Upset stomach & diarrhea

· Blood in vomit or stool, or stool that looks like black tar
· Repeated unproductive retching — this can be bloat, which is an emergency measured in hours
· A painful or swollen belly
· Lethargy, collapse, pale gums, or a dog who will not stand
· A puppy, a senior, or any small dog — they dehydrate fast
· Suspected poison, a foreign object, or a swallowed toy or sock
· More than 24 to 48 hours, or any dehydration

· If they are vomiting, wait until it has stopped for a few hours, then offer small bland meals. If it is diarrhea alone, keep feeding small bland meals — the old 12-hour fast is no longer recommended; earlier nutrition is now linked to faster recovery. Never fast a puppy, a senior or a diabetic dog
· Keep water available, in small frequent amounts
· Then a bland diet: plain boiled chicken and white rice, or plain pumpkin, in small meals
· Return to normal food gradually over three days
· A strain-specific probiotic has decent evidence for shortening acute diarrhea

Press a finger on the gum until it blanches and let go. Color should return within two seconds. Slower than that, or gums that are pale, gray, brick red or tacky, means go now.

Dietary indiscretion — they ate something — leads by a distance. Then sudden diet change, parasites, stress, and infections. Chronic or recurring signs point instead at food sensitivity, inflammatory bowel disease, pancreatitis or an endocrine problem, and those need a work-up rather than more chicken and rice.

· Merck Veterinary Manual (merckvetmanual.com) — the standard clinical reference, free online
· American College of Veterinary Internal Medicine (acvim.org)
· Cornell Riney Canine Health Center (vet.cornell.edu)

The gum test costs nothing and is the single most useful thing on this page.

Straining with nothing passing, hard dry stools, or fewer than usual. Common causes: dehydration, too little fiber, ingested hair or bone, a matted rear, or pain that makes posturing hard. Plain pumpkin and water help mild cases. What matters: straining to DEFECATE and straining to URINATE look similar and the second is a life-threatening emergency, so be sure which you are watching. More than 48 hours, or any lethargy or vomiting, is a vet visit — and never give a human laxative or an enema at home.

Worth distinguishing, because it changes the diagnosis. VOMITING is active — heaving, abdominal effort, usually preceded by drooling and restlessness, and the material is partly digested. REGURGITATION is passive — food simply comes back up, often tube-shaped and undigested, with no effort. Regurgitation points at the esophagus rather than the stomach, and chronic cases need investigating. Yellow foamy bile first thing in the morning is usually an empty stomach, and often resolves with a small late meal.

Rice-like segments near the tail or in the bed are tapeworm, usually caught from swallowing a flea — so treat the fleas too or it returns. Spaghetti-like worms in vomit or stool are roundworm. Neither is diagnosed by looking: a stool sample identifies what is there, and the treatments differ. Some are transmissible to people, particularly children.