Acute Vomiting & Diarrhea: Overview & Presentation

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Vomiting and diarrhea may indicate a primary gastrointestinal (GI) disorder or a manifestation of a systemic, non-GI disease. A thorough history helps characterize the problem as acute, chronic, intermittent, recurrent, and/or progressive. The veterinary team’s initial goal is to distinguish between a mild, self-limiting GI problem and a more serious disorder. If the condition is determined to be serious, the patient may require a more complete diagnostic workup and possibly hospitalization for advanced treatment.

Related Article: Top 5 Indications for Fluid Therapy

There are many causes of acute vomiting and diarrhea (see Table 1), and more than one may be present. Primary GI disorders may be distinguished from metabolic or systemic diseases that can affect more than one system.

Table 1. Common Causes of GI Signs

GI

Systemic

  • Dietary indiscretion
  • Drug reaction
  • Food allergy
  • Infection
  • Inflammation
  • Motility disorder
  • Neopasia
  • Obstruction
  • Parasites
  • Toxicosis
  • Ulceration
  • Cardiorespiratory disorder
  • Electrolyte imbalance
  • Endocrinopathy
  • Liver or biliary disorder
  • Neoplasia
  • Neurologic disorder
  • Pancreatitis
  • Peritonitis
  • Septicemia, endotoxemia
  • Urologic disease, uremia

Initial Assessment

The team should first record a clinical history that includes: signalment; vaccinations (especially for puppies and kittens); travel history; environmental, foreign body, or toxin exposure; weight history; current and previous medical conditions and medications; and a thorough dietary history (eg, recent diet changes, appetite, meals, treats, supplements, human food, water intake [see Dietary History]).

The client should be asked to describe the frequency, volume, and characteristics of the vomitus or feces; many online resources are available to assist clients with identifying these characteristics (eg, Waltham Faeces Scoring System). Vomiting should be distinguished from regurgitation, coughing, retching, or gagging. Diarrhea is defined as an increase in the fluid content of feces, often with increased volume and frequency of defecation.

Physical Examination

Thoroughly examine all patients that present for vomiting and/or diarrhea. Lethargy, fever, or hypothermia often indicates a more serious disease. Evidence of dehydration, icterus, or pallor may be detected with an oral/pharyngeal examination and skin turgor assessment. Abdominal palpation may reveal pain, distension, effusion, thickened intestinal loops, organomegaly, or masses. Perform a rectal examination to detect any masses, strictures, blood, foreign material, or anal sac disorders and to collect a fresh fecal sample.

Dietary History

Use these forms to guide the gathering of a full dietary history:

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