Felis ISSN 2398-2950

Vomiting

Contributor(s): Ed Hall, Philip K Nicholls, Kenneth Simpson

Introduction

  • Vomiting is a clinical sign NOT a diagnosis.
  • Differentiate between regurgitation, retching and true vomiting.
  • Cause: primary gastrointestinal problem or secondary to systemic disease.
  • Diagnosis: history, physical, biochemistry, radiography, ultrasonography, endoscopy all useful aids.
  • Treatment: depends on cause. Print off the Owner Factsheet on vomiting and diarrhea Vomiting and diarrhoea to give to your client.
Follow the diagnostic tree for Vomiting Vomiting.

Pathogenesis

Etiology

  • Visceral stimulation of vomiting center.
  • Central stimulation of vomiting center.
  • Vestibular stimulation of vomiting center.
  • Stimulation of chemoreceptor trigger zone (CRTZ).

Pathophysiology

Visceral stimulation

  • Distension of visceral organ/inflammation of visceral mucosa or peritoneum   →   neural stimulation of vomiting center via sympathetic and vagal nerves.

Central stimulation

  • Fear, stress, excitement and head trauma   →   vomiting by unknown mechanisms.

Vestibular stimulation

  • Irregular motion or labyrinthitis   →   disturbance in semi-circular canals   →   stimulation of vomiting center.

Chemoreceptor trigger zone stimulation

  • Inflammation in CNS   →   increased intracranial pressure or toxins   →   uremia/drugs/toxins stimulate chemoreceptor trigger zone in brain   →   dopamine release   →   stimulation of vomiting center.

Effects of vomiting

  • Dehydration.
  • Potassium deficiency (minor loss due to vomiting - most lost through urine as kidney tries to maintain blood volume).
  • Acid-base balance is disturbed - usually metabolic acidosis. (Alkalosis suggests pyloric outflow obstruction with large loss of acidic gastric contents.)

Timecourse

  • See specific conditions.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Huang-Kornic E (1999) Chronic intermittent vomiting in a cat - a case of chronic lymphocytic-plasmacytic gastritis. Can Vet J 40 (3), 196-198 PubMed.
  • Steiner J M, Williams D A (1999) Feline exocrine pancreatic disorders. Vet Clin North Am Small Anim Pract 29 (2), 551-575 PubMed.
  • Guilford W G et al (1998) Prevalence and causes of food sensitivity in cats with chronic pruritus, vomiting or diarrhea. J Nutr 128 (12 Suppl), 2790S-2791S PubMed.
  • Hirt R, Iben C (1998) Possible food allergy in a colony of cats. J Nutr 128 (12 Suppl), 2792S-2794S PubMed.
  • Sullivan M, Yool D A (1998) Gastric disease in the dog and cat. Vet J 156 (2), 91-106 PubMed.


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