50. vomiting and regurgitation Flashcards
What is the difference between Regurgitation and Vomiting?
- Regurgitation
- Passive - no heaving
- No nausea or retching
- +/- undigested food
- +/- no bile
- Vomiting
- Active- heaving
- usually nausea or retching
- usually digested food with bile
find out history from owner types of questions+ differential diagnosis?
- Rule out regurgitation: Heaving, retching, bile, digested food
- When? Associated with eating or not (if yes then most likely gastrolntestinal related)
- Frequency?
- Duration: Acute/chronic
- Appetent or lnappetent
- Water Intake: Normal or altered
- Concurrent diarrhoea
- Parasite control: Hookworm
- Current medications: e.g. NSAIDS or antibiotics
- Diet: Currently fed, recent changes, how much, treats/scraps
- Access to toxins: e.g. Toxic plants -Cycads, Brunfelsia sp., compost or decaying vegetable matter
- Access potential foreign bodies: Bones, toys, string
Mechanisms of vomiting?
- Activation of peripheral receptors within the gastrointestinal tract
- Activation of central vomit centre by CNS disease e.g. Motion sickness, neoplasia etc,
- Vestibular disease
- Activation of chemoreceptor trigger zone by chemicals/toxins, e.g. Uraemia, diabetic ketoacidosis
Gastrointestinal diferentials for vomiting?
Gastritis/enteritis:
Acute gastritis:
• Most common cause • not seriously ill
• Garbage Ingestion, high-fat content, allergy, specific protein intolerance, •viruses, parasites, plants • Bacterial: Helicobacter sp, (difficult to Dx)
> Haemorrhagic gastroenteritis (HGE): • Clostridium perfringens hypersensitivity, parvovirus, parasites
> Chronic gastritis:
• Sporadic vomiting
• Endoscope and biopsy to assess for inflammatory bowel disease and neoplasia
• Gastric/intestinal foreign body/outlet
> Signs of obstruction:
• Foreign body, Intraluminal masses or ;.
intussusception ;.
• Muscular proliferative or infiltrative disease
• Compression of outflow tract e.g. >
neoplasia, granulomatous disease >
• Malposition of stomach e.g. GDV >
• Gastric/intestinal ulceration and erosion:
> Signs of haematemesis, haematochezia,
abdominal pain, melaena, anaemia and hypoproteinaemia:
• Drugs e.g. NSAIDs, corticosteroids
• Hypotensive states
• Severe hepatic or liver disease
• Neoplasia - mast cell tumours
• Stress e.g. severe illness
• Bacterial, viral and parasites
• Gastric motility disorders:
Differential for vomiting extra gastrointestinal
Diagnostics for vomiting?
General treatment plans?
Differentials for regurgitation?
Diagnostics for regurgitation?
Megaoesophagus?
