Vomiting and Regurgitation Flashcards
What are the clinical signs of regurgitation?
Hypersalivation - Odynophagia (pain when eating) - Anorexia - Dysphagia (difficulty swallowing) - Nasal discharge - Coughing
A dog is passing up with abdominal effort, prodromal nausea, the food seems digested and they are eating normally. Vomiting or regurgitation?
Vomiting
How could you tell a dog is regurgitating food and not vomiting?
No abdominal effort - No prodomal nausea - Undigested food - Alkaline pH - Pain when eating
What diagnostics should be carried out to determine the problem?
Physical exam (oesophageal palpation) - Haematology - Biochemistry - Urinalysis - Diagnostic imaging - Endoscopy
What are the differential diagnosis of Mega-oesophagus?
Idopathic megaoesophagus - Myasthenia gravis - Thymoma - Hypoadrenocorticism
What can cause oesophagitis?
Chemical injury (corrosive, medication) - Gastro-oesophageal ruflux - Oesophageal foreign bodies
How do you treat oesophagitis?
Dietary - small meals with high protein and low fat to minimise acid reflux
Sucralfate liquid - chemical bandage
Gastric acid inhibitors - H2 blockers and proton pump inhibitors (omeprazole)
If there is an oesophageal foreign body what do you do next?
Endoscopy - Either push into stomach or try a retrieval
When you know an animal is vomiting, what is the next step?
Refine the problem - is it acute/chronic? Is it primary (GI) or secondary (extra-GI)
Name some primary acute causes of vomiting
Indiscretion, intolerance, hypersensitivity (dietary) - Parasites, parvovirus (infection) - Neoplasia, foreign body, gastric hypertrophy (obstruction) - Motility disorders
Name some primary chronic causes of vomiting
Gastritis, IBD, ulceration (inflammatory disease) - Neoplasia
Name some secondary causes of vomiting
Uraemia - Addison’s disease - Hepatic disease - Pancreatitis - Toxic ingestion - Drugs
What should be investigated when a dog/cat is presented with chronic vomiting?
Bloodwork - Urinalysis - Imaging - Possible endoscopy
What is sucralfate and what does it protect against?
Aluminium hydroxide and sucrose octasulfate - Dissociates and sucrose octasulfate reacts with HCl to produce viscous sticky substance forming protective barrier against ulcerations
What is omeprazole used to treat? How does it work?
Gastric hyperactivity, Ulcers and erosions, Zollinger-Ellison syndrome (gastrinoma) - Proton pump inhibitor - Binds to parietal cells irreversibly blocking H+ secretion
