Hannah Zulueta TCVM · Digestive
The Door That Will Not Stay Shut
Five patterns behind acid reflux in dogs, and how to work out which one you are looking at.
Acid reflux is when acid, or the contents of the stomach, move upward into the esophagus. That irritates the lining and it hurts. The lower esophageal sphincter is the door that keeps food inside the stomach, and reflux happens when that door will not close.
The one thing
If the wrong food caused it, the appropriate food can correct it.
Chinese Medicine does not treat diseases or illnesses. It looks for patterns of disharmony. With acid reflux, that means looking at the Spleen, which is in charge of digestion, and the Liver, which is in charge of Qi.
The goal is not to suppress the acid. Your dog needs that acid strong enough to break down food. The goal is to feed the food that lets digestion in the Spleen and Stomach happen properly, so the door closes on its own.
The mechanism
Understanding acid reflux
Acid reflux happens when the lower esophageal sphincter, the LES, will not close. You may also see delayed or slow gastric emptying, with acid and food moving in the opposite direction from the one intended.
Symptoms may or may not include:
Go to your vet first. There may be medical reasons this is happening, and nothing replaces a hands-on examination and testing by your primary care veterinarian. Ask them to check for megaesophagus, cricopharyngeal dysphagia, esophageal dysmotility, esophageal strictures, esophageal diverticula, esophageal obstruction, esophagitis, esophageal neoplasia, bronchoesophageal fistula, hiatal hernia, and a reaction to flea preventative medication.
Why will the door not stay closed?
The LES is a muscle, and it fails to close when it is too relaxed. Setting aside the medical conditions above, these are the things that relax it:
- The food is too cold.
- The food is too hot.
- The food is too spicy, turmeric being the usual culprit.
- The food is pungent, meaning garlic or peppermint.
- The food weakens the stomach.
- The food is inappropriate for producing the right acid level.
The eastern view
Where the food actually goes
The Spleen here is not the anatomical spleen of Western medicine. It is the symbolic organ of digestion, in charge of the intake, processing and distribution of nutrients from food.
Identifying the root cause is not always black and white. When I work with clients on this, I start by working out which pattern we are in.
Differentiation
Five patterns
Pick a pattern to see its signs. The tongue is usually the fastest way to separate two that look similar from the outside.
You, as the dog parent, will always have the most information on your dog. Your ability to observe and write down what you see is what identifies the pattern.
Working it out
Five questions to ask about the bowl
Is the food too cold?
Dogs eating cooked or raw meals are often fed straight from the fridge. That leads to a Stomach Cold. There will be other signs confirming it, but if you are feeding cold meals, try feeding at body temperature for a week and see whether anything changes.
Is the food too hot?
Kibble can be too heaty for some dogs. If you feed kibble, try cooked or raw meals for a week and see if it makes a difference.
Hot can also mean too high in fat. Raw food at 20 percent fat is more warming than cooling. It can mean too much bone content for the body to digest. And it can simply mean food that is too hot for a dog with a hot constitution.
Is the food too spicy or pungent?
Well-meaning dog parents feed golden paste, or food with turmeric, or add garlic and ginger to every meal. These ingredients are beneficial. But we cannot eat food with these ingredients daily or in excess, and neither can a dog. Overeat turmeric and you can develop a stomach ulcer. Feed too much turmeric to a dog and it starts as acid reflux and at worst ends as a stomach ulcer.
I am alarmed by how concentrated golden paste is and by the number of people feeding it. I do not question the benefits. I question the quantity. A small amount of turmeric helps the digestive process.
Is the food too damp?
Dogs eating too much dairy, kefir or goat’s milk, or raw and cooked meals with no vegetables, can develop damp conditions. Pause the damp engendering ingredients, frozen food and dairy included, and add a digestive enzyme to meals.
Is the food inappropriate?
Some raw-fed dogs cannot process bone while they have acid reflux. If the acidity in the stomach is not high enough for the LES to close, it is probably not high enough to process bone either.
Try ground bone, or boneless meals with a calcium source added, and watch whether the symptoms improve.
The root goal
Correct the mechanism, not the symptom
The root goal is to feed the food that lets digestion in the Spleen and Stomach happen properly.
Use supplements with caution, because a supplement is a bandage over the situation rather than a correction of the cause. What we want is to understand why the body’s mechanisms are not working, so we can bring them back into balance.
Try one thing at a time. When the answer reveals itself, you want to know which change produced it. My order is: work out whether the dog runs hot or cold and rebalance the temperature of the food. Then heal the gut lining with something like honey. Then look at which ingredients build the right stomach environment so the reflux stops happening.
The bowl
Foods that can help
Supplements
If you are going to use one, use it slowly
Note: Some links in this article are affiliate links (Amazon Associates or other programs I participate in). At no charge to you, as an affiliate, I earn from qualifying purchases.
Digestive enzymes help the body function rather than change the internal environment, which is why they are the category I reach for first.
Slippery elm coats the stomach lining, which means it also blocks the absorption of any supplement or medication. Feed it one to two hours before meals.
Common questions
The things people ask me
What about anti-acid supplements?
You do not actually want to lower the acid level in your dog’s stomach. I would caution against anti-acids. The acid is not the enemy here. The door is.
What about betaine HCl?
Well-meaning dog parents turn to betaine HCl to correct stomach acid levels. Use caution, because you have no way of knowing whether you are helping or, at worst, causing a stomach ulcer. This should be done under the guidance of your vet.
What about slippery elm or marshmallow root?
Both are demulcents, and both help if your dog has a dry heat stomach condition. Remember that slippery elm coats the stomach lining and blocks absorption of anything else, so feed it one to two hours before meals.
What about elevated liver numbers?
The Liver often acts like the check engine light on a car. Liver numbers can rise while your dog has reflux. Removing or lowering the dietary liver you are feeding is one approach, but if the underlying issue is untouched, that is like changing the condiments without changing the food.
Why do you not recommend anti-acids or betaine HCl at all?
Both raise or lower acid levels, and both are effective at doing so. I prefer whole food sources first. The body knows what to do with whole food. It can respond to these supplements, but that is not the most natural route to the same place.
Two rules
Avoid the kitchen sink
There is no doubt that you want to help your dog, and in that love you may want to try several ingredients and supplements at once. Go slow and methodical instead. Try one thing. Observe whether it improves the situation or makes it worse.
Simplify the diet and clean it up
Our dogs suffer from excess, because we overfeed:
- Dairy
- Fermented food
- Exotic treats
- Too many supplements
- Supplements that are too hot in nature, turmeric being the main one
- Shellfish
Clean up the diet and feed only what your dog needs. Avoid recipes with too many ingredients until the acid reflux resolves.
Putting it together
Three takeaways
Work with me
If you cannot tell which pattern you are in
Two of these five patterns look nearly identical from the outside and separate on the tongue. Once the pattern is clear, the ingredient list follows from it rather than being guessed at. If you have been changing one thing at a time and still cannot find it, book a consultation and we will work the pattern out together. The Heal The Gut package includes one call, two recipes, three months of email support and a wellness plan to outline what food and herbs will help.
Related reading: the cold and hot nature of foods, leaky gut, and it is all about the umami.
Resources
Where this comes from
- Disorders of the esophagus in dogs, Merck Veterinary Manual.
- Gastrointestinal dysmotility disorders in critically ill dogs and cats.
- Esophagitis in cats and dogs.
- Diagnosis and management of reflux esophagitis.
- Megaesophagus in dogs: causes, symptoms and remedies.
- Sphincter mechanisms at the lower end of the esophagus.
The information on Daily Dog Food Recipes is intended for nutritional, informational and educational purposes only. Nothing here is intended to diagnose, cure, treat or prevent any disease or illness. Please consult your veterinarian about your dog’s medical care.
Hannah Zulueta obtained her Certificate in Canine Nutrition from CASI Institute. She is also studying for her Doctorate in Acupuncture, Traditional Chinese Medicine, and Herbalism from the esteemed Pacific College of Health and Medicine. If you’re as keenly interested in health for yourself, visit her website for human health: Satori Acupuncture and Herbs.
She resides in San Diego with her three dogs, Maggie, Orbit, and Mr. Higgins.
She is available for one on one consultations. She develops evidence-based recipes that meet both NRC and AAFCO nutritional standards while integrating the therapeutic food principles of Traditional Chinese Veterinary Medicine into her formulations.
Additionally, you can find her sharing free content on Instagram.
