Regurgitation, vomiting and diarrhoea

image of Regurgitation, vomiting and diarrhoea
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Vomiting and diarrhoea are extremely common reasons for owners to present their dogs at veterinary clinics. A logical systematic approach, beginning with a full history and thorough physical examination, is necessary to ensure that appropriate further investigations and treatments are instigated. This chapter discusses presenting signs and causes, diagnostic approach and principles of treatment.

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13.3 A lateral thoracic radiograph of a 7-year-old Whippet with regurgitation, pyrexia and a soft cough. A large gas-filled megaoesophagus is visible, and there is patchy increased opacity in the cranioventral lung lobes consistent with aspiration pneumonia.
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13.4 An oesophageal foreign body (bone) viewed endoscopically in a West Highland White Terrier with acute regurgitation. Oesophagitis is evident following removal of the foreign body. The dog was treated with gastroprotectants for 7 days.
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13.5 Initiation of vomiting. CRTZ = chemoreceptor trigger zone; GI = gastrointestinal.
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13.8 A suggested approach to acute vomiting and/or diarrhoea. MDB = minimum database.
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13.9 A suggested approach to chronic vomiting and/or diarrhoea. EPI = exocrine pancreatic insufficiency; GI = gastrointestinal; IBD = inflammatory bowel disease; SI = small intestinal; TLI = trypsin-like immunoreactivity.
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13.13 Right lateral radiograph of a large-breed dog with gastric dilatation–volvulus. The pylorus can be seen in the dorsocranial abdomen and is gas-filled, giving a ‘boxing glove’ or reverse c-shape appearance.
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13.14 Lateral abdominal radiograph showing a small region of gaseous distension of the small intestine, and a more obvious increased soft tissue opacity in the cranial abdomen consistent with a fluid-filled distended stomach, in a Labrador Retriever bitch with acute vomiting. During surgery, a proximal duodenal foreign body was identified. An enterotomy was performed and the dog recovered uneventfully.
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13.16 Ultrasound images from a 1-year-old dog with diarrhoea and a palpable abdominal mass. The images show an intussusception in cross-section and longitudinal section. (Courtesy of M Costello)
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13.17 An appropriately sized midline laparotomy incision in a large-breed dog with a GDV. A gaseous distended stomach can be seen covered in greater omentum.
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13.18 The appearance of a linear intestinal foreign body on exploratory laparotomy. Note the bunching of the intestines.
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13.19 A perforated gastric ulcer at laparotomy in a dog presenting with haematemesis and signs of an acute abdomen. The ulcer was thought to have been caused by long-term NSAID medication.
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