If reasonable concern is established, then a minimum data base of CBC, biochemical profile (or specific tests for evaluation of liver, kidney, pancreas, electrolytes), complete urinalysis (pre-treatment urine specific gravity extremely important for diagnosis of renal failure), and fecal examination is essential. Vomiting patients in some cases require an extensive workup, but an organized approach will help to minimize the tests necessary for an early diagnosis. Vomiting from systemic or metabolic causes may be an acute or chronic sign and generally there is no direct correlation with eating and no predictable vomitus content. It is important to note that chronic intermittent vomiting is a common clinical sign of inflammatory bowel disease in both dogs and cats. A detailed work-up including gastric and intestinal biopsies is often required for definitive diagnosis in these cases. When presented with this pattern of clinical signs, the clinician should strongly consider chronic gastritis, inflammatory bowel disease, irritable bowel syndrome, and a gastric motility disorder as leading differential diagnoses. Depending on the disorder, other signs such as diarrhea, lethargy, inappetence, and salivation (nausea) may occur as well. Often there is no specific time relation to eating, the content of the vomitus varies, and the occurrence of vomiting may be very cyclic in nature. Rule-Outs for Chronic Vomiting, once the Causes listed above are Ruled Out (Main categories)Ĭhronic intermittent vomiting is a common presenting complaint in veterinary medicine. Other drugs (e.g., cardiac glycosides, antibiotics, chemotherapeutic agents) Indigestion (e.g., table scraps, garbage ingestion)įood adverse reaction (dietary sensitivity) Most Common Causes of Acute or Chronic Vomiting in Dogs First need to Rule-Out Consideration of the following features is useful in assessing and diagnosing a patient with vomiting: (1) duration of signs,(2) signalment and past pertinent history, (3) environment and diet, (4) systems review (e.g., history of PU/PD, coughing and sneezing, dysuria or dyschezia, etc.), (5) time relation to eating (vomiting of undigested or partially digested food more than 8-10 hours after eating often indicates a gastric motility disorder or gastric outlet obstruction ), (6) content of the vomitus (food, clear fluid, bile, blood, material with fecal odor), and (7) type and frequency of vomiting (projectile?, chronic intermittent?, cyclic?, morning vomiting only?). A complete historical review with emphasis on all body systems is essential for determining a realistic and effective initial work-up plan and treatment protocol. Regurgitation may occur immediately after uptake of food or fluids or may be delayed for several hours or more.īecause of the wide variety of disorders and stimuli that can cause it, vomiting may present the clinician with a major diagnostic challenge. Failure to recognize the difference between regurgitation and vomiting often leads to misdiagnosis. Regurgitation is defined as passive, retrograde movement of ingested material, usually before it has reached the stomach. It is essential that the clinician make a clear differentiation between regurgitation and vomiting at the outset. Serious consequences of vomiting include volume and electrolyte depletion, acid-base imbalance, and aspiration pneumonia. The vomiting act involves three stages: nausea, retching, and vomiting. Vomiting refers to a forceful ejection of gastric and occasionally proximal small intestinal contents through the mouth. Books & VINcyclopedia of Diseases (Formerly Associate).
VINcyclopedia of Diseases (Formerly Associate).
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