by Barry B. Burtis D.V.M
When vomiting persists for more than 5-7 days or when it occurs intermittently for several days or weeks and is non-responsive to symptomatic treatment, we call it chronic vomiting. In a previous column, there was a discussion of acute vomiting and of course, on first examination, issues that can be associated with the acute disorder will need to be considered.
However, when vomiting continues over a longer period of time, there will possibly be other significant points that can be determined by a veterinarian taking the history of the problem. Stomach disorders are more likely to be associated with bringing up food, clear or bile-coloured fluid, a reduced appetite, increased water intake and abdominal distention. If diarrhea and significant weight loss are present with the vomiting, that is more characteristic of intestinal tract ailments. If there is weakness, increased urination or jaundice, along with vomiting, it is more likely disease elsewhere in the body exists.
When a veterinarian examines a patient with a history of prolonged vomiting, certain findings on the physical may be helpful in reaching a diagnosis. Weight loss and poor haircoat may indicate chronic malnutrition. When the abdomen is palpated, abdominal distention, pain, palpably thickened bowel loops or masses are things that are specifically looked for. Pale mucus membranes would likely suggest anemia. It would be important to assess for dehydration. A rectal examination might be done to detect diarrhea.
It is important for both pet owners and veterinarians to differentiate vomiting from regurgitation. Regurgitation is passive movement back into the mouth and nasal region of fluid and undigested food that has not yet reached the stomach. It occurs without any abdominal component. It suggests, the esophagus, the tube connecting the mouth and the stomach, is involved in the problem. Cats and dogs that are vomiting may also regurgitate ingesta. Vomiting by a pet is often preceded by restlessness, nausea, salivation and repeated swallowing. If a patient is vomiting recently eaten or partially digested food, it is more likely the stomach is involved. Vomitus that is bile or yellow coloured is more likely intestinal in origin.
Treatment for vomiting should be directed at the specific cause. Often supportive measures will also be necessary. Fluid therapy is often necessary to correct dehydration and provide for ongoing needs. Correction of any electrolyte imbalances will also be necessary. Patients with food allergies or inflammatory bowel disease may require dietary therapy. If gastro-intestinal bleeding has been associated with the vomiting, blood transfusions may be needed to treat an anemia. If obstruction or perforation of the bowel is diagnosed, surgical intervention will be necessary.
Additionally, there are a great number of drugs that can be used, under a veterinarian's direction, to control the vomiting. There are anti-vomiting drugs that work directly on the vomiting control center in the brain. Antibiotics are given for certain stomach or intestinal problems. There are medications that can be given to coat, protect and/or soothe irritated, inflamed lining tissues of the stomach and intestines. Anti-secretory drugs can be given to reduce buildup of fluid secretions in the stomach. There are medicines that assist a vomiting patient by enhancing the emptying and movement of contents from the stomach. If patients receiving chemotherapy experience nausea and vomiting, there are medicines that can be given before treatment to help counteract that problem. Parasite control medications are used to eliminate parasitic causes of vomiting.
Pet owners should always seek the advice of a veterinarian when their pet experiences repeated vomiting. Barry Burtis is a local companion animal veterinarian. Past Pet Tales can be found at www.baycitiesanimalhospital.ca