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Wayne Veterinary Hospital PA

Discussion of Vomiting cont.

If laboratory testing fails to identify a nongastrointestinal cause of vomiting, the focus should move to investigation of gastrointestinal disease as a possible cause. The diagnostic approach includes contrast radiography, ultrasonography, endoscopy, or laparotomy. Frequently, inflammatory gastro-intestinal lesions are a cause of chronic vomiting; these conditions include gastritis, inflammatory bowel disease (IBD) of the small intestine, and colitis. The diagnosis should be confirmed with gastrointestinalbiopsies. In cats with inflammatory bowel disease, vomiting often is the predominate clinical sign, with diarrhea being a minor component of the disease. Conditions such as gastric antral pyloric mucosal hypertrophy, antral polyps, foreign bodies, or neoplasia can cause gastric outflow obstruction, with gastric retention and vomiting. These gastric lesions usually are easily identified endoscopically or by contrast radiography.

 

Obstructive intestinal lesions, such as foreign bodies, intussusception, and neoplasia, usually require radiographic contrast studies or ultrasonography for diagnosis. The diagnosis of gastrointestinal motility disorders should be considered when clinical signs support abnormal gastric retention and a failure to identify inflammatory or obstructive gastrointestinal lesions. Specialized contrast studies that evaluate motility, or possibly a clinical response to gastrointestinal prokinetic agents, may support a diagnosis of gastric hypomotility.

In summary, vomiting is a complex clinical sign that is associated with a vast number of clinical conditions. Frequently, only through a complete and systematic approach is the cause of the vomiting identified. The veterinarian who understands the mechanisms of vomiting is able to select the appropriate diagnostics or therapy for this clinical sign.

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