We’re all familiar with that “urp, urp, urp” sound that can wake any dog owner up from a dead sleep in milliseconds. But while we know what causes that kind of gagging, what about the gags that don’t result in vomiting?
What Is Gagging?
Gagging is a term often used interchangeably for retching, but it’s technically different.
Retching refers to the action that precedes vomiting when the abdominal muscles and then esophageal muscles contract. That’s the “urp, urp, urp” sound you hear. The function of retching is to start vomit on its trip up the esophagus. If your dog is vomiting, or throwing up liquid, this isn’t gagging, but should still be checked by a veterinarian.
Gagging occurs higher in the throat. Its function is to keep things out of the esophagus. You’re most familiar with it as the gag reflex when something touches the very back of your throat, but it can also happen in response to nauseating smells.
AKC Chief Veterinarian Dr. Jerry Klein, DVM, says the technicalities that have been studied in humans are likely the same in dogs. He explains that it’s believed to be an evolutionary reflex that developed as a method to prevent swallowing foreign objects and prevent choking. “In my opinion, I feel that, like in humans, the gag reflex, also known as the pharyngeal reflex, is an involuntary reflex involving bilateral pharyngeal muscle contraction and elevation of the soft palate,” he says. “This reflex may be initiated by stimulation of the posterior pharyngeal wall, the tonsillar area, or [the] base of the tongue.”
Why Would a Dog Gag and Not Throw Up?
Neither gagging nor retching is the same as vomiting or regurgitating. In vomiting, the stomach contents come up, usually after retching. In regurgitation, the esophagus’s contents are suddenly expelled before they reach the stomach and without retching.
Gagging in dogs is often associated with coughing. When a dog coughs, it may bring up fluid or mucus, but only as far as the throat. The dog may then gag because the mucus stimulates the gag reflex. The gagging is an attempt to bring it the rest of the way up and into the mouth.
What Conditions Cause Gagging?
Here’s a handy hint: If the dog coughs and then gags, the problem is more likely a lower respiratory problem, or sometimes a heart problem. If the dog gags and then coughs, it’s more likely to be a problem in the larynx, such as laryngeal paralysis. In this condition, the larynx doesn’t close all the way, allowing food or liquids to enter the airway. But there are other possibilities:
- Bloat: Even though it’s more likely associated with retching, not gagging, this is one of the most life-threatening possibilities. If your dog is trying over and over to vomit, but nothing comes up, they could have bloat or gastric dilatation-volvulus (GDV). This is an extreme emergency that warrants contacting your vet immediately.
- Foreign object: The other possible extreme emergency is a foreign object that interferes with breathing. Dogs are notorious for swallowing things they shouldn’t, including things that are too big to go down. If your dog has been chewing on a rawhide or other chew item, or if they’re pawing at their mouth, look and even feel down their throat. If they’re choking and their tongue or other mucous membranes are turning blue, try to remove the object with tongs, get to the closest emergency clinic, or, as a last resort, perform the canine Heimlich maneuver.
- Respiratory infections: Kennel cough and other infections can also cause a dog to gag and cough. Kennel cough typically causes a harsh “good-honk” cough, often followed by a gag.
- Inflamed larynx: An inflamed or swollen larynx can cause this condition, which is more common in brachycephalic breeds and often associated with coughing or noisy breathing.
- Laryngeal paralysis: In some dogs, especially older ones, the nerves controlling the muscles of the larynx weaken, and the cartilage and the larynx collapse. Dogs with this condition usually gag and then cough.
- Upper respiratory infection: This includes kennel cough and dog flu.
- Pneumonia: An infection of the lungs can cause air sacs within the lungs to become inflamed, making it hard for a dog to breathe. This can cause a dog to cough or gag.
- Sinus infection: When nasal fluids down into the back of a dog’s throat, it can cause them to gag or cough.
- Intestinal parasites: Some parasites move from the intestines to the lungs, causing a dog to gag or cough in the process.
- Megaesophagus: In some puppies or dogs, the esophageal sphincter, which allows food and liquids to travel from the esophagus into the stomach, doesn’t open, trapping the food in the esophagus. When it becomes distended, the dog will regurgitate it suddenly. If food remains near the back of the throat, the dog may also gag.
- Tracheal collapse: In some dogs, the cartilage rings that hold the trachea’s shape weaken and collapse, causing coughing and gagging.
- Irritation: Sometimes, the dog’s throat is irritated by things in the environment, and may cough or gag in response.
Is Gagging an Emergency?
Generally, gagging isn’t considered an urgent condition. However, there are exceptions. If your dog is choking on a foreign object, has signs of bloat, or has difficulty breathing, head to an emergency vet immediately. In addition, if they seem otherwise unwell, can’t get comfortable, are gagging every few minutes, or are clawing at their mouth, you should make an immediate appointment.
“I would check to make sure the airway is clear, and the dog is not having difficulty getting air and the gums are pink, etc. and the dog is not in distress,” Dr. Klein advises. Otherwise, you’re probably okay to wait and see for a day or two. If they’re still gagging days later, or their condition worsens, it’s time to see the vet.
How Is Gagging Diagnosed?
If you can, film your dog while they’re gagging, so you can show the video to your vet if your dog isn’t gagging once at the clinic. Note when the gagging occurs. Is it after eating or drinking? That could suggest laryngeal paralysis. Is it at night? That could suggest congestive heart failure. Did it start while they were chewing on something or playing with a small toy or ball? That could be a foreign object.
If the problem isn’t obvious the veterinarian will listen to the dog’s heart and lungs to rule out congestive heart failure or lung disease. The vet will also do blood work to look for signs of infection, and possibly take radiographs to look for a foreign body or signs of pneumonia. If laryngeal paralysis is suspected, the dog may need to be sedated, so the vet can examine their larynx.
How Is Gagging Treated?
Treatment options vary based on the cause of the gagging. Dr. Klein cautions against trying home remedies and instead says you should contact a veterinarian for guidance. “The causes of gagging can vary from ‘simple’ nausea to possible megaesophagus to a severe, life-threatening condition, such as GDV,” he explains. “Any time a dog is exhibiting signs that are unusual for that dog, or if signs do not resolve adequately within a couple of minutes, or if a dog seems in distress and unable to become comfortable within a minute or so, you should notify a veterinarian for advice right away.”
Remember that gagging is a symptom, not a disease. Its treatment depends on the cause. If the veterinarian diagnoses GDV, surgery may be the best treatment. If it’s a foreign object, the veterinarian may remove it under sedation or anesthesia. If it’s pneumonia, the veterinarian may prescribe antibiotics, other drugs, and humidifiers. In severe pneumonia cases, the dog may need oxygen. Laryngeal paralysis may respond to drug therapy. If gagging is due to Megaesophagus, dogs may respond to drug therapy plus alternate ways of getting food and nutrients. Cough suppressants and anti-inflammatories may be treatment options for tracheal collapse. In some cases, your dog may need to stay in an environment with less dust, pollen, or allergens. Do not determine the cause on your own: consult your veterinarian to get to the root cause and get appropriate treatment for the cause of the gagging.