🩺 Pyloric Stenosis in Dogs – Vet‑Led Guide 2025 🐕🔍

By Dr. Duncan Houston BVSc

Greetings, I’m Dr Duncan Houston, BVSc, founder of Ask A Vet. Pyloric stenosis—a narrowing of the stomach’s exit passage—can cause chronic or projectile vomiting, nutrient loss, and potentially life-threatening complications. In this comprehensive guide, we’ll explore causes, signs, diagnostics (ultrasound, X‑ray, endoscopy), surgical corrections, post-op plans, and prevention strategies to ensure your dog thrives 💙.

📘 What Is Pyloric Stenosis?

Pyloric stenosis refers to thinning of the pyloric canal from stomach to small intestine, often due to thickening (hypertrophy) of the mucosa and/or smooth muscle, resulting in delayed gastric emptying and vomiting.

🚩 Forms & Causes

• Congenital: puppies born with excessive pyloric muscle thickness; signs usually start after weaning, 4–12 months old, are common in brachycephalic breeds like Boxers, Bulldogs, Boston Terriers.
• Acquired: middle-aged to older dogs develop mucosal or muscular thickening for unclear reasons—possible chronic gastritis or high gastrin levels—predisposing breeds include Lhasa Apso, Maltese, Pekingese, Shih Tzu.
• Obstruction mimics: pyloric tumors, foreign bodies, ulcers, and spasms can mimic stenosis.

🚩 Who’s Affected?

Congenital cases are seen in young, brachycephalic dogs; acquired forms appear in older small breeds. Any dog with persistent post-meal vomiting should be evaluated.

⏱️ Key Symptoms to Watch For

• Chronic or intermittent vomiting, often 1–3 hours post-meal; may projectile-style undigested food.
• Regurgitation-like episodes, especially after eating.
• Weight loss, dehydration, and decreased appetite.
• Complications like aspiration pneumonia—coughing, fever.
• Bloating or visible stomach enlargement after meals.

🔍 Diagnostic Approach

1. History & exam: note timing of vomiting, weight changes, palpation of the stomach.
2. Blood & biochem: may show dehydration; assess kidney/liver function, electrolytes.
3. Radiographs: plain X-rays often reveal stomach distension; barium contrast X‑ray shows delayed emptying and narrowing.
4. Fluoroscopy: live barium study helps confirm obstruction dynamics.
5. Ultrasound: shows thickened pylorus; look for “target”, “donut”, “nipple”, and cervix signs.
6. Endoscopy + biopsy: direct visualization plus tissue sampling to rule out ulcers, tumors.
7. Surgical exploration: sometimes required to confirm severe or intermittent cases.

💉 Treatment Options

1. Stabilize First

• Rehydrate with IV fluids and correct electrolyte imbalance.
• Control vomiting with antiemetics.
• Feed small amounts of bland, low-fat food repeatedly until surgery.

2. Surgical Repair

Surgery is the mainstay for moderate to severe stenosis:

• Pyloromyotomy (Fredet–Ramstedt): incises the muscle to widen canal.
• Pyloroplasty (Heineke–Mikulicz): flap procedure to enlarge the outlet.
• Gastrojejunostomy or gastroduodenostomy: bypasses area—used in severe or tumor cases.

3. Post-Op Management

• 2–3 days hospitalization; IV fluids, antibiotics, pain meds.
• Start small, frequent soft or liquid meals; gradually transition to normal diet.
• Evaluate for complications—vomiting, ileus.
• Schedule follow-up exams and repeat imaging to confirm gastric emptying.

4. Medical Management (Mild Cases)

For mild stenosis or high-risk dogs unsuited for surgery:

• Smaller, frequent meals, low-fat digestible diets.
• Medications: prokinetics (cisapride, metoclopramide), acid-reducers (famotidine, omeprazole).
• Monitor symptoms; surgery if condition worsens or fails to improve.

📅 Prognosis & Long-Term Care

• Most surgically treated dogs recover fully and resume normal life.
• Mild recurrences may need diet changes or medication adjustments.
• Serious cases (tumors) have variable outcomes depending on pathology.
• Long-term prognosis for congenital and acquired forms post-surgery is excellent.

🏡 Home Care & Owner Tips

1. Stick to small, frequent meals. Avoid large servings.
2. Use easily digestible, low-fat diets as recommended.
3. Prevent bloat by feeding slowly and avoiding exercise immediately after meals.
4. Monitor hydration and appetite closely.
5. Track vomit episodes and report any changes promptly.
6. Maintain rechecks with vet for weight, imaging, and progress note.

🐾 Ask A Vet Assistance

If you're unsure about symptoms or recovery, consult a veterinarian or Ask A Vet for 24/7 support. Post-op, find feeding bowls with controlled flow and recovery cushions via 💕

✨ Key Takeaways

• Pyloric stenosis—narrowing of the stomach exit—causes delayed emptying and vomiting.
• It can be congenital in young brachycephalics or acquired in older small breeds.
• Diagnosis requires imaging: X‑rays, barium studies, ultrasound, and endoscopy, sometimes.
• Surgical correction (pyloromyotomy/pyloroplasty) has excellent outcomes.
• Supportive care and careful follow-up enable full recovery.
• Post-op diet and lifestyle adjustments help prevent recurrence.
• Early detection and treatment lead to the best prognosis—reach out to your vet or Ask A Vet if you spot symptoms. 🐾❤️

If your dog is vomiting undigested food several hours after eating, especially with weight loss or fatigue—don’t wait. Contact your veterinarian or Ask A Vet promptly. Early diagnosis and timely intervention give your dog the best chance for recovery. 🩺