default

Chronic Vomiting in Pets

overview

default

What is Chronic Vomiting?

default

Vomiting is the active process of bringing up food or fluid from the stomach. Vomiting regularly for more than two weeks is considered chronic and, unlike an acute bout of vomiting, is more likely to be caused by an underlying problem.

Vomiting can be caused by conditions affecting the stomach or intestines, as well as more systemic conditions such as endocrine disease or organ dysfunction. Common conditions affecting the stomach and intestine that cause vomiting include enteritis (chronic inflammation), ulceration, and obstruction.

symptoms

default

What are the symptoms of Chronic Vomiting?

default

Vomiting is always accompanied by contraction of the abdominal muscles, and may be preceded by signs of nausea such as lip-licking and gulping. A passive process in which food or fluid is emitted from the mouth with little to no warning and no abdominal contraction is known as regurgitation. Regurgitation often occurs shortly after eating. It is important to differentiate between vomiting and regurgitation as they have different causes and treatment.

Coughing may sometimes be mistaken for vomiting. Coughing tends to occur in bouts, and causes a longer period of hacking/retching, followed by a relatively small amount of emission from the mouth. Coughing causes clear or white froth, foam or fluid to be brought up, but not food.

diagnosis

default

Which tests are used to diagnose Chronic Vomiting?

default

When approaching cases of chronic vomiting, the animal's age and breed, any known concurrent disease, and their vaccination and worming status will help to guide investigations. Other important information includes the duration and progression of symptoms, the nature and timing of the vomiting, whether diarrhoea is present and any recent dietary changes. You may also be asked if your pet has other symptoms, is a scavenger, or could have had access to anything toxic.

A thorough clinical exam and history taking is always the first step in diagnosis. Further testing will then be required, including some or all of the following:

default

General Blood Tests

default

These are used to provide an overview of organ health, as well as checking electrolytes (such as potassium) and often lipase (suggestive of pancreatitis). If results suggest a systemic disease is present, more directed blood tests may be required.

default

Intestinal-Specific Blood Tests

default

Measurement of three specific parameters, known as folate, TLI and B12, provide more precise information about gastrointestinal function and nutrient absorption. Deficiencies can be indicative of a disease process but also require treatment.

default

Imaging

default

Ultrasound and/or x-rays may be required to assess organ shape and size, examine the gastrointestinal system, and screen for signs of obstruction (such as with a foreign body). Not all foreign bodies will be evident on x-ray, and if there is a high suspicion, exploratory surgery may be recommended. Sedation or anaesthesia is often required for imaging, especially if the abdomen is uncomfortable.

default

Biopsy

default

Ultimately, endoscopic or surgical biopsies of the stomach and intestines may be required for diagnosis, especially to differentiate between severe inflammatory disease and cancerous changes.

treatment

default

How is Chronic Vomiting treated?

default

Treatment depends largely on the results of investigations. Any underlying disease identified should be treated first, as this may lead to resolution of the vomiting. If the patient is dehydrated due to repeated vomiting, hospitalisation and intravenous fluid therapy may be recommended.

default

Surgery

default

If an obstruction or foreign body is suspected, exploratory surgery may be advised to diagnose and treat the problem.

default

Medication

default

Non-specific medication for vomiting includes anti-emetics (prevent nausea/vomiting), pro-kinetics (encourage movement of the intestines), and antacids (reduce the amount of stomach acid produced). These may be used as sole treatment or alongside other treatment.

default

Diet Trial

default

A prescription exclusion diet is used to diagnose and manage food responsive enteropathy. This diet is fed for 4-6 weeks but improvement may be seen as early as 2 weeks. If chronic enteropathy is suspected, parasite treatment and an antibiotic trial may also be used.

outlook

default

What is the outlook for pets with Chronic Vomiting?

default

The prognosis for chronic vomiting is variable, depending on the cause. Pets vomiting due to gastrointestinal obstruction can usually see complete recovery after surgical resolution of the obstruction. Pets who are systemically well and respond well to a diet trial can usually be managed very successfully long term.