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1294 Vomiting, Chronic Vulvar Discharge, Hemorrhagic

Vomiting, Chronic
VetBooks.ir Category Disorder Salient Feature

Systemic: extra-abdominal Uremia Serum biochemistry profile + urinalysis: azotemia + isosthenuria
Hypoadrenocorticism Wax-wane clinical course is common; absence of stress leukogram in ill dog; ACTH
stimulation test confirms
Diabetic ketoacidosis Hyperglycemia, glucosuria, ketonuria, and acidosis
Hypercalcemia Serum calcium concentration
Hyperthyroidism (cats) Serum thyroxine concentration
Heartworm disease (cats; variable) D. immitis antibody and antigen test, echocardiography, or all
Systemic: intraabdominal Hepatobiliary disease Icterus; serum liver enzyme concentrations, serum bile acids concentrations
Pancreatitis Pancreatic lipase immunoreactivity, abdominal ultrasound
Peritonitis Inflammation/infection on abdominocentesis cytology
Gastrointestinal causes Chronic gastritis Endoscopic (with biopsy, histopathology) diagnosis
Food intolerance/allergy Evidence of polysystemic allergies common (otitis/atopic dermatitis, allergic rhinitis/
bronchitis, etc.), dietary elimination trial confirmatory
Foreign body Behavior (“Does this dog like to mouth objects?”), history, radiographic obstructive
pattern
Intussusception Abdominal ultrasound (target/bull’s-eye appearance of intussusceptum within
intussuscipiens)
Parasites (Physaloptera spp, Ollulanus tricuspis) Serial fecal flotations and/or empirical anthelmintic treatment; usually acts otherwise
well
Neoplasia Abdominal imaging +/− needle aspirate; endoscopic or laparotomy (with biopsy,
histopathology) diagnosis
Inflammatory bowel disease Endoscopic or laparotomy (with biopsy, histopathology) diagnosis
Bilious vomiting syndrome History of recurrent early-morning/preprandial vomiting suggestive; response to frequent,
smaller feedings
Motility disorders Radiographic evidence of persistent functional ileus without identifiable cause; diagnosis
of exclusion
Colitis (up to 30% of dogs with colitis vomit) Colitis signs prominent (tenesmus, mucoid stools, dyschezia, hematochezia)
Gastrinoma Evidence of gastric ulceration (usually endoscopic), laparotomy for excision of pancreatic
neoplasm and/or hypergastrinemia confirmatory
Hiatal hernia Serial radiographs (assuming dynamic/“sliding” hiatal hernia)
Pyloric stenosis Delayed gastric emptying on plain or barium-contrast radiographs or flouroscopy;
endoscopic/laparotomy diagnosis
Gastric antral mucosal hyperplasia Endoscopy

AUTHORS: Sylvie Daminet, DVM, PhD, DACVIM, DECVIM; Etienne Côté, DVM, DACVIM

Vulvar Discharge, Hemorrhagic

Hemorrhagic Vulvar Discharge in the Bitch and Queen
With Mainly Superficial (Mature) Epithelial Cells (Estrogen Without Superficial (Mature) Epithelial Cells (No Estrogen
Influence) Influence)
Normal estrus, late proestrus, or early diestrus (most common) Normal lochia, early postpartum (most common)
Ovarian remnant (common) Subinvoluted placental sites, late postpartum (young, primiparous bitches)
Ovarian pathologic condition (i.e., cystic follicles, functional ovarian tumor) Vaginal laceration
Exogenous estrogen Neoplasia of vagina or uterus (most common cause in elderly bitches)
Uterine torsion
Bleeding disorder (especially primary hemostatic defects)

Modified from Willard MD, Tvedten H: Small animal clinical diagnosis by laboratory methods, ed 5, St. Louis, 2012, Elsevier.

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