Emesis in dogs and cats - full review

Question 1

What are the broad gastrointestinal conditions associated with emesis?

Answer 1

Gastritis
Gastric or intestinal neoplasia/ polyps
Gastric ulceration
Gastric/ intestinal entrapment
Pyloric stenosis
Foreign body
Dietary
Infection/ infestation
Inflammatory bowel diseases

Question 2

What types of gastritis are there?

Answer 2

Eosinophilic
Lymphoplasmacytic
Granulomatous
Acute

Question 3

What can cause gastric ulceration?

Answer 3

NSAIDs
Irritants
Neoplasia
Metabolic
Hypergastrinaemia
Mastocytosis

Question 4

What can cause gastric/intestinal entrapment?

Answer 4

Diaphragmatic hernia
Hiatal hernia
GDV
Intusussception
Strangulation

Question 5

What types of pyloric stenosis are there?

Answer 5

Congenital

Chronic hypertrophic pyloric gastropathy

Question 6

What are the main infections/ infestations associated with vomiting in dogs?

Answer 6

Parvovirus
Campylobacter
Distemper
Salmonella
Mycobacterium
Fungus (not in UK)
Hookworms/ Roundworms

Question 7

What are the three main types of inflammatory bowel diseases?

Answer 7

Eosinophilic
Lymphoplasmacytic
Granulomatous

Question 8

What are the main severe possbile consequences of emesis?

Answer 8

Acid-base imbalances/ electrolyte disturbances
Hypovolaemia
Protein-calorie malnutrition
Aspiration pneumonia

Question 9

What are the main systemic types of condition associated with vomiting?

Answer 9

Metabolic
Toxic
Drug induced

Question 10

What metabolic issues are associated with vomiting?

Answer 10

Uraemia
Ketoacidosis
Hepatic encephalopathy
Hypoadrenocorticism
Hyper/hypocalcaemia
Hypokalaemia
Hyper/hyponatraemia
Septicaemia
Hyperviscosity

Question 11

What are some of the main toxins associated with vomiting?

Answer 11

Lead
Ethylene glycol
Theobromine
Apomorphine
Ethanol
Lillies (cats)

Question 12

What are some of the main drugs assocaited with vomiting?

Answer 12

Chemotheraputics (e.g. cisplatic, methotrexate)
Digoxin
Erythromycin

Question 13

What nervous system disorders are associated with emesis in the dog?

Answer 13

Trauma
Space occupying lesions
Hydrocephalus
Meningitis/ encephalitis
Motion sickness
Vestibular disease
Cerebella disease
Visceral epilepsy

Question 14

In what breeds is chronic hypertrophic pyloric gastropathy more common in?

Answer 14

Certain toy breeds

Question 15

How is the relationship to eating important with vomiting?

Answer 15

> 10-12 hours after suggests delayed gastric emptying

No relationship to eating possibly more likely to be extra GI (not including pancreas)

Question 16

Why is lipid profile something to use with parvovirus?

Answer 16

It works as in indicator of prognosis

Question 17

Why is oral feeding better than perenteral?

Answer 17

Studies in humans show reduced infection rate, better prognosis, decreased bacterial translocation, earlier discharge, cheaper

Question 18

What receptors are in the CRTZ?

Answer 18

D2
NK-1
5-HT3

Question 19

What receptors are in the vomiting centre?

Answer 19

NK-1

AChM

Question 20

What are the main infections that can cause vomiting in cats?

Answer 20

Coronavirus
FIP
Feline panleukopaenia virus
Other bacterial infections
Virulent calicivirus

Question 21

What is feline acute haemorrhagic vomiting syndrome?

Answer 21

Self limiting acute vomiting, often with fresh blood, occurring in outbreaks in rescue shelters in UK, aetiology currently unknown.

Question 22

What is Zollinger-Ellison syndrome?

Answer 22

Gastrinomas secrete gastrin, leading to overproduction of acid.

Question 23

What non GI tract abdominal causes of emesis are there?

Answer 23

Hepatobiliary disease
Pancreatic disease
Peritonitis
Renal disease
Splenic disease
Steatitis
Urogenital disease
Adrenal gland tumours

Question 24

What hepatobiliary diseases are associated with vomiting?

Answer 24

Neoplasia
Chronic hepatitis
Cholangiohepatitis
Cholangitis/ cholecystitis
Hepatic lipidosis
PPDH
Biliary cirrhosis/ atresia

Question 25

What pancreatic diseases may cause vomiting?

Answer 25

Pancreatitis Pancreatic cysts/ abscess EPI Neoplasia

Question 26

What types of urogenital disease may cause vomiting?

Answer 26

``` Pyo Prostatitis Uroperitoneum Urethral obstruction Uterine rupture Congenital abnormalities ```

Question 27

What are the main types of periotonitis?

Answer 27

Bile Urine Septic

Question 28

What are the MOST common causes of chronic vomiting in cats?

Answer 28

``` IBD Adverse reactions to food Liver disease Uraemia (Hyperthyroidism) ```

Question 29

What respiratory disease may relate to vomiting?

Answer 29

Chronic nasal disease

Question 30

Compare abdominal pain with pancreatitis in dogs and cats

Answer 30

More consistent in dogs, may not be present in cats.

Question 31

What does bile in the vomit suggest?

Answer 31

Patent pylorus

Question 32

What are the more common reasons for GI obstruction in cats?

Answer 32

Linear FBs Trichobenzoars Megacolon Focal intestinal neoplasia

Question 33

What is skin fragility associated with?

Answer 33

Cholangiohepatitis and hepatic lipidosis

Question 34

How may cholesterol change in IBD?

Answer 34

May be low

Question 35

What systems can cause hypocobalaminaemia

Answer 35

Intestines, pancreas, hepatobiliary system

Question 36

What is the correct test for pancreatitis in cats?

Answer 36

Must be fPLi - amylase and lipase of no use

Question 37

What would a suitable food for acute vomiting be?

Answer 37

``` 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 ```

Question 38

Why may B12 be needed for life with EPI?

Answer 38

Some of the intrinsic factors needed are from the pancreas, therefore may never return

Question 39

What further test should you do if you diagnose atypical addisons?

Answer 39

Aldosterone stimulation test. An animal may prove to fail the test even when electrolytes are normal

Question 40

What is bilious vomiting syndrome in dogs?

Answer 40

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

Question 41

What are the signs of septic peritonitis on tap

Answer 41

Low glucose High bacteria Plant material Lots of degenerate neutrophils with bacteria

Question 42

What on abdominal radiographs would suggest the need for surgery?

Answer 42

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)