this little muscle opens to allow food to pass through to the stomach. Then it remains closed to prevent backflow of stomach contents into the esophagus.
In some dogs, the esophageal sphincter doesn’t work properly. This can lead to acid reflux. When stomach acid travels up through the sphincter, it irritates the lining of the esophagus. The end result is esophagitis in dogs (i.e. inflammation of the esophagus).
What are the symptoms of acid reflux in dogs?
Signs of acid reflux can be really variable and sometimes hard to recognize. Some dogs have very mild reflux. Therefore, they have very subtle symptoms. Other dogs have more severe inflammation of the esophagus. This can cause more serious or obvious signs.
If you think your dog may be experiencing acid reflux, watch for these symptoms:
- Decreased appetite
- Retching, burping, or gagging after eating
- Dog keeps licking lips—lip licking can indicate nausea
- Regurgitation of undigested food
- Chronic vomiting
- Vomiting bile
- Weight loss
- Coughing or wheezing
Not all dogs with acid reflux exhibit all of these signs, and this is not an exhaustive list. Always consult your veterinarian if you are concerned about your dog.
Watch out for aspiration pneumonia
It’s important to note that dogs with acid reflux can be predisposed to developing aspiration pneumonia in dogs. This lung infection occurs when a dog inadvertently inhales food or water when vomiting or regurgitating. If your dog has acid reflux, watch for these aspiration pneumonia signs:
- Lethargy in dogs
- Fever
- Cough
- Difficulty breathing
If you notice these signs, make an emergency vet visit.
Which dogs are most commonly affected?
Acid reflux can affect any dog at any age. However, there are some predisposing factors. Brachycephalic (“smushed faced”) dogs, like my friend Rusty, are more likely to deal with this condition. Overweight dogs are also more prone to developing issues with acid reflux.
If you are unsure if your dog is the correct weight, talk to your veterinarian. I also recommend using my three-step canine body condition score to assess your dog’s weight.
What causes acid reflux in dogs?
As discussed earlier, a dysfunctional esophageal sphincter muscle allows acidic stomach contents to flow backward into the esophagus. A variety of conditions may lead to acid reflux, including:
Hiatal hernia
This congenital condition results in a portion of the stomach protruding through the diaphragm into the chest cavity. The stomach is malpositioned. As a result, stomach contents travel backward through the esophageal sphincter. This causes many of the signs described above.
Hiatal hernias are most commonly seen in English Bulldogs. However, this didn’t end up being Rusty’s problem. Sometimes, your vet can diagnose the hiatal hernias on an X-ray. Other times, definitive diagnosis requires more specialized imaging such as endoscopy.
Delayed stomach emptying
In other situations, acid reflux occurs because the stomach doesn’t empty as fast as it should. Normally, muscle movements called peristalsis push contents through the GI tract at an appropriate rate. However, some dogs may have a functional problem of the digestive tract itself. This causes peristalsis to slow down.
In other cases, something like a foreign body in the stomach blocks the exit. Now contents can’t be moved out of the stomach, and a “traffic jam” of sorts ensues. Unable to move forward into the small intestines, stomach contents and acid backflow into the esophagus.
Problematic foods
People who have heartburn may have a pretty good idea which foods are the culprit. Certain foods, especially high-fat foods, can trigger acid reflux in dogs too. However, dogs can’t tell you which food caused their heartburn.
Discuss your dog’s diet with your vet if you notice signs of GI upset. Be sure to mention it if your dog recently changed foods or got a new treat. Some dogs also steal food they shouldn’t, so be on the look out for this too.
How is acid reflux diagnosed?
If your vet suspects your dog may have acid reflux based on your dog’s symptoms, breed, and history, he or she may recommend several tests.
The best way to definitively diagnose acid reflux in dogs is endoscopy. This test involves using a camera to visualize the lining of the esophagus and stomach. If the lining of the esophagus looks red, swollen, rough, or ulcerated, this is consistent with acid reflux. However, occasionally endoscopy will not show obvious esophageal irritation, even when the dog has acid reflux.
Since endoscopy often requires referral to a veterinary specialist near you, your family vet may start by running some tests to rule out other problems with similar symptoms. This may involve blood tests for dogs such as a blood chemistry and complete blood count (CBC). And the vet may want to take X-rays of the chest and abdomen. Sometimes, prior to the X-rays, the vet may have the dog swallow a contrast material like barium, which shows up on X-rays and can highlight some esophageal or stomach abnormalities.
Alternatively, if the symptoms fit, the vet may recommend a therapeutic trial to rule in or rule out acid reflux. This involves starting the dog on the appropriate treatments for acid reflux and seeing if the symptoms improve, worsen, or stay the same. If the dog gets better with treatment, acid reflux was likely to the be culprit.
How is acid reflux treated?
After reaching a diagnosis of acid reflux, your vet will work with you to develop a treatment plan for your dog. To some extent, treatment for acid reflux depends on the underlying cause.
Surgery to treat acid reflux in dogs
Some dogs may need surgery to remove a foreign body from the stomach or repair a hiatal hernia. Traditionally, surgical repair of a hiatal hernia involves opening the abdomen. However, a recent Veterinary Surgery article looked at the possibility of laparoscopic correction for hiatal hernias in dogs.
Medical treatment of acid reflux in dogs
When treating other causes of acid reflux, medications can help alleviate symptoms.
Antacids
The vet may recommend using acid reducing medications, such as omeprazole for dogs (Prilosec®), famotidine (Pepcid®), ranitidine (Zantac®), or cimetidine (Tagamet®), just like in people. These medications treat acid reflux by blocking the production of stomach acid or suppressing the release of stomach acid. This makes the contents of the stomach less acidic, and therefore less likely to burn the esophagus when reflux occurs.
If your vet prescribes an antacid that is only given once a day, you may want to ask him or her about the optimal time to give it. For example, to treat acid reflux that is worst at night, it may be best to give the antacids shortly before bedtime.
Some dogs improve with short courses of these medications. But other dogs will be on antacids long-term to control their reflux. Thankfully, antacids are generally safe for long-term use and have few side effects.
Sucralfate
While it doesn’t change the acidity of the stomach, some dogs benefit from sucralfate (Carafate®). This medication acts like an esophageal band-aid by coating damaged areas of the esophagus and protecting the lining of the esophagus. Once the acid reflux is under control, the dog usually won’t continue to take sucralfate. However, it can be very helpful for treating acid reflux in dogs short-term.
If your dog is on sucralfate, the vet will probably either prescribe a liquid version or have you dissolve the tablet in water to make a slurry shortly before giving it to your dog. This is because liquids do a better job of binding to the ulcerated or eroded esophageal lining.
Additionally, since sucralfate binds to other drugs, you will need to give your dog’s other medications at least two hours prior to sucralfate for best results.
Pro-motility drugs
Sometimes, the vet may recommend pro-motility medications such as metoclopramide (Reglan®) or cisapride (Propulsid®) for treating acid reflux. Both of these medications can help move food through the GI tract faster so it is less likely to sit in the stomach and contribute to reflux. Plus, they may tighten the esophageal sphincter so that less acid can leak into the esophagus.
How do you treat acid reflux in dogs naturally?
For dog parents who prefer a more natural approach to treating acid reflux, there are a few potential options to try. However, it is important to realize that these methods may not be sufficient or effective for every dog, especially if the acid reflux is severe. Therefore, they may need to be combined with more traditional medical therapy.
Probiotics
Probiotics can help restore the natural balance of good bacteria in the gut, which improves gut health for dogs. This in turn could potentially decrease acid reflux.
Yogurt
Plain yogurt can sometimes be soothing to a dog’s esophagus and it contains beneficial probiotics. However, not all dogs can tolerate dairy products well. And you need to ensure the yogurt is free of artificial sweeteners like xylitol, which is toxic for dogs or other harmful ingredients.
What should you feed a dog with acid reflux?
For dogs whose clinical signs are associated with certain types of foods, simply avoiding those foods may work. Otherwise, there are several potential approaches that may end up being helpful. Some veterinarians recommend a highly-digestible low-fat diet because it promotes GI emptying. Others suggest doing a diet trial with a hypoallergenic hydrolyzed diet. Or alternatively, some dogs may do better on a fresh or home cooked diet.
Therefore, it may take some trial and error to find the food that is best for your dog with acid reflux. But what we do know is that feeding several small meals rather than one large meal can make a big difference too.
Feed several small meals a day
In some dogs, the stomach isn’t equipped to handle one to two large meals per day. The dog goes from having an empty stomach to very full one. This may create issues with moving food through to the intestines. If food can’t move forward, it may reflux backward into the esophagus.
To avoid this issue, break down the total daily allotment of food into three to four (or more!) smaller meals. This places less stress on the stomach. I’ve often found that we can get a good handle on reflux issues, such as regurgitation, nausea, and vomiting bile, just by feeding smaller meals and possibly using acid reducing medications and/or natural treatments.
What can you give a dog for acid reflux?
As you have learned, there are a wide range of options for treating acid reflux. Ultimately, the best thing you can do if you suspect your dog has reflux is to make an appointment with your vet. That way he or she can rule out any more serious conditions and help create a treatment plan customized to your dog.
However, I know it can be difficult to see your dog so uncomfortable, so you may want to give your dog something for the acid reflux while you wait for the appointment. Unless your vet advises you otherwise, I would recommend sticking with probiotics or yogurt and small frequent low-fat meals (perhaps a low-fat bland diet for dogs) rather than buying an over-the-counter antacid. When it comes to medications for our beloved dogs, the safest thing to do is to only give them under the direction of a veterinarian.
Back to Rusty
In Rusty’s case, his blood work and X-rays were normal, so I presumptively diagnosed him with acid reflux. We tried a couple different ways to help him. I wrote his dad a prescription for a highly digestible, low-fat food. Hopefully, it would not only decrease his reflux issues, but also it might help him shed some excess weight. Also, I shared with him the tips found in my article: How to Help a Dog Lose Weight.
Lastly, we had a discussion about which treats are appropriate for him and the foods that may trigger reflux. Rusty had been doing well with one large meal a day—until he wasn’t. So that changed too. I recommend that his dad split his dog’s daily food into four smaller meals.
While his dad was working on making those changes, I also put Rusty on a two-week course of acid-reducing medication, then weaned him off it slowly.
Overall, Rusty did great. With the lifestyle changes and the short course of medication his clinical signs improved drastically. He no longer seemed uncomfortable after meals, he stopped vomiting bile, and his breath even improved! Occasionally, Rusty needs a short-term course of antacids or sucralfate, as he sometimes has a tendency to “counter surf” and get a hold of a triggering food. Overall though, he is much happier and healthier!
Don’t delay….talk with your veterinarian
Is your dog showing any of the symptoms we talked about, even intermittently? Are you concerned he or she may be suffering from acid reflux? If so, make an appointment with your veterinarian. I am a firm believer that dog parents know their dogs best. If you think something is wrong, do exactly what Rusty’s dad did—mention it to your vet. Your dog will thank you.
What has worked well to control your dog’s acid reflux?
Please comment below.
My moms 2 1/2yr Husky/Malinois mix is a medium sized dog. A few weeks in to having him he ate some pits from a cherry tree in the yard (now blocked off/maintained from his activities back there) that left him very ill. He stuck through, and since then has some behaviors develop.
A very food motivated fella, he will occasionally not eat his breakfast (a maze-bowl so he chews) and leave it until mom gets home. To which he’ll likely pick at, then fully injest the next morning.
We go on walks, for which he will occasionally upchuck whatever’s in his belly (water if he didn’t eat brekky, or brekky w grass+water/acid) during the walk or after getting home.
He does gag/hack pretty often, sometimes without anything coming out, others will lead to coughing out a piece of food/grass/acid. I always check to see if his collar is too tight first, it’s always pretty slack. He doesn’t always chew his food, ie when giving treats, and so have to use tricks that make him chew, he still doesn’t always.
He will drink water, then also obstain from it during walks, after, and just being at home some days. Sometimes he prefers the “dirty bowl” outside.
I’ve walked in the door some days to see he barfed earlier and is usually clear with some grass from the morning.
After walks he may not want to sit or lay down for a bit, or really listen to commands. I got frustrated with him early on once, not understanding his belly might be upset, and used a more forceful command, to which he obeyed but stood up immediately and barfed his little guts out. I haven’t done that again.
These little things go on and on. My theory is those cherry pits messed up his stomach PH, mom has dubbed him her quirky little man and takes him day by day.
Hi Amanda,
I am sorry your mom’s dog is living with these worrisome symptoms. It definitely sounds like there is a major GI issue present that warrants further investigation. Unfortunately, without being able to examine the pup myself, it is hard to offer specific conclusions or recommendations. What you describe is very concerning and may or may not be related to the previous cherry ingestion incident. Has your mom’s dog had any lab work done recently (since these new issues started)? If not, that would be a great place to start. Hoping you can get some answers and find a way to offer this sweet boy relief. Thank you for advocating for his health and well-being. Wishing you nothing but the best and keep up the good work. ♥
Hi! My pup is pittie/husky mix and he’s just over 2 years old. When we first got him, he would often throw up bile in the morning. He does a few odd things that I wonder if they’re related to acid reflux. He does lip smack often throughout the day and constantly swallowing. He’s always stretching (what looks like a play bow but does it constantly and he doesn’t want to play). And throughout he’ll just stand there and hang his head like he’s in some sort of discomfort. He doesn’t eat grass, but he’s constantly eating bunny poop, just immediately hunts for it the moment we’re outside. Lastly, he does have a number of behavioral issues that I wonder if there correlated to a stomach ache. Would greatly appreciate your thoughts here!
Hi Brian,
I understand your concern for your pup and agree it sounds like he could have an underlying GI issue. Without examining him myself it is hard to offer specific conclusions and recommendations. I do think this warrants further investigation. Have you discussed these symptoms with your vet? Has your boy had any routine lab work done recently? Depending on what is found on the initial testing, you may also want to consider asking about abdominal ultrasound or even a consultation with a specialist. Hoping you can get some answers and find a way to offer your boy relief. Feel free to keep us updated on how things go!
My 34kg lab-husky mix, Murphy, seemed mostly back to normal after recovering from a scary episode of acute hemorrhagic diarrhea syndrome (AHDS) in November – finally back to solid poos and his mix of butternut box and kibble. But around 4am most nights, he’s started lip licking, gulping/burping —classic signs of nausea or acid reflux, without vomiting. He had a course of omeprazole, antibiotics and Cerenia and i cant help but feel one of these may have encouraged esophagitis or GERD. ive tried probiotics, tree bark powders, smaller meals and changing the diet up but he still always gets nausea in the middle of the night, particularly when lying flat. propping him upright (head and chest above somache) seem to help but he doesnt seem to sleep as deeply this way and seems to always want to return to lying flat.
im finding it really hard to have a normal life when waking up most nights to his discomfort , any suggestions on what this could be or remedies to try?
Hi David,
I am sorry Murphy is dealing with these ongoing GI issues. From what you describe it does sound suspicious for reflux or GERD. I would be very surprised if the medications you mentioned caused these symptoms as they are what we routinely use to treat these types of GI conditions. I understand how frustrating it can be to be left with more questions than answers after all you have tried. Losing sleep just complicates the situation and your quality of life matters too. My best recommendation is to ask about a consultation with a veterinary internal medicine specialist. It makes me worry that Murphy could have something else contributing to the situation especially with his history of other GI problems in the recent past. It may be time to do more in-depth testing such as abdominal ultrasound or blood work to check for a vitamin deficiency. Specialists have lots of experience dealing with more complicated or confusing cases and may have ideas about testing or treatment that isn’t readily available in general practice. Hoping you can get some answers and find a clear path forward. Praying for healing for Murphy and rest for you both.