Vomiting: (Upset stomach, Nauseous, Barfing, puking, throwing up retching, erping, yacking)
What we will do
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- Gather Historical Data: When did the vomiting begin? Is the client finding vomit or witnessing the patient in the act of vomiting? If the act of vomiting was witnessed, we will ensure that the patient was not actually regurgitating, which can have a similar appearance but requires different treatment. Sometimes patients actually have an upper respiratory tract infection and cough repeatedly until bringing up white foam, or even vomit. IS the vomiting accompanied by diarrhea? Is the patient otherwise alert with normal energy, or did lethargy develop? Is the patient distressed, uncomfortable, unable to lay down? Is the patient still willing to eat, or does looking at food make them nauseous? Is there anything the patient ate that could trigger the vomiting?
- Gather Current Data: We perform a thorough physical examination which can at times immediately alert us to a very serious condition, such as gastric dilatation volvulus (GDV or Bloat). Baseline bloodwork and sometimes a pancreatitis test are necessary so we have something to compare to as symptoms change. Often, the baseline bloodwork is abnormal. Some blood values (such as electrolytes and liver enzymes) can change in hours and at times need to be closely monitored. Bloodwork is run on site and can uncover illnesses that are causing nausea, such as pancreatitis, diabetes, Addison’s Disease, and kidney or liver disease. Radiographs (X-rays) Are also necessary with the vomiting patient because the cause of the vomiting could be a mechanical obstruction (usually from eating an object that is not digestible) or the large dog patient could have gastric dilatation volvulus. At times, the radiographs reveal aspiration pneumonia, meaning the patient aspirated some of the vomit into the lungs, or megaesophagus.
Occasionally, an abdominal ultrasound is required for more complex cases.
- Treatment: Vomiting can be very serious because continued vomiting prevents patients from being able to receive any nourishment at home (they will vomit it back up). Depending on what we find from the history and test results, patients receive treatment that ranges from as minimal as outpatient care to full inpatient hospitalization with surgery. Nonsurgical causes of vomiting can also be very serious and require hospitalization. Patients that are hospitalized for vomiting receive intravenous fluids, electrolytes and medication for nausea (if not contraindicated). Depending on the causes of the vomiting and degree of sickness or discomfort, some patients receive pain medication.