Chronic Vomiting Flashcards
whats the difference between vomiting and regurgitation?
Vomiting may have abdominal contractions, vomitus may contain bile, nausea or salivation.
Regurgitation is passive.
Does exocrine pancreatic insufficiency cause chronic vomitting?
no, but it does cause weight loss with a normal appetite
list some differentials for chronic vomiting in cats
Primary gastrointestinal: IBD, neoplasia, parasitism, idiopathic gastritis, chronic gastric foreign body
Extra GI/systemic: hyperthyroidism, chronic pancreatitis, hepatobiliary disease, chronic kidney disease, hypercalcemia
list a few diagnostic tests for chronic vomiting
- CBC/Chem
- Urinalysis
- T4
- hypoallergenic diet trial
- abdominal imaging
- surgical and endoscopic GI biopsies
Surgical vs endoscopic biopsies
surgical: more invasive, full thickness biopsies, access to all portions of the small intestine
endoscopic: less invasive, biopsy of mucosa +/- submucosa, access to stomach, duodenum and ileum
A cat with chronic vomiting has histopathology come back with moderate lymphoplasmacytic gastritis and mild to moderate lymphoplasmacytic enteritis, whats the most likely diagnosis?
IBD
treatment for IBD in cats
prednisolone, recheck in 2 weeks and once clinical signs and albumin are controlled taper the pred
prednisolone side effects
diabetes mellitus, skin fragility, weight gain, polyphagia, pu/pd, increased risk of infection
what could you consider if IBD was not well controlled with pred alone or if the patient couldn’t tolerate corticosteroids long term?
secondary immunosuppressants -> chlorambucil, cyclosporine
cerenia (maropitant)
Neurokinin-1 receptor that acts in CNS by inhibiting binding of substance P (nt involved in vomiting)
antiemetic
Ondansetron
5 -HT3 receptor antagonist, receptors are found on vagal nerve and chemoreceptor trigger zone
antiemetic
t/f: maropitant and ondansetron can be used together if needed
T
small cell GI lymphoma treatment
prednisolone and chlorambucil
chronic vomiting differentials for dogs
Primary GI: IBD, neoplasia (lymphoma, adenocarcinoma), parasitism, idiopathic gastritis, chronic gastric foreign body, dietary indiscretion, bilious vomiting syndrome, pyloric hypertrophy
Extra GI/ systemic: hypoadrenocorticism, chronic pancreatitis, hepatobiliary disease, CKD, hypercalcemia, hyperthyroidism
how could you differentiate IBD from small cell lymphoma if you can’t differentiate on histo?
PCR for antigen receptor rearrangements (PARR)
