Page 490 - Small Animal Internal Medicine, 6th Edition

462 PART III Digestive System Disorders

CHAPTER 30
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Disorders of the Stomach

GASTRITIS 1 to 2 days, abdominal imaging (preferably ultrasound), a
complete blood count (CBC), and a serum biochemistry
ACUTE GASTRITIS profile are indicated.
Etiology Treatment
Ingestion of spoiled or contaminated foods, foreign objects, Withholding food and water for 24 hours often controls
toxic plants, chemicals, and/or irritating drugs (e.g., nonster- vomiting. If vomiting persists or is excessive, or if the animal
oidal antiinflammatory drugs [NSAIDs]) are common becomes depressed because of the vomiting, central-acting
causes of acute gastritis. Infectious (i.e., viral and bacterial) antiemetics (e.g., maropitant, ondansetron) and/or fluids
causes occur but are poorly defined in dogs and cats. may be administered parenterally (see pp. 437-438). If there
is minor hematemesis (i.e., a few specks of digested blood),
Clinical Features then a proton pump inhibitor (e.g., omeprazole) might be
Dogs are more commonly affected than cats by acute gastri- administered but is rarely necessary. Begin oral intake by
tis, probably because of their less discriminating eating frequently offering small amounts of cool water. If the animal
habits. Signs usually consist of acute onset of vomiting; food drinks without vomiting, then small amounts of an easily
and bile are typically vomited, although small amounts of digested diet (e.g., one part cottage cheese and two parts
blood (usually specks or spots of blood as opposed to larger potato; one part boiled chicken and two parts potato) are
amounts) may be present. Affected animals are typically offered. Antibiotics and glucocorticoids are rarely indicated.
uninterested in food and may or may not feel sick. Fever and
abdominal pain are uncommon. Prognosis
The prognosis is excellent as long as the fluid and electrolyte
Diagnosis balance is maintained.
Unless the animal was seen eating some irritative substance,
acute gastritis is usually a presumptive diagnosis of exclusion HEMORRHAGIC GASTROENTERITIS
based on history and physical examination findings. Abdom- (ACUTE HEMORRHAGIC DIARRHEAL
inal imaging and/or clinical pathologic data are indicated if SYNDROME—SEE UNDER “DISORDERS
the animal is severely ill or if other disease is suspected. In OF THE INTESTINAL TRACT”)
such a case, acute gastritis is a reasonable tentative diagnosis
after alimentary foreign body, obstruction, parvoviral enteri- Etiology
tis, uremia, diabetic ketoacidosis, hypoadrenocorticism, The cause of acute hemorrhagic diarrheal syndrome (AHDS)
hepatic failure, hypercalcemia, and pancreatitis are ruled is suspected to be Clostridium spp. The name has been
out. If the hyporexia/vomiting resolves after 1 to 2 days of changed to AHDS recently because histologically the damage
symptomatic and supportive therapy, the tentative diagnosis is in the intestines, not the stomach.
is generally assumed to be correct (acute pancreatitis is still
possible; see Chapter 37). Clinical Features
Because acute gastritis is a diagnosis of exclusion and its AHDS occurs in dogs and is a more severe disease than
signs are suggestive of various other disorders (e.g., foreign acute gastritis, typically causing profuse hematemesis and/or
bodies, intoxication), good anamnesis and physical exami- hematochezia. It classically occurs in smaller breeds that have
nation are critical. The owner should monitor the pet, and if not had access to garbage. This disorder has an acute course,
the animal’s condition worsens or does not improve within which, if severe, can rapidly produce severe dehydration,

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