Vomiting and Diarrhea

One of the most common ailments we see on an emergency basis is vomiting and/or diarrhea.  There are many different causes, and unfortunately the clinical signs alone are not enough to give a definitive diagnosis in most cases.  Common causes include obstructions (ingestion of a toy, abnormal food material), intestinal parasites, organ dysfunction (gastritis, pancreatitis, enteritis), metabolic abnormalities, hormonal conditions (hypoadrenocorticism, diabetes), toxin ingestion, insect bites, or even simple ingestion of inappropriate foods. 

Because there are so many different causes, diagnosis is based on multiple factors.  First and foremost, an accurate and detailed history is needed.  Did you see your puppy swallow a toy?  Did you give your dog a cheeseburger? Did you see your cat play with a string and it is no longer there?  Diagnostics may be needed such as imaging studies (radiographs to evaluate the inside of the stomach/intestines) or an abdominal ultrasound to evaluate the organs themselves.  We may require bloodwork and urine testing to evaluate for organ function, evaluation of electrolytes, testing for pancreatitis, or even hormonal testing.

The urgency of evaluation by your veterinarian varies on multiple factors.  Patients that just swallowed a toy may still act absolutely normal.  However, those cats and dogs should be evaluated as soon as possible to determine if removal of the foreign body by endoscopy or surgery is even required.  However, patients suffering from organ dysfunction may look sicker and should be evaluated by a veterinarian as soon as possible to diagnose the cause. 

Once your pet has been evaluated, the veterinarian may recommend a bland diet.  For dogs, bland foods can consist of one part non-fat cottage cheese, one part cooked white rice, and several strips of boiled chicken (no bones and no skin) for several days.  This is not a balanced diet and should not be used for an extended amount of time.  For cats the issue of starvation syndrome (hepatic lipidosis) becomes more of an issue.   Foods to entice cats to eat include cooked canned tuna, cooked canned chicken, or even chicken flavored human baby food.  If your cat has not eaten in 24 hours, it should be seen by a veterinarian immediately. 

In general Pepto Bismol, milk of magnesia, or remedies that people use are not recommended for dogs or cats.  They can sometimes make dogs and cats sicker or make it harder to diagnose them.