Gastroenteritis in Dogs
Diagnosis In-depth Obtaining a complete medical history, and performing a thorough physical examination are necessary to create an appropriate diagnostic plan for the patient who present with acute vomiting and diarrhea. A complete blood count (CBC) will evaluate for the presence of infection, inflammation and anemia, associated with some diseases that cause acute vomiting and diarrhea. A biochemical profile evaluates very important parameters of the patient including the kidneys, liver, electrolytes, total protein and blood sugar status. A urinalysis helps evaluate the kidneys and hydration status of the patient. Abdominal radiographs (X-rays) evaluate the abdominal organs, presence of fluid, and the presence of a foreign body or tumor. Multiple fecal examinations are important to rule out gastrointestinal parasites.
Your veterinarian may recommend additional diagnostics to ensure optimal medical care. These tests are selected on a Case-by-case basis. An ACTH stimulation test may be recommended to rule out hypoadrenocorticism (addison’s disease), which is an insufficiency of the adrenal glands. It is a safe timed blood test that can be performed at your regular veterinarian. Bile acids should be considered in those patients where assessing liver function is in order. It is a safe timed blood test that can be performed by your regular veterinarian. An upper gastrointestinal (GI) barium (dye) series should be considered in those cases where the baseline diagnostics are not confirming a diagnosis, and the vomiting and diarrhea is persisting. It may be of benefit in those cases where foreign bodies or tumors are not apparent on radiographs, or to confirm a diagnosis if GI ulceration. A safe dye is given to the patient by mouth, and is then watched as it travels through the GI tract. It is a non-invasive test that can often be performed by your local veterinarian, however in some cases may need to be transferred to a specialty facility. An abdominal ultrasound evaluates the abdominal organs and helps assess for the presence of tumors or masses. Abdominal organs, lymph nodes and masses can be biopsied with the guidance of ultrasound through the abdominal wall. The procedure is relatively safe, however may necessitated a mild sedative. It is often recommended that a specialist perform the procedure. Gastroduodenoscopy (upper GI endoscopy) may be of benefit in these patients. It may facilitate the removal of foreign bodies, help evaluate for ulcer disease, and sample tissue for the presence of inflammation or cancer. Hospitalization is brief, and healing is generally quick and uncomplicated. The procedure does necessitate general anesthesia, and therefore is associated with minor risks. It is often necessary to refer the patient to a specialist. Endoscopy is performed when other diagnostics are inconclusive, inflammatory bowel disease or gastrointestinal lymphosarcoma is suspected, or a foreign body is located in an accessible area and needs to be retrieved. Lastly, an exploratory laparotomy should be performed as a diagnostic tool in any individual who has had extensive diagnostics without a confirmed underlying cause, or in the patient with a poor response to therapy who continues to vomit and have diarrhea.
Your veterinarian may recommend one or more of the diagnostic tests described above. In the meantime, treatment of the symptoms might be needed, especially if the problem is severe. The following nonspecific (symptomatic) treatments may be applicable to some, but not all pets with acute vomiting and diarrhea.
These treatments may reduce severity of symptoms or provide relief for your pet. However, nonspecific therapy is not a substitute for definite treatment of the underlying disease responsible for your pet’s condition. Withholding food and water for several hours allows the GI tract to “rest”, and is the single most important means of symptomatic therapy in the patient with acute vomiting and diarrhea. Complete dietary restriction allows the lining of the GI tract to heal. Gradual reintroduction of small amounts of bland food should be instituted after the fast, and the original diet may be slowly reintroduced after 2-3 days if there has been no vomiting. If at any point vomiting recurs, discontinue everything given by mouth and contact your veterinarian. Oral medication of any kind should be avoided if at all possible. Even a tiny pill can perpetuate vomiting by contacting an already inflamed stomach lining. Fluid and electrolyte therapy may be necessary in some patients with acute vomiting and diarrhea, and is directed toward correcting dehydration, acid-base and electrolyte abnormalities. Occasionally, subcutaneous (under the skin) administration may be acceptable, and is able to be performed by the pet owner at home. In severe cases, intravenous administration may be necessary, and necessitates hospitalization. Antiemetics and antidiarrheal agents (drugs that stop vomiting and diarrhea) should be used with caution. It is best to identify and treat the underlying cause of vomiting and diarrhea, however in selected cases may be recommended. Antacids (drugs that decrease acid production) such as Tagamet® (cimetidine), Pepcid® (famotidine) or Zantac® (ranitidine), may be of benefit in many cases. Gastrointestinal protectants and adsorbents (medications that protect or sooth) are felt to coat an “irritated” intestinal lining and bind “noxious” (harmful) agents.