Unit 4- Vomiting, Diarrhea, and Anorexia

What is Vomiting?

“Emesis”

• Forcible ejection of stomach contents through the mouth

• Includes 3 parts: nausea, retching, and vomiting

4 signs prior to vomiting?

• anxiety

• Depression

• Salivation, licking of lips

• Increased swallowing

Vomiting vs. Regurgitation

Vomiting

• visible food partially digested and mixed with fluid

• Obvious abdominal movements before expulsion

• PH is acidic

Regurgitation

• food is undigested

• Maybe slightly moist

• “Tube” shape

• Expulsion is effortless

• PH neutral to alkaline

How to determine the cause of vomit / regurgitation?

• history

• PE

• Abdominal rads

• Endoscopy

• Lab tests (cbc, chem screen, fecal)

What is some history that you should collect for about vomit?

• diet change

• Environmental change

• Appetite change

• Exposure to noxious substances

• Exposure to infectious animals-vax up to date

• Any toys/clothes missing?

• Frequency of vomiting?

• Description of contents (texture, color)

What kind of things to collect in description of contents?

Color: yellow, clear, red flecks, “coffee grounds”, green

Consistency: mucous. Foam, food present, abnormal contents, odor, pieces

Rule of thumb for estimating volume of throw up?

5mls= 1tsp

15mls= 1 tbsp

Take the volume you think and double it

Consequences of vomit (3)?

1. Dehydration

2. Acid-Base Imbalance

3. Possible aspiration

What is the importance of electrolytes in the body? (Specifically chloride, potassium, and sodium?)

Chloride- maintains fluid balance

Potassium- regulates heart contraction, helps maintain fluid balance

Sodium- maintains fluid balance and necessary for muscle contraction and nerve function

Management and treatment of vomiting?

• remove initiating cause

• Control vomit

• Correct deficits (dehydration, electrolytes)

• Assess dehydration (IV fluids if over 5% dehydrated)

• Control water intake

• Withhold food to give stomach and intestine time to rest

How to reintroduce animal to food?

• over 3 days

• Feed small amounts 3-6 times/day

• Use bland food

How to reintroduce animal to their regular diet?

• slowly

• Feed 2-3 times/day

• Over 4 days animal can be returned to regular food

1:3

2:2

3:1

4:0

Define “Diarrhea”, “Tenesmus”, and “Dyschezia”

Diarrhea- “Passage of loose or liquid watery stool at increased frequency”

Tenesmus- “Feeling that you need to pass stool, even though your bowels are empty. May involve straining, pain, cramping.”

Dyschezia- “Difficult or painful evacuation of feces from the rectum.”

What is “Frank Blood” and “Melena”?

Frank Blood- fresh, red blood on feces

Melena- black tarry feces

3 steps for assessing diarrhea in a patient?

• assess dehydration

• Withhold food or change to intentional diet

• Isolate affected animals

What are some consequences to anorexia?

• animal catabolizes body tissue for energy

• Loss of body weight

• Decreased healing ability

• Decreased immune system

• Decreased GI absorption

Treatment and Management for anorexia?

• appetite stimulation (smelly foods, meds)

• Force feeding (gently syringe feed soft foods)

• Enteral Nutrition (feeding tubes)

How to provide Enteral Nutrition?

• Nasoesophageal Tube

Small tube placed through nares to above the stomach

• Esophagostomy tube

Feeding tube surgically placed into cranial esophagus to above the stomach

• Gastrotomy tube

Feeding tube surgically placed into stomach

What is RER (resting energy requirement?)

RER = 30 x (body weight in kg) + 70

RER = how many kcal required per day

Water requirements for dogs and cats?

Dogs: RER x 1.6 = mls water needed

Cats: RER x 1.2 mls = mls water needed