Causes of vomiting in dogs and usefulness of clinical investigations

Abstract

SummaryTo find the most common diagnoses of dogs where vomiting was the main reason for referral and to determine the usefulness of various diagnostic investigations.213 dogs referred for vomiting as main or one of the main causes were analysed retrospectively. Diagnosis was reassessed and categorized into six groups, namely gastrointestinal, systemic, non-gastrointestinal abdominal, neurological, miscellaneous or no diagnosis. All diagnostic investigations were reviewed to assess their usefulness to reach a diagnosis. The usefulness of a diagnostic investigation was scored into the following four groups: enabled a diagnosis; assisted a diagnosis; no assistance, diagnosis reached by another procedure; no assistance, no final diagnosis made.In 203 dogs (95.3%) a diagnosis was reached and was categorised as gastrointestinal (43.7%), systemic (27.7%), non-gastrointestinal abdominal (16.4%), neurological (1.4%) and miscellaneous (6.1%). Laboratory tests enabling or assisting a diagnosis as blood tests in 12.2%; 26.8%, as faecal analysis in 6.6%; 1.4%, as ultrasound in 5.2%; 17%, as cytology in 3.3%; 4.2%, as urinalysis in 2.3%; 9.9% and as radiographs in 1.9%; 8.5% of all cases.Overall, there was a high incidence of dogs referred for vomiting with non-gastrointestinal diseases. Amongst them, renal problems were most commonly seen, which emphasises the need to perform a urinalysis in most dogs with vomiting as major complaint. However, vomiting can be due to a large variety of underlying pathophysiological mechanisms and no single problem seems to be much more common compared to other problems in a referral institution.Based on this investigation it is not possible to clearly state a most useful single diagnostic test in dogs with emesis, however, it could clearly been shown that more than one test is often needed to reach a final diagnosis. This is important for owners to understand but also for referring veterinarians.

Utility of diagnostic tests in vomiting dogs presented to an internal medicine emergency service

“…However, thereby exclusively chronically vomiting patients were included ( 3 ). Another study had a retrospective design without a standardized diagnostic protocol ( 2 ). In contrast, this study had a prospective design and evaluated the diagnostic utility of different tests using a standardized diagnostic approach.…”

“…In the present study, a definite diagnosis was achieved by initial blood tests (bloodgas analysis, complete blood count, serum biochemistry profile) in only one dog, which is contrary to the results of a previous study in which a diagnosis by blood tests was possible in 13% of the cases ( 2 ). The present study was conducted in an emergency setting.…”

“…Further examinations, such as endocrine testing, diagnostics for infectious diseases and parameters for clinical chemistry analysis, such as bile acids or ammonia, were not part of the initial blood tests. It should be noted that in the aforementioned study, this kind of laboratory testing was also included in the assessment ( 2 ), which might explain the divergence.…”

“…In a study involving 213 dogs, the following conditions were reported as the most common causes of vomiting: gastrointestinal disorders, such as gastroenteritis or gastrointestinal foreign bodies, followed by systemic metabolic or toxic disorders, such as uremia, diabetic ketoacidosis, electrolyte disturbances, or intoxication (including drugs). Besides, non-gastrointestinal abdominal disorders such as pancreatic and hepatobiliary disorders or peritonitis, followed by neurological problems were documented as etiologies ( 2 ).…”

“…A recently published study demonstrated that a higher age and a higher frequency of vomiting was correlated with a better utility of sonography in dogs with chronic vomiting ( 3 ). However, another study reported, that radiography and ultrasound did not assist diagnosis in vomiting dogs in ~ 75 and 45% respectively ( 2 ).…”