Unit 4: Vomiting, Diarrhea & Anorexia

Vomiting Basics

Vomiting (Emesis)

Foreible ejection of stomach contents through the mouth; includes nausea, retching, and vomiting.

Signs Prior to Vomiting

Anxiety, depression, salivation, lip licking, increased swallowing movements.

Vomiting vs. Regurgitation

Vomiting Characteristics

Partially digested food, obvious abdominal effort, acidic pH.

Regurgitation Characteristics

Undigested food, may be tubular, effortless expulsion, neutral to alkaline pH.

Determining Cause & History

Key to Determining Cause

Taking a thorough history.

Important History Questions

Ask about diet change, environment change, appetite, exposure to toxins or infectious animals, frequency, and vomit description.

Vomit Description Factors

Color, consistency, volume, and presence of abnormal contents or odor.

Consequences of Vomiting

Primary Consequences of Vomiting

Dehydration, electrolyte imbalance (hypokalemia, hyponatremia), acid-base imbalance, and risk of aspiration.

Important Electrolytes to Check

Sodium, potassium, chloride (maintain fluid balance, nerve/muscle function).

Management & Treatment of Vomiting

Goals of Management

Remove the cause, control vomiting, correct deficits (fluids, electrolytes, acid-base).

Initial Management Steps

Assess dehydration, start IV fluids if >5% dehydrated, control water intake, withhold food.

Reintroduction of Food

Reintroduction Process

Should occur over 3-5 days with small, frequent meals of a highly digestible, bland diet.

Example Reintroduction Diet

Boiled rice with cooked chicken, or veterinary diets like Hills I/D, Royal Canin Gastrointestinal.

Food Transition Period

A gradual 7-day process mixing old and new food to prevent GI upset.

If Diarrhea Occurs During Transition

Slow down the transition; go back to the previous day's feeding ratio until stool forms.

Diarrhea Basics

Diarrhea Definition

Passage of loose or liquid stool at increased frequency.

Tenesmus

The feeling of needing to pass stool despite empty bowels; involves straining, pain, cramping.

Dyschezia

Difficult or painful evacuation of feces.

Diarrhea Description Factors

Color (e.g., frank blood, melena), consistency, volume, presence of foreign material.

Melena

Black, tarry feces; can indicate digested blood or be caused by medications like Kaopectate.

Consequences & Treatment of Diarrhea

Consequences of Diarrhea

Fluid/electrolyte loss, acid-base imbalance, dehydration, weakness, lethargy, anorexia.

Treatment of Diarrhea

Assess dehydration, withhold food or use intestinal diet, IV fluids if severe, isolate if infectious.

Anorexia Basics

Anorexia Definition

Lack or loss of appetite.

Consequences of Anorexia

Catabolism of body tissues, weight loss, decreased healing/immune function, decreased GI absorption; in cats, can lead to hepatic lipidosis.

Hepatic Lipidosis in Cats

A life-threatening condition where fat accumulates in the liver due to anorexia.

Treatment of Anorexia

Anorexia Treatment Methods

Appetite stimulation (smelly foods, meds), force feeding (syringe), enteral nutrition (feeding tubes).

Types of Enteral Feeding Tubes

Nasoesophageal tube, Esophagostomy tube, Gastrotomy tube (PEG tube).

Nutritional Calculations

Resting Energy Requirement (RER)

RER = 30 x (body weight in kg) + 70; the daily kcal requirement.

Water Requirements (Dogs)

RER x 1.6 = mL of water needed per day.

Water Requirements (Cats)

RER x 1.2 = mL of water needed per day.