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Clinical approach to vomiting and diarrhea in the dog and cat (Proceedings)

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Aug 01, 2008

History
• Signalment
o Age
o Breed
• Previous Medical History
• Current Medical History
• Physical Examination!!

Causes of Vomition
• Activation of Vomition Center:
o Peripheral sensory receptors (afferents)
o Chemoreceptor trigger zone (area postrema)
o Vestibular afferents ("motion sickness")
o Psychogenic ("higher centers")
• Intestinal inflammation
• Heartworms — cats

Acute Vomiting (< 3 days)
• Young Dogs & Cats (< 6 months)
o Dietary
o Intestinal Parasites
o Systemic Diseases
■ Viral
■ Bacterial
■ Fungal
o Intussusception
o Foreign Body
o Toxins

Minimum Data Base — Acute Vomiting
• History
• Physical Examination
• Fecal flotation
• Abdominal Radiographs
• ± CBC (systemic signs!)
• ± Chemistry panel (systemic signs!)
• ± Urinalysis (systemic signs!)

Chronic Vomiting (> 3 Days)
• Young Dogs & Cats (< 6 months)
o Dietary
o Intestinal Parasites
o Systemic Diseases
■ Bacterial
■ Fungal
o Intussusception
o Foreign Body

Minimum Data Base — Chronic Vomiting
• History (past and present)
• Physical Examination
• Fecal flotation
• Abdominal Radiographs
• CBC
• Chemistry panel (electrolytes!)
• Urinalysis
• ± Blood gases

Vomition
Specific Diagnostic Procedures
• Contrast radiography – Barium series for filling defects, mucosal or mural lesion and transit (emptying).
• Ultrasonography — mural masses & thickening, possible guided biopsies.
• Endoscopy — gastric foreign body, ulcerations, masses, mucosal biopsies for histologic examination.
• Exploratory laparotomy – gastrotomy, biopsies or resection for histologic examination