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1040 Vomiting, Acute

Advanced or Confirmatory Testing meloxicam 0.1 mg/kg PO q 24h), PROGNOSIS & OUTCOME
Depending on prior results, any of these tests antibiotics if indicated (penetrating Varies, depending on condition:
VetBooks.ir • Ultrasound, CT, or MRI of larynx 12.5 mg/kg PO q 12h, then base the • Infectious tracheobronchitis: excellent
wound; consider amoxicillin-clavulanate
may be helpful:
decision on aerobic and anaerobic
• Trauma, inflammation, or foreign body: good
• Serum acetylcholine receptor antibodies titer
to guarded
(myasthenia gravis [p. 668])
• Electromyography (myopathies) culture and sensitivity [C&S]), soft • Laryngeal paralysis: for life, good to guarded
palate resection if indicated
• Exploratory surgery ± biopsy and histopatho- ■ Eversion of laryngeal saccules: resection with surgery; voice change will not resolve
logic exam ■ Laryngeal mass: resection (ventricu- • Resectable laryngeal mass: good if benign and
locordectomy/partial laryngectomy), clean resection; poor if malignant, nonresect-
TREATMENT radiation therapy, or chemotherapy able, and/or not responsive to chemotherapy
■ If mass resection impossible: total or radiation therapy
Treatment Overview laryngectomy with permanent trache-
• Stabilize the patient if upper airway ostomy PEARLS & CONSIDERATIONS
obstruction/dyspnea. ○ If secondary to functional cause
• Determine cause of voice change. ■ Laryngeal paralysis: unilateral cricoary- Comments
• Address primary cause of the condition. tenoid lateralization • A very common underlying cause in dogs
■ Surgical decompression of recurrent is laryngeal paralysis.
Acute and Chronic Treatment laryngeal nerve (hematoma, abscess • Ingestion of irritants (e.g., liquid potpourri)
• Stabilization of the patient drainage, mass excision) can cause oral ulceration along with laryngitis.
○ If associated with mild inspiratory ■ Acquired neuropathy/neuromuscular
stridor disease: treat according to primary Technician Tips
Sedation of the patient, oxygen supple- cause. Voice change is often the first sign of laryngeal
■
mentation if necessary (p. 1146) paralysis. Ask owners of predisposed dogs (i.e.,
○ If associated with severe inspiratory stridor Possible Complications older retrievers) about any change in bark.
and dyspnea Varies; depends on primary cause:
Sedation of the patient, oxygen • Laryngeal paralysis: aspiration pneumonia Client Education
■
supplementation, intubation/ventilation • Tumor: recurrence, progression of disease If the cause is infectious tracheobronchitis, the
if necessary, emergency tracheostomy (local, regional, systemic) affected dog should avoid contact with other
(p. 1166) if indicated • Inflammation, infection, or foreign body: dogs.
• Addressing the primary cause. airway obstruction, recurrence possible
○ If secondary to anatomic cause • Trauma: potential irreversible nerve damage SUGGESTED READING
Tracheobronchitis (infectious) (p. 987)
■ Monnet E: Surgical treatment of laryngeal paralysis.
Local trauma/inflammation: foreign Recommended Monitoring
■ Vet Clin Small Anim 46:709-717, 2016.
body removal, antiinflammatory drugs Depends on primary cause
(e.g., carprofen 2 mg/kg PO q 12h or AUTHOR: Bertrand Lussier, DMV, MSc, DACVS
EDITOR: Leah A. Cohn, DVM, PhD, DACVIM

Vomiting, Acute Client Education
Sheet

BASIC INFORMATION GEOGRAPHY AND SEASONALITY (difficulty swallowing) and regurgitation (passive
Infectious causes often are more prevalent in movement of ingesta). Important components
Definition specific geographic regions. of the history:
Active expulsion of stomach and sometimes • Vaccination status (parvoviral enteritis and
duodenal contents is preceded by nausea and ASSOCIATED DISORDERS canine distemper are more likely in unvac-
retching; duration is less than 7 days. The most common cause of acute vomit- cinated dogs)
ing is dietary indiscretion, but numerous • Administration or ingestion of potentially
Synonym gastrointestinal (GI) or systemic diseases can ulcerogenic drugs such as NSAIDs or
Acute emesis also cause vomiting. glucocorticoids
• Possibility of ingestion of a foreign body
Epidemiology Clinical Presentation (e.g., exposure to objects that could be
SPECIES, AGE, SEX DISEASE FORMS/SUBTYPES ingested; individual propensity to such
• Any animal can be affected; patient • Patients can be presented looking healthy ingestions)
demographics depend on the underlying with no concurrent signs of systemic disease. • Dietary history (e.g., recent changes; content
cause. These are classified as nonserious cases. and volume of recent and typical meals)
• Young animals are more likely to ingest • Patients can be presented while showing • Description of the vomitus (e.g., hemateme-
foreign bodies or acquire infectious diseases systemic clinical signs (e.g., lethargy, dehydra- sis) and productiveness (e.g., nonproductive
(viral and parasitic). tion, abdominal distention, icterus, fever). with gastric dilation/volvulus [GDV])
These are classified as serious cases. • Time relation of vomiting to food intake: if
RISK FACTORS vomiting of undigested or partially digested
Use of drugs such as nonsteroidal antiinflam- HISTORY, CHIEF COMPLAINT food occurs 7-10 hours after ingestion, gastric
matory drugs (NSAIDs) and chemotherapy; It is important to differentiate vomiting (active outflow obstruction or gastric hypomotility
inadequate vaccination; dietary indiscretion abdominal movement, nausea) from dysphagia is likely.
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