Acid Reflux In Dogs: Symptoms And Treatment

Dogs can and do get acid reflux and it’s very similar to what happens in people. Acid reflux in dogs is usually due to over- or underproduction of stomach acid … but unfortunately, it’s not that simple.

What Is Acid Reflux In Dogs?

Acid reflux is when intestinal or gastric fluid comes up from the stomach and flows into the esophagus … the tube that leads to the mouth. The sphincter where the esophagus connects at the stomach should be closed to stop acid flow. But with acid reflux or gastroesophageal reflux disease (GERD), the sphincter is open and allows acid to flow into the esophagus.

Because of its caustic nature, acid can cause inflammation, irritation and damage to the esophagus and its lining. It’s most prevalent in brachycephalic breeds like pugs that have a shorter esophagus.

Neither acid reflux nor regurgitation should be mistaken for vomiting which happens when your dog compresses his abdomen and has several contractions and wretching which forces food out. In contrast, acid reflux or regurgitation happens without warning … when fluids reach the esophagus they cause your dog to immediately bring up the contents of his stomach. 

Acid Reflux Symptoms In Dogs

When your dog gets acid reflux he’ll look uncomfortable. The top signs include:

• Licking lips or licking the air
• Empty swallowing
• Decreased or increased appetite
• Vomiting bile
• Retching, burping or gagging
• Eating dirt, grass, inanimate objects
• Bad breath coming from the stomach, not just dental issues
• Grinding teeth or snapping his jaw
• Painful swallowing (maybe crying or whining and may not want to eat)
• Coughing, laryngitis, wheezing, aspiration pneumonia caused from inhaling acid because muscles aren’t contracting
• Change of voice
• Restless, pacing, can’t get comfortable
• Hunched up back showing discomfort and tightness
• Reluctance to move, lethargy
• Weight loss
• Esophageal ulceration – throwing up blood (hematemesis) from irritation of things coming back up
• Lab results show changes

What Causes Acid Reflux?

There are many possible causes of acid reflux …

• Highly processed diet
• Antibiotic drugs that destroy the microbiome
• Nutrient deficiencies
• Food sensitivities
• Microbiome imbalance (SIBO, yeast, bacterial overgrowth, parasites)
• Inflammation of the digestive tract (poor immunity and leaky gut) 
• IBD especially if they have issues in the upper area of the digestive tract
• Foreign bodies
• Myasthenia gravis/megaesophagus, is an autoimmune disease that causes nerve issues so the esophageal sphincter can’t contract. The animal needs to be fed in an upright position and held stable so the food doesn’t back up into the esophagus, to ensure digestion.
• Impaired nerve flow to sphincters – both upper and lower
• Being overweight, obesity
• Slow/inappropriate peristalsis (delayed stomach contractions and emptying)
• Overproduction of stomach acid (from stress, hernia, spicy food)
• Underproduction of stomach acid (antacids, nutrient deficiencies) so sphincter won’t close properly
• Chronic vomiting possibly from pancreatitis, kidney and liver issues)
• Stress – causes imbalance in the microbiome that leads to an increased chance of infection and inflammation, with slowed digestion or accelerated (diarrhea)
• Anesthesia, slows down body processes, so wait for recovery before feeding
• Esophageal sphincters not fully developed (younger dogs) as they get older it usually improves
• Hiatal hernia 
• Trauma (something swallowed or something that perforates the throat from the outside)
• Tumors

Acid reflux cam be complicated. If you’d like to understand more about what can cause the problem, read the section below on Digestion And Acid Reflux In Dogs.

Diagnosis Of Acid Reflux In Dogs

Given the long list of possible reasons for acid reflux, Dr Odette Suter DVM advises asking your holistic veterinarian to look deeper to find the cause of your dog’s acid reflux. This helps identify the root of the problem and allows the veterinarian to manage the underlying reason for the condition.

Dr Suter treats acid reflux in dogs by starting with a physical exam, including an evaluation of the nervous system that includes:

• Checking for pain along the esophagus
• Range of motion testing
• Neurologic exam  
• A chiropractic exam: adjustments can sometimes resolve the problem
• Visceral manipulation to ensure there is movement within organs
• Cranio-sacral exam to ensure vagus nerve isn’t restricted 

Sometimes there are physical issues impeding proper digestion. There may be a misalignment of the body that impairs the vagus nerve, a major nerve that runs through the body. Loss of mobility can also contribute to gut issues and the ability to move food through the digestive process. Tight fascia within muscles and organs, scarring and arthritis can restrict movement. Even untrimmed toenails can affect posture and movement causing misalignments. A misalignment of the elbow or carpus (wrist) can lead to tension in the neck … and neck tension and pain in the front legs can compress the vagus nerve.

In some cases, Dr Suter will give a natural antacid to bring relief … and it can also be a diagnostic tool to determine if there’s too much or too little acid.

Other issues to check for include …

• Microbiome testing to check the gut’s flora
• Looking for parasites

In severe cases she’ll do a biopsy, imaging (endoscopy, ultrasound, X-ray, fluoroscopy ).

RELATED: How to support your dog’s microbiome health …

Medications For Acid Reflux In Dogs

There are some conventional medications for acid reflux in dogs. Medications like prokinetic drugs can increase the ability to empty the stomach … but they don’t get to the root of the problem. There are also acid neutralizers but they don’t change the reason for the excess acid. And there are some serious side effects. Medications for acid reflux may cause …

• SIncrease in bone fractures because of malabsorption of calcium
• Possible autoimmune disease
• Reduced absorption of B12, iron and magnesium
• Stomach cancer (found in long-term use of omeprazole in humans)

So, here are some safer, natural ways to help your dog with acid reflux.

Home Remedies For Acid Reflux

These solutions will help your dog’s comfort and assist healing. Nutrients that help include …

• Zinc, which is essential in the production of hydrochloric acid (HCL)
• Digestive enzymes to support the pancreas and assist the digestion of food
• Probiotics to restore and rebalance your dog’s microbiome. They’ll support the beneficial bacteria in his gut to fight harmful bacteria.
• Ashwagandha as stress management for both you and your dog  

Dr Suter may perform a fecal transplant to help some dogs.

What To Feed A Dog With Acid Reflux

• Avoid dry, processed foods that contain known allergens like grains and starches, chemical preservatives and ingredients with low nutritional value. 
• Feed high-moisture meals made of whole foods. Make them easier to digest by gently cooking meats and lightly steaming vegetables. 
• Feed smaller and more frequent meals, or feed lower fat and lower protein so less stomach acid is released. 
• Feed a late-night snack to avoid an empty stomach all night.
• If your dog has food sensitivities, try an elimination diet where you start with one food source at a time over a course of days or weeks and watch for reactions. Slowly add additional foods and wait and see what happens. 

Is There A Natural Antacid For Dogs?
There are soothing herbs that are natural antacids. They include ginger, slippery elm, licorice, marshmallow root. These can calm irritation of the lining of the esophagus and stomach. You can add stomach coating supplements like pure organic aloe vera juice.

Ripe bananas also have natural antacid properties that can be soothing and relieve pain.

Ginger tea or chamomile tea can also be soothing. Simmer slices of ginger in water for 30 minutes, cool and give to your dog or spoon over his food. 

Other Ways To Relieve Acid Reflux In Dogs
Exercise is often underestimated and will help reduce stress, promote the release of endorphins and provide movement of your dog’s internal organs and digestive system.

And here’s some background information about your dog’s anatomy and his digestive system.

Digestion And Acid Reflux In Dogs

The muscle tone of your dog and his organs, his nervous system and his microbiome are just some parts of his anatomy that lead to good digestion. When your dog has other diseases like arthritis, it can cause tightness and lead to difficulty within the digestive system. Here is how your dog’s anatomy affects digestion and how it can lead to acid reflux:

• The diaphragm is important to close the sphincter at the esophagus; a hiatal hernia is a bigger opening at the sphincter from a malformation or tear and can lead to backup of food and acid.
• The central nervous system receives input from internal and external environments that can affect internal organs affecting digestion and the movement of organs and food through the system. There are more nerves in the gut than in the spine.
• The vagus nerve runs through the body integrating organs. An injury or disconnect can derail digestion. Age can also impair nerve flow from the spine through to the organs.
• Fascia surrounds muscles and organs so if there’s stricture or tightness from scar tissue (eg: spay/neuter), gastropexy (when the stomach is tacked for bloat), or arthritis causing decreased mobility, it affects proper digestion.
• Microbiome studies show that overgrowth of certain microbes affects how the sphincter of the stomach closes, or doesn’t, and can lead to acid reflux.
  • Unbalanced microbial flora can affect the sphincter of the esophagus
  • The microbiome has 100 trillion microbes for brain chemistry, behavior, digestion and modulation of inflammation and immunity.
  • Growing imbalance of the microbiome increases inflammation and diminishes digestion.
  • Leaky gut causes inflammation in the GI tract and can lead to longer times for digestion and regurgitation.

Role of Acid in Digestion

Appropriate hydrochloric acid (HCL) levels in the gut are important as they:

• Break down dietary proteins
• Aid absorption of nutrients
• Eliminate bacteria and viruses
• Prevent overgrowth of pathogens in the upper GI tract

Hypochlorhydria (low HCL) can lead to:

• SIBO (small intestinal bacterial overgrowth), which damages the microbial flora
• Fungal overgrowth
• Increased intestinal permeability (leaky gut)
• Food sensitivities

Hyperchlorhdria (high HCL) can cause:

• Ulcers in the stomach and esophagus
• Esophageal inflammation

With so many causes and so many physical influences, acid reflux in dogs is a tough problem to tackle. But taking a holistic view of your dog is essential to find the cause and the best way to return your dog to health.