Your dog got into the trash and had a feast. Here's what a vet says to do.

My dog got into the trash and now is vomiting. What should I do?

Dogs eat just about anything — toys, paper, socks, rocks, condoms, underwear, electronics — the list goes on and on. Some dogs get away unharmed after eating all sorts of garbage. Other dogs have exquisitely sensitive stomachs — just a tiny bite of something weird leads to blowout diarrhea and vomiting. In most cases, these signs resolve after 24 to 48 hours with a bland diet.

If they don’t, see your vet as soon as possible.

Dogs that don’t feel better after getting into trash might have eaten something that caused a physical blockage (like a corn cob or dog toy that obstructs the normal passage of food through the stomach — we call these foreign bodies).

They might have eaten something poisonous (like discarded human medications), or they could have a bacterial infection from rotting or raw foods (equivalent to food poisoning in people).

Dogs are also very susceptible to a condition called pancreatitis, which can follow consumption of fatty foods (like discarded fast foods). Initially, vets will treat these dogs with fluids to combat dehydration and do some basic tests, such as bloodwork and an abdominal X-ray to look for evidence of a foreign body.

Once, I treated a sweet, smooth-coated collie named Brit, who was owned by a soft-spoken man who belonged to a hardcore motorcycle group. Lovingly, Brit’s owner fed him a $1 deep-fried taco. Within a day or two, the dog stopped eating and started vomiting.

Brit had pancreatitis.

Brit also developed a life-threatening complication of pancreatitis called diabetic ketoacidosis (DKA). DKA typically requires days to weeks of hospitalization, continuous treatment with intravenous insulin and special dietary management. I ended up fostering Brit during his recuperation. After several weeks, Brit recovered, but he required life-long twice-daily insulin treatment (given as an injection under his skin).

To make matters worse, Brit developed diabetic cataracts and became blind. Thanks to funds that the owner crowdsourced from his friends, Brit’s sight was restored after cataract surgery. Ultimately, the cost of that $1 taco ended up amounting to over $20,000.

The pancreas, which lies between the liver and the stomach, makes special enzymes that are secreted into the intestines after a meal to help break down food particles. However, sometimes these spill into surrounding tissues and digest the pancreas itself, with more enzyme spillage and severe inflammation — a vicious cycle.

In addition to containing cells that make digestive enzymes, the pancreas contains the cells that make insulin. When pancreatic enzymes destroy these cells, the body can’t make insulin, leading to diabetes, which is typically irreversible.

When pancreatic enzymes spill into the blood, this can lead to multiple organ failure, including cardiac arrest and death.

Brit’s story seems dramatic, but it’s not uncommon. At UC Davis, we diagnose dogs with pancreatitis multiple times a week. In a study of over 43,500 dogs enrolled in the Dog Aging Project, pancreatitis was one of the most common owner-reported causes of gastrointestinal illness.

Although some dogs seem to get pancreatitis from eating high-fat diets or getting into trash, “high-fat foods are not the only story,” said Harry Cridge, a small animal internal medicine specialist at Michigan State University who studies pancreatitis in dogs. Conditions that predispose to high blood lipid levels can also increase the risk for pancreatitis, especially hypertriglyceridemia, a hereditary condition in breeds like miniature schnauzers and Shetland sheepdogs. Other breeds that are at risk for pancreatitis include miniature dachshunds, poodles and cocker spaniels. Common dog endocrine diseases that increase blood lipid levels (such as Cushing’s disease and hypothyroidism) can also predispose dogs to pancreatitis.

Dogs with pancreatitis can have a gut-ache, picky appetite and lethargy, and they might show other signs of nausea, such as repeated swallowing or drooling. Dogs with abdominal pain might yelp or try to bite when they’re picked up, or they might periodically go into a downward dog pose (known as “the prayer sign”) — which seems to provide some relief.

Dogs with chronic pancreatitis can have signs that wax and wane for months to years. In dogs with acute pancreatitis (like Brit), signs of not eating, vomiting, diarrhea and abdominal pain appear suddenly and can be severe. Dogs with severe pancreatitis can vomit multiple times a day, have bloody diarrhea and be so weak that they are unable to stand.

Your vet might suspect pancreatitis after asking questions about diet (including access to trash), doing a physical exam to look for signs of abdominal pain and ruling out other causes by doing blood work and taking X-rays of your dog’s abdomen to look for an obstruction. “More advanced tests for pancreatitis, such as specialized blood tests and an abdominal ultrasound are often reserved for dogs that have recurrent signs or those that are more severely affected,” Cridge said. However, pancreatitis can be hard to diagnose. Some dogs — especially those with mild signs — can have normal blood tests and even a pancreas that looks normal using ultrasound.

Dogs with acute pancreatitis often need to be hospitalized and are given fluids through a vein, medications to stop them from vomiting, nutrition (such as through a feeding tube), pain control and other supportive treatments. Cridge recently published a study that showed that dogs with mild to moderate disease can sometimes be successfully treated on an outpatient basis, with fluids given under the skin and a novel wearable device that continuously infuses pain medication.

Dogs with milder, more chronic forms of pancreatitis are typically managed by feeding them a diet that is low in fat, although Cridge said that many of these dogs still have recurrent problems. “Identifying and managing any underlying lipid disorders or endocrine diseases [like diabetes, Cushing’s disease, or hypothyroidism] can be just as important in preventing disease relapse,” he said. Medications to help with nausea and vomiting can be given at home.

Avoid feeding your dog high-fat foods, including table scraps, and prevent them from getting into garbage. However, your dog could still get pancreatitis, especially if you have a predisposed breed. See your vet yearly for wellness care so any endocrine problems or hyperlipidemia can be identified and managed. If your dog gets sick, seek care early; because pancreatitis is self-perpetuating, early intervention can prevent it from progressing from just a mild stomach upset to a condition that costs thousands of dollars to treat and could threaten your dog’s life.

Jane Sykes is a Professor of Veterinary Medicine at the University of California-Davis. She is a board-certified specialist in small animal (dog and cat) internal medicine with a special interest in infectious diseases. She is the proud owner of two Labrador retrievers (Bodhi and Lucille) and an orange tabby cat (Freckles).