Emesis in dogs and cats - full review Flashcards
What are the broad gastrointestinal conditions associated with emesis?
Gastritis Gastric or intestinal neoplasia/ polyps Gastric ulceration Gastric/ intestinal entrapment Pyloric stenosis Foreign body Dietary Infection/ infestation Inflammatory bowel diseases
What types of gastritis are there?
Eosinophilic
Lymphoplasmacytic
Granulomatous
Acute
What can cause gastric ulceration?
NSAIDs Irritants Neoplasia Metabolic Hypergastrinaemia Mastocytosis
What can cause gastric/intestinal entrapment?
Diaphragmatic hernia Hiatal hernia GDV Intusussception Strangulation
What types of pyloric stenosis are there?
Congenital
Chronic hypertrophic pyloric gastropathy
What are the main infections/ infestations associated with vomiting in dogs?
Parvovirus Campylobacter Distemper Salmonella Mycobacterium Fungus (not in UK) Hookworms/ Roundworms
What are the three main types of inflammatory bowel diseases?
Eosinophilic
Lymphoplasmacytic
Granulomatous
What are the main severe possbile consequences of emesis?
Acid-base imbalances/ electrolyte disturbances
Hypovolaemia
Protein-calorie malnutrition
Aspiration pneumonia
What are the main systemic types of condition associated with vomiting?
Metabolic
Toxic
Drug induced
What metabolic issues are associated with vomiting?
Uraemia Ketoacidosis Hepatic encephalopathy Hypoadrenocorticism Hyper/hypocalcaemia Hypokalaemia Hyper/hyponatraemia Septicaemia Hyperviscosity
What are some of the main toxins associated with vomiting?
Lead Ethylene glycol Theobromine Apomorphine Ethanol Lillies (cats)
What are some of the main drugs assocaited with vomiting?
Chemotheraputics (e.g. cisplatic, methotrexate)
Digoxin
Erythromycin
What nervous system disorders are associated with emesis in the dog?
Trauma Space occupying lesions Hydrocephalus Meningitis/ encephalitis Motion sickness Vestibular disease Cerebella disease Visceral epilepsy
In what breeds is chronic hypertrophic pyloric gastropathy more common in?
Certain toy breeds
How is the relationship to eating important with vomiting?
> 10-12 hours after suggests delayed gastric emptying
No relationship to eating possibly more likely to be extra GI (not including pancreas)
Why is lipid profile something to use with parvovirus?
It works as in indicator of prognosis
Why is oral feeding better than perenteral?
Studies in humans show reduced infection rate, better prognosis, decreased bacterial translocation, earlier discharge, cheaper
What receptors are in the CRTZ?
D2
NK-1
5-HT3
What receptors are in the vomiting centre?
NK-1
AChM
What are the main infections that can cause vomiting in cats?
Coronavirus FIP Feline panleukopaenia virus Other bacterial infections Virulent calicivirus
What is feline acute haemorrhagic vomiting syndrome?
Self limiting acute vomiting, often with fresh blood, occurring in outbreaks in rescue shelters in UK, aetiology currently unknown.
What is Zollinger-Ellison syndrome?
Gastrinomas secrete gastrin, leading to overproduction of acid.
What non GI tract abdominal causes of emesis are there?
Hepatobiliary disease Pancreatic disease Peritonitis Renal disease Splenic disease Steatitis Urogenital disease Adrenal gland tumours
What hepatobiliary diseases are associated with vomiting?
Neoplasia Chronic hepatitis Cholangiohepatitis Cholangitis/ cholecystitis Hepatic lipidosis PPDH Biliary cirrhosis/ atresia
What pancreatic diseases may cause vomiting?
Pancreatitis
Pancreatic cysts/ abscess
EPI
Neoplasia
What types of urogenital disease may cause vomiting?
Pyo Prostatitis Uroperitoneum Urethral obstruction Uterine rupture Congenital abnormalities
What are the main types of periotonitis?
Bile
Urine
Septic
What are the MOST common causes of chronic vomiting in cats?
IBD Adverse reactions to food Liver disease Uraemia (Hyperthyroidism)
What respiratory disease may relate to vomiting?
Chronic nasal disease
Compare abdominal pain with pancreatitis in dogs and cats
More consistent in dogs, may not be present in cats.
What does bile in the vomit suggest?
Patent pylorus
What are the more common reasons for GI obstruction in cats?
Linear FBs
Trichobenzoars
Megacolon
Focal intestinal neoplasia
What is skin fragility associated with?
Cholangiohepatitis and hepatic lipidosis
How may cholesterol change in IBD?
May be low
What systems can cause hypocobalaminaemia
Intestines, pancreas, hepatobiliary system
What is the correct test for pancreatitis in cats?
Must be fPLi - amylase and lipase of no use
What would a suitable food for acute vomiting be?
Moderately energy dense Low fibre Wet Lowish fat Given in small bits All of these as they do not cause slow down of gastric emptying
Why may B12 be needed for life with EPI?
Some of the intrinsic factors needed are from the pancreas, therefore may never return
What further test should you do if you diagnose atypical addisons?
Aldosterone stimulation test. An animal may prove to fail the test even when electrolytes are normal
What is bilious vomiting syndrome in dogs?
Early vomiting of bile in otherwise healthy dogs
Most commonly in young males
Thought to be due to reflux of duodenal fluid into gastric lumen causing gastric mucosa irritation
Possibly associated with abnormal gastric motility
What are the signs of septic peritonitis on tap
Low glucose
High bacteria
Plant material
Lots of degenerate neutrophils with bacteria
What on abdominal radiographs would suggest the need for surgery?
Gas in the peritoneum without recent Hx of Sx (rupture)
Plication of intestines
GVD
Ground glass appearance of the abdomen (septic peritonitis)
Evidence of obstructive ileus (FB, volvulus, FB, pyloric stenosis, intussusception)
