Acid Reflux in Dogs: Causes, Symptoms, and Treatments

If your dog is gagging, coughing, or swallowing excessively, especially after eating, they could be suffering from acid reflux. This backflow of stomach fluids towards the throat can be a source of discomfort for your dog, and if left untreated, it can result in chronic symptoms.

Fortunately, most dogs go on to live comfortable lives following a diagnosis of this common condition. Learn more about acid reflux in dogs to help you recognize the early, often subtle signs and put the right treatment plan in place.

What Is Acid Reflux in Dogs?

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Acid reflux, also known as gastroesophageal reflux, is a common condition in dogs (and humans). It occurs when gastric fluids, including stomach acid and digestive enzymes, flow backwards into a dog’s esophagus. This action causes irritation and inflammation of the esophageal lining.

For some dogs, acid reflux may be an easy-to-manage problem, only occurring occasionally and for short periods. For others, this can be a chronic, long-term condition, known as gastroesophageal reflux disease (GERD).

What Causes Acid Reflux in Dogs?

“[Acid reflux] happens because the lower esophageal sphincter, which acts as a valve, isn’t functioning properly, allowing stomach contents to escape,” explains Dr. Michael Stone, internal medicine veterinarian and associate clinical professor at Cummings School of Veterinary Medicine at Tufts University.

Any dog can develop acid reflux. However, certain conditions and other risk factors commonly contribute to the occurrence of acid reflux in dogs. These include:

• Respiratory issues: “Increased breathing effort due to constricted nostrils (seen in short-nosed dogs, aka brachycephalics) worsens reflux,” says Dr. Eliza O’Callaghan, Managing Veterinarian for Small Door Veterinary.
• Diet: Certain foods, especially those high in fat, can trigger acid reflux
• Digestive tract problems: Delayed stomach emptying can occur when peristalsis (muscle movements that push contents through the gastrointestinal tract) is slow
• Eating habits: Dogs that wolf down their dinner and regurgitate their food are at higher risk
• Foreign bodies: If your dog is experiencing a gastrointestinal blockage, this can delay emptying
• Hiatal hernias: This is where part of the stomach lining or wall is pulled into the chest cavity. High-risk breeds include Bulldogs, Pugs, French Bulldogs, and Boxers.
• Medications: Some drugs, including anti-inflammatories, can relax the lower esophageal sphincter
• Obesity: The additional weight can place extra pressure on the abdomen

Symptoms of Acid Reflux in Dogs

Symptoms of acid reflux are variable and range from subtle to more obvious, depending on the individual dog and the severity of the reflux. You may notice any of the following:

• Bad breath
• Burping
• Changes in bark due to throat and airway irritation
• Coughing or throat-clearing sounds
• Excessive drooling
• Excessive swallowing
• Gagging
• Grass eating, which can be a sign of nausea
• Lip licking, another indication of nausea
• Reduction or loss of appetite
• Regurgitation (where undigested food or fluids are passively expelled from the esophagus soon after eating)
• Vomiting (active expulsion of bile or partially digested food from the stomach)

“Untreated reflux can cause chronic vomiting or regurgitation, discomfort, weight loss, and/or chronic coughing,” Dr. Stone says. “Irritation of the esophagus (esophagitis) can be very painful, and chronic esophagitis may lead to stricture (narrowing due to scar tissue) formation.”

Dogs that vomit or regurgitate because of their acid reflux can also be at greater risk of developing aspiration pneumonia. This serious condition occurs when dogs inhale materials, such as food particles or vomit, into the trachea and lungs rather than down the esophagus. It can lead to respiratory distress and lung bacterial infections. If your dog shows signs of this condition, such as lethargy, fever, or difficulty breathing, consult with a veterinarian immediately.

Diagnosing Acid Reflux in Dogs

Dr. O’Callaghan explains that diagnosing acid reflux in dogs typically begins with your veterinarian taking a thorough history and performing a physical exam. She says they may ask about vomiting, changes in appetite, or any unusual swallowing behavior. Given that acid reflux symptoms can overlap with those of other gastrointestinal issues, diagnosis often involves ruling out other causes.

“In many cases, a presumptive diagnosis is made based on clinical signs and response to treatment,” Dr. O’Callaghan says. In these instances, your veterinarian may recommend trialing treatment and monitoring symptoms to see if they worsen, improve, or stay the same.

A definitive diagnosis is most commonly achieved through an esophagoscopy. If your veterinarian recommends this procedure, they will insert a small camera into the esophagus while your dog is under anesthesia. “In dogs with reflux, the lining may appear red, inflamed, or even ulcerated,” Dr. O’Callaghan says.

However, even when a dog has acid reflux, occasionally the endoscopy won’t show signs of irritation of the esophagus. In more complex cases, Dr. O’Callaghan says veterinarians may also recommend blood work, abdominal imaging, or a referral to a specialist for further evaluation.

Treating Acid Reflux in Dogs

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Sometimes, establishing and treating the underlying cause can resolve acid reflux in dogs. When management is required, a combination of lifestyle changes and medication may be necessary to control symptoms. The mainstays of acid reflux treatment are diet modification, acid-reducing drugs, such as omeprazole and other proton pump inhibitors (PPIs), and mucosal protectants.

“Treatment typically involves dietary changes to easily digestible, low-fat meals, feeding smaller meals more frequently, and medications to reduce stomach acid or improve gastrointestinal motility,” Dr. O’Callaghan says.

Your veterinarian may also recommend administering probiotics for dogs. The live microorganisms can help promote a balanced microbiome, aiding your dog’s digestion and protecting against harmful bacteria.

In severe cases, surgery may be recommended for dogs that don’t improve (or worsen) with medical management. Dr. Stone explains that surgery to tighten the lower esophageal sphincter and/or tack the stomach may be considered. “Surgery to relieve airway obstruction (upper airway surgery for brachycephalic dogs) may be helpful [in some instances],” he says.

Managing Acid Reflux in Dogs

“With attentive care and regular veterinary monitoring, most dogs with acid reflux live healthy, happy lives,” Dr. O’Callaghan says. “The key is recognizing the signs early and working closely with your veterinarian to find the right treatment and management plan.”

If treating the underlying cause or making some simple lifestyle changes doesn’t resolve your dog’s acid reflux, the condition may need ongoing management.

Some dogs with chronic GERD can experience more serious flare-ups. “The prognosis for dogs with GERD is variable, with some patients responding well to medical management and others requiring surgery,” Dr. Stone says. “Consultation with a veterinary internal medicine specialist may be helpful in refractory cases.”