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Regurgitation in Cats

By: Dr. Bari Spielman

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Regurgitation is the backward flow or effortless evacuation of fluid, mucus, or undigested food from the esophagus. Unlike vomiting, it is not accompanied by nausea and does not involve forceful abdominal contractions. It is a symptom of esophageal disease and not a disorder in itself.

The timing of regurgitation in relation to eating is determined by the location of esophageal dysfunction, degree of obstruction, and presence or absence of esophageal dilatation.

  • Regurgitation immediately after eating is most likely to occur with proximal esophageal lesions or esophageal obstruction.

  • Regurgitation may be unassociated with eating when the esophagus is dilated, because this provies a reservoir for food and fluid.

  • Selective retention of fluids over solid food is more likely with partial obstruction.

    Causes of regurgitation fall into two categories:

  • Esophageal structural disorders – which include foreign bodies, stricture and vascular ring anomaly

  • Esophageal motility disorders – which include megaesophagus

    What to Watch For

  • Weight loss
  • Coughing
  • Difficulty breathing
  • Lethargy

    Veterinary Care

    Care should start with a discussion with your veterinarian who will obtain a medical history about your pet. The initial differentiation between vomiting and regurgitation is important because, not only are different organs involved, but also different diagnostic techniques and therapeutics are warranted. Diagnostic tests and treatment should follow.

    Diagnosis

    Diagnostic tests are usually needed to determine the cause of regurgitation. A thorough medical history is of paramount importance, confirming that your pet is regurgitating and not vomiting. A thorough physical examination is always necessary as well. Diagnostic tests may include:

  • Complete blood count (CBC)
  • Biochemical profile
  • Urinalysis
  • Endocrine testing (ACTH stimulation, thyroid profile)
  • Thoracic (chest) radiographs (X-rays)
  • Acetylcholine receptor antibody test, antinuclear antibody testing
  • Electromyography and muscle biopsy
  • Esophagram (barium swallow)
  • Fluoroscopy
  • Esophagoscopy
  • Blood lead and/or organophosphate levels

    Treatment

    Treatment of the regurgitating patient can either be supportive or specific, where the latter can be instituted when a known underlying cause is identified. Supportive therapy may consist of the following:

  • Dietary modification

  • Gastrointestinal motility (movement) enhancing drugs

  • Acid blocking agents and esophageal/gastric coating agents in cases of suspect or associated esophagitis

  • Hospitalizing and restoring fluid and electrolyte balance and nutritional support in the severely ill patient

  • Antibiotic therapy in cases of pneumonia

    Home Care

    Home care recommendations depend on the underlying cause of the problem. The following general recommendations should be considered:

  • Administer all prescribed medications and practice the directed feeding instructions.

  • Watch very closely for signs that might suggest secondary pneumonia, which include labored breathing, coughing and/or general lethargy and a poor appetite.

  • Pay close attention to the body condition of your pet. Maintaining an appropriate nutritional plan can sometimes be difficult in these animals.

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